Below are quotes from the book:
- Honesty and kindness were basic responsibilities of a modern doctor.
- Scientific advances have turned the process of aging and dying into medical experiences, matters to be managed by health care professionals. And we in the medical world have proved alarmingly unprepared for it.
- The difference between standard medical care and hospice is not the difference between treating and doing nothing.... The difference was in the priorities. In ordinary medicine, the goal is to extend life. We'll sacrifice the quality of your existence now - by performing surgery, providing chemotherapy, putting you in intensive care - for the chance of gaining time later. Hospice deploys nurses, doctors, chaplains, and social workers to help people with a fatal illness have the fullest possible lives right now - much as nursing home reformers deploy staff to help people with severe disabilities. In terminal illness that means focusing on objectives like freedom from pain and discomfort, or maintaining mental awareness for as long as feasible, or getting out with family once in a while....
- Courage is strength in the face of knowledge of what is to be feared or hoped. Wisdom is prudent strength.
- At least two kinds of courage required in aging and sickness. The first is the courage to confront the reality of mortality - the courage to seek out the truth of what is to be feared and what is to be hoped. Such courage is difficult enough. We have many reasons to shrink from it. But even more daunting is the second kind of courage - the courage to act on the truth we find.
- When it is hard to know what will happen, it is hard to know what to do. But the challenge, ... is more fundamental than that. One has to decide whether one's fears or one's hopes are what should matter most.
- ... there are times when the courageous thing to do is not to persevere but to retreat or even flee.
- At root, the debate is about what mistakes we fear most - the mistake of prolonging suffering or the mistake of shortening valued life.
- For human beings, life is meaningful because it is a story. A story has a sense of a whole, and its arc is determined by the significant moments, the ones where something happens. Measurements of people's minute-by-minute levels of pleasure and pain miss this fundamental aspect of human existence. A seemingly happy life may be empty. A seemingly difficult life may be devoted to a great cause. We have purposes larger than ourselves. Unlike your experiencing self - which is absorbed in the moment - your remembering self is attempting to recognize not only the peaks of joy and valleys of misery but also how the story works out as a whole.... And in stories, endings matter.
- ... our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one's story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, our conversations in ways that transform the possibilities for the last chapters of everyone's life.
- Being Mortal is about the struggle to cope with the constraints of our biology, with the limits set by genes and cells and flesh and bone. Medical science has given us remarkable power to push against these limits, and the potential value of this power was a reason I became a doctor. But again and again, I have seen the damage we in medicine do when we fail to acknowledge that such power is finite and always will be.
We've been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way. Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: What is your understanding of the situation and its potential 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?
- If to be human is to be limited, then the role of caring professions and institutions - from surgeons to nursing homes - ought to be aiding people in their struggle with those limits. Sometimes we can offer a cure, sometimes only a salve, sometimes not even that. But whatever we can offer, our interventions, and the risks and sacrifices they entail, or justified only if they serve the larger aims of a person's life. When we forget that, the suffering we inflict can be barbaric. When we remember it the good can be breathtaking.
- I never expected that among the most meaningful experiences I'd have as a doctor - and, really, as a human being - would come from helping others deal with what medicine cannot do as well as what it can.
