books that can be described as a “life changing experience,” which is how Dr Rumi Ahmed Khan, a medical professor, talks about Atul Gawande’s Being Mortal. “I make all my trainees read this,” he says. But it’s not only medical students and practitioners for whom reading this book might present an epiphany. And while written for an American audience, the book is not only relevant to the wider world, that relevance is only likely to increase for the global south over time.

“I learned about a lot of things in medical school, but mortality wasn’t one of them.” That is how Dr Gawande — a former surgeon and Harvard professor of public health — opens this 2014 book. He ends the first paragraph with “…the purpose of medical schooling was to teach how to save lives, not how to tend to their demise.” The rest of the book is about the implications and consequences of this prevailing attitude in a world where more and more people are living into their old age.

The twilight years


The first few of the book’s eight chapters explores different models of senior living. Gawande writes lyrically about multigenerational households, based on the lives of his desi grand­parents, of the days when it was taken for granted that families looked after their elders. But he is also unsentimental about the realities of modern life that makes multigenerational families not a viable option in the West.

The economic realities of the 20th century West necessitated pensions, superannuation, welfare systems such as the American Social Security, but also retirement and nursing homes and aged care facilities. And Gawande shows that this is often a good thing for the elderly, who do not necessarily want to live with their children and follow their rules. Through anecdotes and stories of his family, friends and patients, backed up by his professional experience and expertise, and citations of research, he argues that like everyone else, the elderly too have a more fulfilled life when they feel they have a degree of autonomy.

The latter chapters try to show how the current medical and aged-care practises in the West fail the elderly when it comes to that vital sense of autonomy. “Our most cruel failure in how we treat

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