Category: nonfiction

Being Mortal by Atul Gawande

beingmortalBeing Mortal, by surgeon and New Yorker staff writer Atul Gawande, confronts aging and the life well-lived — two of my personal fascinations. I received this book as a gift from one of my coworkers at the start of my sabbatical. (Thank you, as-yet-unguessed friend!)

For all its technical advancements, Gawande posits that medical science struggles to achieve what should be its most important goal: focusing on well-being for the frail, the aging, and the terminally ill, as opposed to attempting to cure often incurable diseases and conditions. (You can’t cure old age, but you can do things to reduce pain, and improve comfort, mobility, and overall quality of life.)

We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive.

As you age and become unable to manage the tasks of daily existence (cooking food, shopping, using the toilet independently, cleaning, and personal grooming) there are few options for a well-lived life. Assisted living offers some autonomy — but not nearly enough when you’re forced to rise, dress, shower, and eat on a pre-determined schedule meant to create institutional efficiency, not happy, fulfilled, human beings. Gawande’s book challenges the institutional default setting by profiling small-scale, successful assisted living communities that allow elderly and frail people to do the things that bring them happiness on a schedule they choose.

For the terminally ill, the treatments are often much worse than the illness itself, although science’s default setting is try everything, to exhaust all options — even when death is an eventuality. Gawande suggests doctors should seek to understand what’s most important to patients, their fears, and the trade-offs they’re willing to make when considering treatments that can never cure, only extend life.

Well-being is about being able to live the life you want to live and do the activities you want to do, on your terms. It’s about ice-cream in front of the hockey game at home, as opposed to wasting away in a hospital as disease takes over. It’s about maximizing comfort and the quality of the time remaining, as opposed to focusing on mostly useless treatment.

This is a book I’ve seen advertised though I’d bypassed it several times. I’m so glad that I read it. Reading it, I reflected on how difficult it was for Mike’s family when his mom was diagnosed with pancreatic cancer. Although we really could have benefited from reading this book over 20 years ago, we did what we could to help Joan enjoy the time she had left. There were trips to the lake, lots of chocolate milkshakes, and most importantly, time with friends and loved ones.

Reading this book has also made me think of what I want for myself and my loved ones was we all age and eventually become frail. Being Mortal has equipped me with a set of questions to consider when time is running short, to help reveal fears and hopes and help choose which to live and make decisions by. Not only has it helped me to think about the (hopefully!) long-term future, it’s helped me to re-evaluate how I spend my time in the present.

Each day of my sabbatical is a gift. I get the exquisite luxury of being able to choose precisely how I want to spend my time each day. I’m fortunate to be in good health and the fact that I can run, bike, read, and sit on the deck and listen to bird radio has been a tremendous joy. I’ve been able to think about my life, what I’ve done so far, what’s most important to me, and how I want to spend my time going forward.

Being Mortal is an excellent read and it couldn’t have come at a better time. Highly recommended!

June, 2016

Nocturne by Helen Humphreys

nocturneA “nocturne” is a musical composition inspired by or evocative of the night.

In her memoir of the same name, Helen Humphreys grieves her brother Martin James Humphreys by writing directly to him over 45 chapters — one for every year of his short life.

In July of 2009, after complaining of a backache and some acid reflux, accomplished pianist and composer Martin is diagnosed with stage 4B pancreatic cancer. (There is no 4C.) He dies on December 3rd of the same year.

Pancreatic cancer is an especially aggressive beast. My mother-in-law died of the same disease almost as quickly as Martin (diagnosed in April, 1997, after being unable to beat a persistent cold, she passed in October of the same year). You are well and then you are terminal. She died only four years into our marriage. One of my biggest regrets is the time I didn’t get to spend with her — she was a beautiful human being.

This book is close to home in more ways than one. Martin dies at age 45 — the very age I am now. Helen Humphreys grieves her one and only younger brother intensely. The existence of  such a profound and loving brother / sister relationship, at this point in my life, is completely foreign to me. My younger brother (born the very same day a decade after Martin James Humphreys) has been estranged from my parents for almost a decade. Either one of us could die of pancreatic cancer in between the superficial birthday and Christmas greetings we exchange and the other would never even know, much less grieve. Their friendship and intimacy is like a foreign language being spoken before my eyes: it’s baffling and incomprehensible to me.

