Before a capacity audience in Stern Auditorium that included faculty, staff, students, and the public, Atul Gawande, MD, MPH, noted surgeon, writer, and public health researcher, recently presented a professional overview—yet highly personalized account—of modern medicine’s impact on how we age, and die, in the twenty-first century. His speech, titled “Being Mortal,” based on his book, Being Mortal: Medicine and What Matters in the End, was delivered as the 2015 Annual Douglas West Memorial Lecture, an event sponsored by Mount Sinai’s Lilian and Benjamin Hertzberg Palliative Care Institute.
Dr. Gawande, Professor of Surgery at Harvard Medical School, and Health Policy and Management at Harvard School of Public Health, recounted how lessons learned as a medical student and accomplished surgeon collided with new experiences caring for aging family members.
“I learned about a lot of things in medical school, but mortality was not one of them,” he told listeners. “In medicine, we see our job as keeping you healthy.” Yet he viewed it as a flawed mission as patients and loved ones approached death. He observed that in the middle of the twentieth century, “Most of us died in our homes. By 1990, 83 percent of us died in institutions, mostly the hospital, and then the nursing home.” Added Dr. Gawande, “We’ve had a 50-year experiment in medicalizing mortality…making it all about your disease-, and what we can direct in the care towards it—not about well-being—and I think that that experiment failed.” To the audience that included many palliative care champions from Mount Sinai, he added: “It’s about what matters most to us…that we have as good a life as possible all the way to the very end.”
The full lecture is available at mountsinai.org/palliative.