On the cover of Atul Gawande’s new book called Being Mortal there is a single piece of grass. If you rub your fingers over it, you can feel that it is embossed, raised off the paper. Even though the picture of the blade appears raised because you can see its shadow, it actually has dimension if you touch it. Although there is nothing overtly religious about this book, it is one of the most theological books I have read in a long time, beginning with the subtle reference to Isaiah 40:6-7 on the cover.  The grass withers, the flower fades, when the breath of the Lord blows upon it. Surely the people are grass. This was a brilliant design metaphor. Kudos to whomever came up with it. Even though we are all grass, each of us can have dimension and dignity until we die.

Gawande is both a brilliant author (and staff writer for The New Yorker magazine) and a practicing doctor, living in Boston. He has dared to challenge the gifts of his own industry by contending with death in a way that most patients and many doctors are unwilling to do. Through a look at how we have dealt with aging and end-of-life culturally as well as medically through the last century, he squarely accepts that while medicine can likely keep us alive longer, all of us will die and most of us will experience some debilitating diminishment that will include physical, mental, and emotional suffering. He bravely exposes his own shortcomings early in his career where he felt he failed his patients by being merely Dr. Informative (his phrase): the medical expert who presents a panoply of treatment options and then lets the patient make the decision for themselves. By the end of the book he is much more concerned about the quality of life one has while they still have it to live, rather than prolonging it at all costs. He advocates having difficult conversations as crisis escalates.  

“Whenever serious sickness or injury strikes and your body or your mind breaks down, the vital questions are the same: What is your understanding of the situation and the possible outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?” (pg. 259) He describes eloquently how these questions actually helped to prolong the life of his patients and very movingly his own father. I pray that when my time comes, I will have people around who love me enough that they will tell me the truth. I pray also that someone will sit down with me and help me think through these questions.