Two more book reviews from my reading list for this year.
On several occasions while reading Being Mortal, surgeon Atul Gawande’s book about end-of-life care, I could feel a lump swelling in my throat and tears behind my eyes pressing for release. I’m not an emotional type but this is an intense book.
The intensity is surprising since Gawande’s lucid style is very matter of fact. The sting comes entirely from the fact that his subject, mortality and death, affects us all. You feel it closing in as Gawande lists the ailments we are likely to encounter as we grow old and our bodies fail and turn against us. More distressing still are the stories of people who, faced with life-threatening conditions, were badly advised and found themselves separated from the world, abandoned to a slow, unpleasant demise punctured by tubes in a hospital bed or locked within the rigid regime of a care home that did not care.
Gawande’s charge is that amidst modern medicine’s obsession with ‘fixing’ people – to keep them from death – doctors have forgotten the importance of enabling people to live a life that is more than just breathing. It is a charge that sticks but this is not a tale of hopelessness because the heart of the book is filled with stories people who do care. People like Keren Wilson, who developed the concept of assisted living in Oregon in the 1980s to give more autonomy to the elderly; or Bill Thomas who took charge of a nursing home in upstate New York and turned it upside-down by focusing on its inhabitants, not its staff; or Jacqui Carson who stuck by the elderly residents the nursing home that she directs in Boston, an apartment building that enables independent living, as their capacities declined and their dependencies grew.
The lessons Gawande learned from these innovators – and other health professionals experienced in helping people to face life before death – are about giving people a clear view of a future that has suddenly shrunk and helping them to choose how to make the best of their remaining days, however limited the options. These lessons may seem obvious but they are not easily assimilated, as Gawande reveals through his own faltering efforts to care for his father, a man he had only ever known to be vigorous, when he is eroded by cancer and infirmity in his seventies.
Being Mortal may not be an easy read but it is a salutary early warning of the bell that tolls for all of us.
Matt Ridley’s Francis Crick: Discoverer of the Genetic Code is a concise biography of the great molecular biologist. At only 210 pages it lacks the heft of Robert Olby’s earlier biography — there is not even room for an index — though Ridley is the more entertaining writer. The book also lacks detailed annotations of the author’s sources, which is a shame since he has dug up several interesting nuggets that I hadn’t come across before. I was unaware, for example, that an early plan for James Watson’s best-selling book on the discovery of the structure of DNA, The Double Helix, had been to publish it as a two-part story in the New Yorker under the fantastically revealing title, “Annals of a Crime”.
Those quibbles aside, this is worthwhile biography of one of the greats of 20th Century science. It’s a speedy read but not a superficial hagiography. Crick’s life – his successes and failures, his talents and foibles – are covered well and Ridley largely has the measure of the important scientific issues that defined and were defined by the man. If you think Crick’s only achievement was solving the structure of DNA, or are wondering why the UK is about to open a new biomedical research institute named in his honour, I suggest you start here.