Sunday, August 09, 2015

Being Mortal – Atul Gawande

How important are the choices we make in life? Depends on the impact it will make rather you expect / estimate it will make to you / your life. But what if I tell you “you need to make a choice for your patient and make them day in day out and complicate it by saying that the decision is about how many months / days will your patient live.” It’s not an easy job for a person with conscience, who believes in “helping others deal with what medicine cannot do as well as it can” (That’s his line).

Sitting in Bangalore and reading Being Mortal takes me and I am sure all readers to our harrowing experience of meeting a doctor. I detest it – the very thought of going to Manipal Hospital gives me the creeps. I know that I am not going to a doctor but someone waiting there to literally play with my emotions & collect cash. This is very unlike the doctors I grew up with – they were more friends rather extension of our family. If you see any Hindi movie made in 70 (I was seeing the original Khoobsoorat), the doctor will invariably come with a suitcase and will be called Doctor Uncle / Doctor chacha & he will visit your home & not the other way around. Things have changed – not sure for good or bad.

I found the book quite philosophically appealing, few notings:

Nice questions to ask,
As the patient in front of you is making a life choice (to live or not) & being a doctor you have given the facts for her to make a choice. To pay a role of an equal partner some questions which the doctor asks to help the patient make the right choice. “What were her biggest fears & concerns? What goals were most important to her? What trade-offs, and what ones was she willing to make & what ones was she not?
I thought these were very nicely put & you could ask these questions not before a live or die operation but also when you are making A big decision in life – Imagine asking these questions when you are looking for a change in job.

Time & how it shrinks
Whenever you battle a deadline, time shrinks, and if it’s the end of life that changes your outlook or revisit your values n beliefs. Just like the author’s father I saw my father (75) – an atheist and a rebel (who refused to stop smoking) quit smoking and be more amenable to temple visits & amenable to discussions around religion. I have seen that of myself as I ride the 40’s I am more health conscious & avoid holding grudges & conflicts with family members & give in more easily – I would rather sleep well than carry a grudge to bed.

Philosophy & Profession
Mostly people will not associate philosophy with profession but with overall life & it’s values. Meaning how will you apply what you learn in your life (outside office) to your job or vice versa. Many of us rarely reflect on the work which we are doing – or reasons behind the decision which we make in our job.
But what life teaches you is very different & more intrinsic as compared to what you learn reading business books or attending a seminar. Being Mortal – merges the professional & the personal as a single person and shows the dilemmas which we all face in job – being doctor is more difficult as compared to a business head because it’s more visible & stark but both of us are taking decisions which will effects the life of our people. The underlying philosophy of a doctor should be healing & not giving a solution or stating a fact and asking the patient to take a decision like an ATM. As a leader our job is to help the team member do the job given to her & not fix the KRA’s & expect her to do the same. The joy I felt of turning around an individual or making him proud of his work always gave me a much bigger high than the quarterly target. But then you have to be ready to defend your position & have a much larger sense of ownership – because you own the individual, his shortcomings & all his problems related to him. Unless you know that you can never help him grow.

Old Age
My most vivid picture of old age & its desperation is when I saw one of my relative who at the age of 80+ had to be bathed – dressed and taken to toilet. He was not allowed to eat sweets as he was diabetic and was on insulin. All bones with no teeth’s and barely able to move n talk, one day as he was talking his grand - daughter who was having sweets and was unaware of the fact gave the sweets to him. After half n hr when his daughter saw him eating she had to snatch it from his tightened fist, but he held on to it and cried to have few morsels of the sweets as his daughter kept telling it’s not good for him and can be fatal for him.

Relationship
The book deals with relationships of a different kind – when one member is in a very dependable state, when both of them are very old, when a daughter want’s to genuinely take care of her mother and puts her in a senior living home where she feels stifled and prefers being at home. Most of us are dealing with it – especially when we hit our 40’s & our parents hit 70 & of course our children are in their teens. Many of us deal with it objectively like a problem to be taken care of i.e. rationally – like the kind of facilities in a senior living place or moving your parent to your city where we are currently working so that you can take care of them.

It’s a difficult choice to make – parents are happy where they are (in their own city) even if they feel lonely at times they get to spend their evenings with their friends & they love the independence. These get accentuated when someone is unwell & completely dependent on other people and if you add to that the scarcity of a genuine doctor who really cares for your well being & not purse plus work & growing up children’s at home & of course our crazy schedule.

The book makes you think on the choices you make or are making.