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Posts Tagged ‘Atul Gawande

Have That [fearful, painful, embarrassing] Conversation

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It’s how humans move forward

We find all sorts of ways to not say something important.

I do this all the time: there are things I need to say to several people in my life—but I hold back, fearful of how my words might be received, questioning where the conversation will lead. Am I able to follow where this potential conversation might go? Do I even have the emotional capacity to stick with that conversation? Will I fall into weeping or fly into a rage?

I’m not talking about drive-by conversations that release a damning monologue and then run away. I’m talking about those sustained conversations with people we are close to, conversations begun with a desire to say and hear. True dialogue about something important—where our thoughts are modified by someone else’s—and something new arises.


Atul Gawande’s book Being Mortal: Medicine and What Matters in the End (Metropolitan Books, 2014) has reminded me of the need to get very specific when talking about end of life stuff—though the entire topic is crazy difficult. One simply does not know how much time anyone has left.

But it is not just death and life stuff that wants a conversation. There is life-direction stuff, talk about fears and hopes and dreams. Talk about how we understand something: what we think of faith now compared to what we thought 30 years ago.

Does that sound like a heavy conversation? It sure could be. But, in fact, we release bits and pieces of this stuff all the time. In conversation with those close to us we always find ourselves talking about these things. But sometimes those conversations need to be ramped up.

A couple years ago I wrote that it is better to have the conversation than not. More and more I think that is true. When we bring up a topic with a friend or family member or colleague, great things can happen. We can find new resolve, or new intimacy. Sometimes the talk conjures raw emotion. But on the other side is a movement forward.

What do you need to say today—and to whom?


Image credit: Kirk Livingston

Written by kirkistan

July 14, 2015 at 9:13 am

Best Case: Stable Health + Quick Decline + Death

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Reading Atul Gawande’s “Being Mortal”


Another happy illustration from Atul Gawande’s “Being Mortal.”

Mr. Gawande is a surgeon and medical professor and writer for The New Yorker. His recent Being Mortal is a long conversation about how humans face death. Or, more to the point, how medicine and our own optimism interact to keep us from planning for this known, finite end.

This is not something you think about at 18 or 28. But it is a wedge topic that soon starts to butt into life. At some point you notice aging people appearing all around you. And then you do the math and start to think you may be aging as well—though we’re all hard pressed to say where the time has gone. Like a favorite, recently-passed in-law said not so long ago, “In my mind, I’m still 18.” No one agrees to aging and few self-select as “old.”

Still, there is this inevitable endpoint.

Mr. Gawande’s book does the reader a favor by naming the moving parts of this process. That is, the slower and slower moving parts. From the shrinkage of the brain to why it is that older people seem to choke more to the insult of not driving to the big fear of dementia. One of my favorite characters in the book is the groundbreaking geriatric physician/researcher who was active until he, well, became old. And then, in a clear-eyed fashion, detailed his decline, his motivations with caring for his wife of 70 years who became blind then deaf, and then broke her ankles. It’s a happy/sad love story of a couple who were active into their 90s.

VerySad-2-06302015As a believer in the God who resurrects, I do not think of death as final. But as aging continues (which I don’t feel but suppose is acting on me even now), my reading of the gospels and prophets and psalms finds me looking for clues that point beyond what medicine says and beyond what my own senses say. I find a good bit of hope in what I read.

Wendell Berry explored this topic with extraordinary care. His The Memory of Old Jack is a solid antidote to our collective denial.


Image credit: Atul Gawande, Kirk Livingston

Written by kirkistan

June 30, 2015 at 9:09 am

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