The one article you need to read before you die

If I could attach a 911 red siren alarm to a recommendation on my blog, this would get the flashing light. If you get no other tip from The Geezer Diary, let this be the one. It’s about how you may choose to graduate from the planet.

Graduating from the Planet--Photo by NASA Goddard

Wonderful writer, surgeon and general genius of thought, Dr. Atul Gawande, has written another of his gems for the August 2nd issue of the New Yorker. Its title is: Letting Go, What should medicine do when it can’t save your life?

Dr. Gawande tells the stories of very ill people who made very different choices about how they would spend their last months on the planet. He focuses on people who had a good end—peaceful, without pain and with family—and people who died with a pitiful quality of life. Each story is riveting and instructive. What I got from it is that if I get a downer diagnosis, I will get myself into a hospice program as fast as my lame little bod will carry me.

For those who do not know, hospice is now a world-wide program that offers tender loving end-of-life care to people who are graduating from the planet and to their families. (It’s a team effort.)

From what I’ve seen with several dying friends,  from hearing the experiences of others and from interviewing hospice staff and volunteers, hospice is the way to go out—not with a bang, not with a whimper—but with some peace of mind about the last great happening of life. Hospice provides pain control, control of symptoms, nursing care, personal care, emotional and spiritual counseling, medical equipment and bereavement counseling.

For my friend, Joan, dying of COPD, having hospice at her home was the way to enjoy her friends and family as she made the next journey. I saw Joan 48 hours before she died. She was looking forward to her evening martini and fell asleep holding my hand after a very pleasant and funny conversation. Joan was so impressed with hospice, she told her friends:

Photo: Kjunstorm

Don’t send flowers, just send money to hospice.

Another friend of mine, S.,  whose husband used hospice in his final months said that she never again would be afraid of death, so comforting were the hospice counselors. So the benefits of the program extend to family and friends, both before, during and after someone’s departure.

Hospice is free. Regardless of  income, the service is available, usually to people whose doctors have given them 6 months or less, though my local hospice has a transitions program for people whose prognosis is one year or less. To find a local hospice, just put the name of your town and the word hospice into the Google search box.

But Dr. Gawande’s article is what you need to read, not this. He talks about this subject so forcefully that when you’ve finished reading, you realize this knowledge can change your life and how you choose to leave it.

Where do I find this article?

August 2, 2010, New Yorker, pages 36 -49. Also currently online at, but I don’t know how long the magazine displays its current articles. You can surf there now—or get to a library or a magazine stand. As for me, I keep my New Yorker subscription going just for the occasional pieces by Dr. Gwande. (OK…. and for the cartoons.)

I want to end this alert with one surprising point from Dr. Gawande: Some of the people who used hospice, who gave up aggressive treatments and instead focused on staying pain-free and enjoying their remaining time, lived longer than those who were using heroic measures such as repeated chemos, many surgeries and other Hail Mary procedures. As Dr. G says, “The lesson seems almost Zen: you live longer only when you stop trying to live longer.”

Image of the heavens by nasa1fan/MSFC
Photo: Jackol/Flickr

7 thoughts on “The one article you need to read before you die”

  1. I read the article. It was great and brought up many points to ponder. When my mother passed from Lung cancer, I am sure my dad felt guilty. She went through so much treatment and the end result was the same. She would have been better off without treatment and her quality of life would have been so much better. Thanks for bringing the article to the attention of your followers.

  2. I printed out the whole article and read every word. In the last two years, I have lost a mother-in-law, a dear aunt, and, recently, my mother. All of these ladies had made their wishes clear, and they all died at home, with loved ones at the bedside, without pain, and without fear. I believe this is the gift that hospice gives, and I am a whole-hearted believer and supporter! Thank you for calling my attention to the article, and reminding me, and others, of the importance of the CONVERSATION, of the talking, of the sharing, both with doctors and with our families, hopefully long before it is medically necessary. The sooner these kinds of discussions are held, as a matter of course, within families and at the annual doctor’s visit, the better we will all be. The article mentions several communities where this is done, and the very positive results experienced by everyone involved. I encourage everyone to read the article, and to get busy really thinking about what you want, when it is your turn. After all, everyone will have a turn!

  3. Here’s another voice urging young and old to read Dr Gawande’s article for all the reasons Mel cites. He’s gutsy, wise, generous, thoroughly engaging, and – after having heard him speak at a local church – I can’t forbear adding “lovable.” And do try to track down the books he’s written (perhaps easiest via Amazon for starters).

  4. I just finished reading The New Yorker article. Thank you so much.
    My husband’s journey through his final months with our Hospice was the perfect ending, and their guidance and sensitivity to what was needed … exceptional. I learned a lot at an extraordinary milestone in both our lives. Since then, more special people in my life have passed and my outlook and understanding have been shaped by my own experiences. This article, sometimes hard to read, but necessary to understand was exceptional. Thank you for your weekly columns and this website.

  5. My husband and I have lost both sets of parents and Hospice was there with us all through the last breath of each parent. The experience was blessed, honorable, gentle, fun, loving and a gift for everyone in the family. It was an honor to share the last moments of the parents we love!

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