Books of 2015, #21: Being Mortal: Medicine and What Matters in the End, Atul Gawande

This was actually been book #20. Or maybe book #19. I let myself get behind on writing these entries, and thus they have ended up out of order.

I remember reading, several years ago, the New Yorker article on Geriatric Medicine that serves as the basis for an early chapter in this book. I remember it in part because it started to transform my yoga practice.

I have now spent many years learning to do ridiculous circus tricks—and don’t get me wrong, I still adore them; when I had hernia surgery a couple of years ago, and a bunch of them were no longer accessible, I started marking time until the day that I was able to do them again. It took a couple of years, but I’m once again able to do all the same silly stuff as before.

After reading that article, though—and while still working on my stunt yoga—I started thinking more about how I could use the practice to help me cultivate strength, mobility and balance thirty years from now. I’m a lot more aware of when I’m starting to push beyond where my body is realistically capable of going—it’s not to say that I stop, but that I try to approach such things more slowly, because even at this point in my life, injuries will take longer to heal, and chronic conditions can start to take hold more easily.

Because what that article convinced me of, and this book reinforced, is that a large part of my quality of life later in life is going to be grounded in my physical capacity; the longer I can be independent and mobile, the longer I feel like I’m able to actually participate in my life, the happier I will be.

So take the time to keep yourself healthy. Work on your posture and your physical mobility. Start creating habits now, because it’s only going to get harder.

The other thing that he emphasizes is cultivating a awareness of what things make life worth living for you.

Certainly nothing is perfectly predictable, but odds are that at some point, you will face a choice: do something that may extend your life for some period of time—maybe months or even years—but that will turn your life upside down: it may severely curtail your ability to do certain things, or it may demand certain up-front sacrifices or what have you.

If you’re lucky, whatever you’re being asked to sacrifice won’t be terribly important to you, and you can easily choose. But more likely, your choice will be harder, and you will have to weigh your options carefully. And the medical professionals you’ll be working with are as human as anyone: they don’t want to tell you bad news. They suck just as badly at taking a hard look at the numbers and saying that, really, your chances are crap.

Your only truly useful guide is what matters to you. If your idea of a good day is to sit in the sun in the window and while away the time reading books and listening to music, then maybe a procedure that radically curtails your mobility is a reasonable thing (as long as you have a place to live that will actually support you in doing these things).

If, on the other hand, you’re a supremely active person, and you’re faced with a treatment that might eke out six more months of life, at the cost of spending that time sick to the point of immobility, maybe you should skip it. Do what you makes you feel whole and damned if you might not actually live longer, too.

Hell, you could do worse whether you’re facing down old age or illness or you’re young and healthy.

Anyway, I can’t recommend this book enough. Mortality is an uncomfortable subject for most of us, but it’s one we’re gonna have to face sooner or later. Start preparing in little ways now, and it can all be easier later.

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Michael Alan Dorman

Yogi, brigand, programmer, thief, musician, Republican, cook. I leave it to you figure out which ones are accurate.