We are strange creatures. It is hard for us to speak about, or let in, the reality of frailty and death — the elemental fact of mortality itself. In this century, western medicine has gradually moved away from its understanding of death as a failure — where care stops with a terminal diagnosis. Hospice has moved, from something rare to something expected. And yet advances in technology have made it ever harder for physicians and patients to make a call to stop fighting death — often at the expense of the quality of this last time of life. Meanwhile, there is a new longevity industry which resists the very notion of decline, much less finitude. Fascinatingly, the simple question which transformed the surgeon Atul Gawande’s life and practice of medicine is this: What does a good day look like? As he has come to see, standing reverently before our mortality is an exercise in more intricately inhabiting why we want to be alive. This conversation evokes both grief and hope, sadness at so many deaths — including our species-level losses to Covid — that have not allowed for this measure of care. Yet it also includes very actionable encouragement towards the agency that is there to claim in our mortal odysseys ahead.
We are strange creatures. It is hard for us to speak about, or let in, the reality of frailty and death — the elemental fact of mortality itself. In this century, western medicine has gradually moved away from its understanding of death as a failure — where care stops with a terminal diagnosis. Hospice has moved, from something rare to something expected. And yet advances in technology have made it ever harder for physicians and patients to make a call to stop fighting death — often at the expense of the quality of this last time of life. Meanwhile, there is a new longevity industry which resists the very notion of decline, much less finitude.
Fascinatingly, the simple question which transformed the surgeon Atul Gawande’s life and practice of medicine is this: What does a good day look like? As he has come to see, standing reverently before our mortality is an exercise in more intricately inhabiting why we want to be alive. This conversation evokes both grief and hope, sadness at so many deaths — including our species-level losses to Covid — that have not allowed for this measure of care. Yet it also includes very actionable encouragement towards the agency that is there to claim in our mortal odysseys ahead.
Atul Gawande's writing for The New Yorker and his books have been read by millions, most famously Being Mortal: Medicine and What Matters in the End. He currently serves as Assistant Administrator for Global Health at the U.S. Agency for International Development. He previously practiced general and endocrine surgery at Brigham and Women’s Hospital in Boston and was a professor at both Harvard Medical School and the Harvard T.H. Chan School of Public Health.
Find the transcript for this show at onbeing.org.
This show originally aired in October 2017.
______
Sign up for The Pause — a Saturday morning companion newsletter to the On Being podcast season, and our mailing list for news and invitations all year round. Be the first to know as tickets go on sale for the On Being 2025 live national conversation tour.