Debra Ruder Communications

Writing that matters

“Letting Go” piece is worth reading

Dr. Atul Gawande is one of the most skilled and respected medical writers around, so when I heard that he’d tackled the topic of end-of-life care, I knew this was a good thing. And it is, not only for his readers and listeners (he’s got a long New Yorker article and was interviewed on NPR last week), but for his patients. As you may know, Gawande is a surgeon at Brigham and Women’s Hospital in Boston, and he says that researching this article gave him a better vocabulary to talk with his patients facing incurable illnesses.

Gawande shares several stories about gravely ill patients to show how hard it is for many doctors and family members to talk about dying with a patient or loved one — even when the odds of treatment working are extremely slim. He argues that our technology-driven health-care system isn’t designed to help people make the switch from “fighting for time” to fighting for the other important things, like spending time with family, being as alert as possible, feeling human touch, and avoiding suffering.

Dr. Susan Block, a psychiatrist and expert on end-of-life care whom I’ve long admired, keeps in her head a set of questions for her patients facing shortened lives. She asks them what they understand about their prognosis (chance of recovery), what they’re worried about, and how they want to spend the time they have left. Atul Gawande does a beautiful job, in his “Letting Go” piece, explaining why these questions are so important to people who want the opportunity to say goodbye.

You can hear his interview on “Fresh Air” here, and you can read his insightful New Yorker article here.

2015 update: The “Letting Go” essay is folded into Atul Gawande’s latest best-selling book, Being Mortal: Medicine and What Matters in the End.