Facing Death, With "Being Mortal"'s Dr.-Author's Help - Atul Gawande

Philadelphia Inquirer, Sunday, May 22, 2016, CURRENTS section, Page C4, Opinion/Commentary:

Facing our last chapter, with doctor-author’s help

Sally Friedman is a writer in Moorestown

File Photograph

At arecent reunion with my “besties” from childhood — two sets of sisters — we covered a lot of ground: reflections on who we are now, who we were way back when, our parents, our worst and best romances.

And then we addressed the elephant in the room: death.

Only with our closest and most trusted friends does this come up. One doesn’t ask a casual colleague, “So what do you think you’ll die of?” Or “What’s in your advance directive?”

But with four women who grew up cheek to jowl in Philadelphia rowhouses, and who have shared every life passage, even death is invited into the conversation.

After all, we know one another better than almost anyone else.

So on a spring afternoon, we shared our visions of dying, now that the youngest of us is in her early 70s, and the oldest was celebrating her 80th birthday on that very day. And an 80th birthday tends to inspire awe, disbelief, and, yes, inevitably thoughts of endings.

So I assumed, a week later, that I was definitely ready to face an evening based on Being Mortal, the wonderful, must-read book about how medicine and mortality inevitably connect — and sometimes collide.

The doctor-author, Atul Gawande, has been hailed for encouraging us to face the inevitable with what critics and readers have lauded as riveting honesty.

I convinced my husband that we had to go to this viewing of a documentary inspired by Gawande’s book and produced by Frontline. He was not delighted. And, frankly, neither was I.

But we both recognized that this was a higher priority than flopping down in the den to watch the political shenanigans that are our daily fodder on CNN.

It wasn’t easy to walk into a Cherry Hill synagogue where Samaritan, a pioneering hospice in Burlington County, had arranged for several of these community gatherings. Definitely missing was the usual social buzz, even before the lights dimmed and the screen came on.

Then the silence grew dense.

We were watching several families on that screen as they traveled through the process of watching a loved one die. Yes, die. No euphemisms like passing away in this film.

For a while, I didn’t even look at my husband. Nor did he turn to me. We sailed separately on this voyage into the pain of loss as we watched husbands and wives move through the most painful of passages of all: saying those unimaginable goodbyes to one another.

One unexpected insight was what doctors themselves were going through as they faced what for some is the ultimate medical defeat: not only losing a patient, but also being unable to find a way to tell that patient the unvarnished truth.

One challenge for some of these doctors is finding how to take away false hope, yet preserve — well, what? That was the question. When hope is gone, what is left?

When we watched a 34-year-old mother on that screen who had managed to live through a pregnancy while an aggressive cancer was destroying her lungs, who had held her baby in her arms, and knew all the while that she would not live to see that baby walk or talk, what is there to say?

That’s the vignette that finally got me to reach for my husband’s hand — and not let go.

Certainly not when a grandmother had dreamed in her hospital bed of taking her grandchild to Disneyland.

And then to have that dream snatched away by the miserable result of one of those scans that “reads” our bodies and sees that plan — and so many others — obliterated. Yes, unbearable.

There was so much pain in the Being Mortal screening. And so much wisdom.

Death is our universal life experience. And this young surgeon, this remarkable Atul Gawande, wanted us to accept that. He wanted to have doctors find wise and compassionate ways to guide us to our own answers. He wanted us to think about how we wanted that last experience to be.

After the screening, there was initially just silence. The kind one seldom experiences in a crowded room.

And once we had caught our communal breath, there was a conversation with a panel of social workers, physicians, and even those who train medical students in one of the most essential courses: not anatomy, not physiology or pathology, but how to help a patient die.

For the healers — and for us — it’s the ultimate lesson of being mortal. pinegander@aol.com

Samaritan has scheduled another showing of
“Being Mortal” at 2:30 p.m. on Thursday, June
16. It is free and open to the public. For more information, visit www.samaritannj.org.