Helen Humphreys sees the absence of her brother everywhere she looks. She quotes American composer John Cage, whose words ring true to me as my thoughts return to my own brother, who’s alive, but essentially gone:

“What we hear is determined by our own emptiness, our own receptivity; we receive to the extent that we are empty to do so.”

— John Cage

Nocturne took me on a voyage to a foreign land I didn’t expect to enter; I read it in 24 hours — perhaps my version of language immersion.

Visit Helen Humphreys’ site to learn more about the book and listen to Martin playing Chopin’s Prelude 20 from Opus 28. (.mp3)

— February, 2016

Born To Run by Christopher McDougall

220px-Born2runFull title: Born To Run: A Hidden Tribe, Super Athletes, and the Greatest Race the World Has Never Seen by Christopher McDougall

My friend Joe Boydston recommended this book to me. I attended one of his running clinics at the Automattic Grand Meetup in Park City, Utah in September. In a short hour, Joe changed the way I approach my training and after applying his tips to my runs, I’ve been given a whole new lease on an activity I’ve been doing off and on for over 20 years. I knew I had to read this book.

Born To Run is one part adventure story, one part science, one part anthropology, and one part sheer guts. As an oft-injured runner, McDougall opens the book lamenting another injury. He’s trying to figure out what he’s doing wrong in an activity that’s natural to all humans.

Conventional science says that running is guaranteed to tear our bodies down over time with the repetitive pounding, yet by investigating science, history, and anthropology, McDougall discovers that the human body — with it’s upright form maximized for air intake, springy, rubber-band-like tendons geared to storing and returning energy repeatedly over long durations, and our well-muscled buttocks — has evolved into a running machine, dispelling the myth that as runners, we’re slowly ruining our bodies over time. 

McDougall posits that we get injured because we use high-tech running shoes as a crutch, and that these cushy shoes create more running injuries than they cure. The book talks of the foot as a marvel of evolutionary engineering that we as a society have allowed to let languish in shoes, essentially weakening our foundation, causing supination, and over pronation — the very form problems shoes, braces, and orthotics are meant to cure. Strengthen the foot, and improve your running form, says McDougall.

The anthropological study of the evolution of The Running Man is accompanied narratively by stories of The Tarahumara, a race of Indians in the remote Mexican Copper Canyons, who run ultra marathons in the mountains for the fun of it. The culmination of the book is an epic 50-‘mile ultra marathon in the Carrabancas pitting ultra-marathoner extraordinaire Scott Jurek against some eccentric and somewhat crazy American athletes and a group of Tarahumarans —  a race arranged by a running-crazed drifter called Caballo Blanco.

The pacing of the book is excellent — it’s difficult to put down and it’s a very enjoyable read. One thing that struck me is that the book opens with McDougall’s running injury, and ends as he completes the Carrabancan ultra. The reader gets occasional advice on the way he revises his form –(easy, light), back straight, head up, knees up, short strides at a cadence of 180 steps per minute — though I would have loved to know more about his personal recovery and how these principles changed his approach to running.

October, 2014

The possibility of rescue: Tiny Beautiful Things

In this sense, Tiny Beautiful Things can be read as a kind of ad hoc memoir. But it’s a memoir with an agenda. With great patience, and eloquence, she assures her readers that within the chaos of our shame and disappointment and rage there is meaning, and within that meaning the possibility of rescue.

— Steve Almond from the Introduction to Tiny Beautiful Things: Advice on Love and Life from Dear Sugar by Cheryl Strayed

Pumped and primed and stoked and monitored

Our kitchen was a Coleman camp stove, a fire ring, an old-fashioned icebox Eddie built that depended on actual ice to keep things even mildly cool, a detached sink propped against an outside wall of the shack, and a bucket of water with a lid on it. Each component demanded just slightly less than it gave, needing to be tended and maintained, filled and unfilled, hauled and dumped, pumped and primed and stoked and monitored.

Wild: From Lost to Found on the Pacific Crest Trail by Cheryl Strayed