ADDENDA Object obscura: Goa stone


This oval goa stone (~1601-1800) with its sliver gilt case still bears traces of gold foil. Goa stones (named after their place of origin) are manufactured versions of bezoar stones found in animal stomachs. They were made from a combination of clay, silt, musk, pearl dust and other exotic ingredients. Scrapings were mixed with water and drunk as medicinal remedies.


Book choice Being Mortal: Illness, Medicine and What Matters in the End


By Atwul Gawande Profile Books, £6.99 paperback Review by Greg Dollman, medical adviser, MDDUS


First published in 2014, Being Mortal explores (as the subtitle puts it) illness, medicine and what matters in the end – all in under 300 pages. How did a book dealing with growing old, written by a neurosurgeon (who begins with an admission that he learnt a lot of things in medical school, but mortality wasn’t one of them), become an international bestseller? I think there are a few reasons: mortality is a topical issue.


Crossword 2


1 9 3 8 10 3 4 5 6 7 11 12 13 14 16 17


19 20


18 15 21


We are living longer and want to live better – but at what financial and personal cost? Gawande combines personal experiences with a keen exploration of the topic, and while the book may not tell us much that we don’t already know, it offers a challenge to the medical profession’s approach to mortality. Gawande first explores the worldwide shift away from multigenerational families living under the same roof to elders living alone. He then proposes that many of those older people living alone are reluctant to give up this imposed independence. The book traces the development of “institutionalised existence, a medically designed answer to unfixable problems, a life designed to be safe but empty of anything the person cares about”. The inherent problems are obvious: how to balance keeping people safe against being controlled, upholding independence and the wishes of the person rather than the goal of society (Gawande writes that one resident “felt incarcerated, like she was in prison for being old”) and preventing ‘the task’ (such as washing or dressing) from becoming more important than ‘the person’. Gawande considers other


22


ACROSS 1 Danger (4) 3 Made less irregular (8) 9 Social status (7) 10 Rib (5) 11 Cocktail (3-9) 13 Rests (6) 15 Law of arousal and performance, Yerkes-____ (6)


17 Pertaining to farming (12) 20 Am (5) 21 Fortified structures (7) 22 Time-management tool (8) 23 Consumes (4)


23


DOWN 1 Answer (8) 2 To be in a vertical state (5) 4 Of which there are 12 annually (6)


5 Corrects the position of teeth (12)


6 _______ Above! (7) 7 Profound (4) 8 Unhappy because of confounded expectation (12)


12 Examination (8) 14 Primary language of USA (7) 16 Facial nerve (6) 18 Tumbles (5) 19 Obtains (4)


end-of-life care scenarios, applauding the skill set of palliative care clinicians and suggesting that all doctors should receive similar training. He then investigates the concept of assisted living, as well as innovations to the traditional models of care homes. What happens when ‘life’ (be it plants, animals, children or students) is incorporated into a care setting? Gawande finds that residents seem to prosper. More and more people are now dying of ‘old age’ and Gawande considers how medicine in particular has responded to this biological transformation. He asserts that the focus has traditionally been on the repair of health (“fixing a problem”) rather than “sustenance of the soul”. He argues that when the problem is a “crumbling” older person, doctors often respond with technical prowess rather than an understanding of human needs. Gawande concludes with a reminder that medicine’s


See answers online at www.mddus.com/news/notice-board 22


interventions are only justified if they serve the larger aims of a person’s life. He puts across a good argument that, when considering being mortal, this is what matters most in the end.


SUMMONS


PHOTOGRAPH: SCIENCE & SOCIETY


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24