Medicine & Meaning

I learned a lot about a lot of things in medical school. Mortality was not one of them.

This is a powerful line that surgeon, doctor, and public health researcher Atul Gawande uses to open his book Being Mortal, as well as to open many of the speeches and talks he has given around the country and around the world since he began exploring the social, personal, and emotional costs of how "medicine has taken over mortality." 

Here, a few excerpts from his interview with Jeffrey Brown of PBS NewsHour shortly after the book was published.

• "Medicine has taken over mortality in some sense. We are responsible for trying to fix the problems of aging and dying—but we don’t know how to do it... And as we face problems that we can't fix, like aging, or terminal illness, we often sacrifice the very reasons that people want to be alive." 

• "In medicine, we prioritize health, safety, and survival, and we think that must be what people place first. Some people will say that it’s really important that my brain work, that I am who I am. Other people will say, look, I just want to know that i’m not suffering and that I’m not in pain. Others will say 'I have a life project that’s really important to me.' And the most reliable way to know patients' priorities is to ask about them. And we don't. Doctors don't. Family members don't."

• "What people actually want [from their doctor] is a counselor, and an effective counselor is someone who can talk to you about 'What do these numbers mean?" and "What are you actually worried about for me, doctor?' And then let me tell you my priorities, and help me choose which option will meet them."

• "We have anxiety about asking these questions, because we haven’t had the words. And I think we know now, increasingly more, what people who are really good at these conversations do. They are skilled. They ask, 'Well, what's your understanding of your condition? And what are the tradeoffs you are willing and not willing to make?' And you have to keep repeatedly asking these questions because people's priorities change over time." 


uses parody to catalyze transformation