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BBC Radio 4 – The Reith Lectures, Dr Atul Gawande: The Future of Medicine – Dr Atul Gawande – 2014 Reith Lectures.

Gleaned from these lectures, questions IMO we should ask all patients. At least once a day for those in the hospital:

“What is your understanding of where you are with your condition or your illness at this time?” “What are your fears and worries…”…“What outcomes would be unacceptable to you?”And with that, they’ve told you their priorities and what they care about and then that tells you both where the bright lines are that you do not cross and what you might actually be aiming for.

I enjoyed so much being stuck in traffic listening to these lectures this week. Gawande, my mentor who doesn’t know he is my mentor, pulls from previous works and his most recent book “Being Mortal,” which covers the medicalization of dying and offers suggestions to bend the system to favor better communication between providers and patients, supporting meaningful living through old age and, hopefully later rather than sooner, an end to life that is most agreeable to the dying person.

I recommend this book people who have parents and loved ones moving into their later 60s, as it kindles the kind of conversations that are much better had over a beer or some tea and biscuits (my dad and mom respectively) than in a hospital room. I promise you it is worth the work now to know what your loved ones want. When they are incapacitated the weight of decision making will fall to you.

I had a loving adult son, flown in from Florida, standing with me in the doorway of his critically ill father’s ICU room the other week. He told me his dad had never been sick a day in his life. He said they knew something would happen some day, but they just didn’t want to think about it.

In truth though enjoy the lectures. Gawande is uplifting and so so logical, a great story teller to boot. One day I will grab the podium and sound like that. Right now it would come out LISTEN TO ME AND FIX IT FIX IT FIX IT. Lacks maturity.

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