(Recommended reading for all physicians)
This book by Atul Gawande, a practicing surgeon, discusses issues related to sickness and aging and the ways in which the American health care system falls short. Most of us with roots in South Asian culture will find this book very interesting, because the author ( whose doctor parents immigrated to the U S from India) compares Western and South Asian attitudes toward aging, and the way families cope.
He uses a very personal story, that of his father, to highlight the difficulties patients confront, when faced with a serious illness. When his father developed a slow growing spinal cord tumor,the family consulted two surgeons at two separate, well-known medical centers. They received two opposing opinions, one very aggressive and the other a much more conservative management plan. His father chose the latter, and was able to continue working as a surgeon for a few more years, and was able to enjoy a decent quality of life until his inevitable demise. Had he chosen the invasive surgery, it may have resulted in paralysis and a greatly diminished quality of life.
He also writes about the lives of several other patients and their struggles. The content may be serious, but Dr. Gawande's writing style keeps one engaged until the end.
This book was written a few years ago and has been discussed extensively in the U.S. media as well as in private discussion groups. It may not have had as much publicity in other countries ( I couldn't find it in Sri Lanka), but many of the issues raised are universal.
Is it necessary to always "treat" a terminal illness, especially when the the possibility of a cure is negligible and the effects of treatment are harsh? Sometimes all we need to do is to offer palliative care to the patients with adequate pain management. Physicians often feel that they must "do something" even if there is a possibility of the patient ending up in a worse state than before. Palliative care is "doing something!"
If you get a chance, or have had a chance to read this book, I would like to hear your comments and generate a discussion on palliative care and other issues raised in this book.