Book Reviews
That Good Night: Life and Medicine in the Eleventh Hour
By Sunita Puri
Pub: Viking (Penguin Random House), 2019
Are you interested in understanding what palliative care is? Read this book.
Do the rigors and demands of medical training fascinate you? Read this book.
Ever wonder what it would be like to be the daughter of a high power anesthesiologist mom? That is here too (hint: not so hot).
Have you spent time considering the spiritual implications of mortality? This book offers ample material for bemused reflection.
Sunita Puri has written a multilayered, complex, insightful book addressing life and death in the confusing, fluorescent lit world of high-tech medicine.
Closely following the Buddha’s teaching of “awaken yourself and others to the reality of suffering in the world”, this book offers story after story of desperately sick people and their families struggling as they face the abyss. Dr. Puri works to awaken herself and her fellow doctors to the seldom mentioned issues of suffering and the preservation of dignity in health care. The reader knows this is going to be a roller coaster ride when the author’s doctor mother tries to convince her to not enter palliative care training because of the certainty that all patients in her care will die. Their deaths will not be pretty and many will “rage against the dying of the light” — making things that much harder.
If this sounds like a dreary book it is not. I found it uplifting and deeply authentic. There are insights into what it is like to be married to the job — we meet the wife. Dr. Puri guides us through the religious teachings bestowed by her parents and how they almost work for her. This is provocative material and I ruminated on it for days.
Do physicians bully each other when they are stuck in their own denial? Yes they do. Can a young physician rise above anger from other doctors and patient’s families in pursuit of better care of a patient? Here we learn how.
Dr. Puri comes off as a striver perfectionist who is simultaneously flawed and lovable. I couldn’t put this book down.
— Dr. David Pratt
Finish Strong: Putting Your Priorities First at Life’s End
By Barbara Coombs Lee
Pub: Compassion & Choices, 2019
When it comes to consideration of our mortality Americans are a hot mess. We are fearful and frightened. We persist in stubborn denial of the only reality in our existence that is certain — our deaths.
Such considerations are so abhorrent we procrastinate, postpone, and pretend that the discussions are too early and have no downstream consequences. Folly follows folly.
And the medical profession provides little meaningful help. Even as “… scientific advances have turned aging and dying into medical experiences managed by health professionals they find themselves alarmingly unprepared” according to Atul Gawande, surgeon and health writer.
We all need to work through these issues or alternatively offer ourselves up to the health care system in perilous naiveté.
So who you gonna call? I suggest Barbara Coombs Lee with her helpful guide entitled Finish Strong. Barbara is a clinician, lawyer and activist in matters dealing with the end of life. Her book reminds me very much of Our Bodies Ourselves published in 1969 to educate women about their bodies and sexuality. Our Body Ourselves was ground breaking and helpful to thousands of women, young and older. Barbara’s book has the very same potential.
Ms. Lee offers a series of “playbooks” to facilitate our considerations through the tough choices we all must face. Each chapter has summary boxes to help the reader retain salient points.
Though some may have begun to consider the fundamental elements needed to assure a good death (living will, health care proxy, durable power of attorney, having that very important talk with loved ones about what you want when the end approaches), fewer readers will have thought about real self-determination in the face of failing health. Seldom has a book provided this level of candor and guidance for ending one’s life when suffering or the loss of dignity become unbearable.
Brace yourself. Barbara pulls no punches. Chapter 8 will help you understand how you might escape dementia — one of American’s greatest fears. While Chapter 10 provides a blue print for how we all might take control of our final days and assure a good death. The author is a long-time advocate for having the medical profession be able to prescribe a lethal dose of powerful medication so dying individuals can end their lives at the time they wish, in the setting they choose. The poignant patient vignettes make her case.
In many ways this is a gutsy, heroic book written by a professional who has seen it all. Every American should own this book, read it and underline it. There is a 100% chance it will come in handy.
— Dr. David Pratt
Having the Last Say: Capturing Your Legacy in One Small Story
By Alan Gelb
Pub: Jeremy P. Tarcher (Penguin Random House), 2015
Alan Gelb is a writer and writing coach whose book Conquering the College Admissions Essay in Ten Steps met with considerable success in helping high school students compose successful essays. Inspired by the Jewish concept of the “ethical will” and by research on the relationship between emotional health and knowledge of family history, but also by his own dissatisfaction with the praise-filled eulogies common at funerals, he adapted his coaching strategies for older would-be writers. Having the Last Say: Capturing Your Legacy in One Small Story invites its readers to create a 500-1000 word story based on a single memory or event. The multi-step process of composition is intended to help people gain greater clarity about their life experiences while “allowing a little piece of us to live on” when their work is read aloud at a funeral.
Gelb employs the direct address and reassuring voice typical of self-help or how-to books, with a list a writing prompts, a four-part formula for successful story-telling, and examples of first, second, and third drafts of “last says” written by members of the writing group he assembled to test his idea. His book resembles other writing handbooks with its advice about sentence structure, de-cluttering prose, attention to tone, avoiding excessive adjectives, adverbs, and replacing clichés and use of the thesaurus with good, clean prose. There are occasional literary and popular cultural references throughout the book, but if you don’t recognize a name (Italo Calvino, for example) it doesn’t matter. Each chapter follows a pattern: advice about an aspect of the writing process followed by a “last say” chosen to illustrate the topic along with some biographical context about its author.
At their best, these “last says” use a defining experience to make a point. Gelb calls them “our last chance to make meaning of life,” a large claim for a short autobiographical essay. He acknowledges that the “last say” is not intended to be “a testament to your life” or a “valedictory.” The real value of this exercise, in my opinion, is the therapeutic experience of structured self-reflection, whether or not it results in a publically performed third draft.
— Martha Rozett