I was never a fan of required reading earlier in my education. For the most part, I was bored and maybe a little rebellious because reading wasn’t my idea. Hence, Sparknotes was an easy out! This time around, I have to say I am quite impressed by a selection made by a professor in my summer research program. The book I’m currently reading is called Being Mortal: Medicine and What Matters in the End by Dr. Atul Gawande. This is a must read for anyone interested in pursuing a career in veterinary or human medicine or simply interested in thinking outside of social norms about the aging process.
Without spoiling the book, I’d like to share just a few things that have been impressed on me so far. One of the most obvious aspects about life is the fact that at one point, it must come to an end. I know, what an obvious statement — but that’s not always how we as medical professionals think about the aging process. There’s a point I feel that students reach, or at least I have, where your focus gets so zoned-in on pathology. We’re trained to look for the disease, but we cannot treat aging. The end of life is a process that deserves special consideration outside our rigid training.
One specific topic Gawande demonstrates very clearly is the autonomy of a dying person. Gawande is a human doctor, but I think the principle applies just as well to animals — although I’ve not considered it this way until recently. Gawande’s father lived to the ripe old age of 110! Up until the year he died, his sons helped him to ride horseback to tend to his fields in India. In the patriarchal society, the old man was still in charge. That’s a far cry from what I would have allowed my father to do had he lived to seventy. I would have been concerned that a simple accident could result in a tragedy, but I know I wouldn’t be upset myself if I died doing what I loved. Perhaps that’s something I should reflect on. Life does not end because we grow old, though our faculties may change our expectations and desires may not.
So how do we apply this to animals and help them live happier in old age? One example that comes to mind is my mother’s ten-year-old lab, Olive. She loves to run but has a cruciate tear and is not a candidate for surgery. Her mind still wants to run, though her knee isn’t up for the challenge. I can see the depression on her face. Perhaps a new activity is the key. Something to engage her mind and body, making her feel capable. I think that swimming is our option.
In any discipline of medicine, I think this book is a really important reference. It’s helpful to think outside the medical aspects and focus on the individual. What do they want? What do they actually need to feel better, beyond medical treatment? One of my goals is to facilitate the human-animal bond, and I believe Gawande is spreading a great message that I hope will influence this generation of healers.