Letting Go

Atul Gawande – Letting Go
New Yorker
2010

Description and Analysis

Gawande is a surgeon, professor, executive, and health-care policy specialist, alongside being a writer, and his articles tend to be amalgamations of his expertise.  This is an instance.  And while that might sound tedious or unenjoyable, Gawande also happens to hold expertise in humanizing and articulating for the fields.

This article is about the process of dying, when it isn’t a peaceful surprise in our sleep.  It is one of my favorites – not because I’m sick and into morbid things – but because it was such an honest account of an under-represented portion of life. It hit me hard the first time I’d read it, and I had to share it, and six years later, I’m stil gleaning information.

It’s a call-to-action, of sorts.  Gawande articulates the nuances of being in intensive care or signing up for hospice care.  The essence though is that Gawande implores us to have the converstations with our loved ones before it’s too late. Situations occur where shock can lead to inaction, and the true wishes of the injured about quality of life are ignored. And, he is first to acknowledge that doctors fall prey to performing unnecessary surgery and risking comfort because they’d skirted the issue.  It was a call-to-action to his colleagues as much as it was to regular readers.

Because of his background in politics, and the timing of this piece, and his association with a think-tank, I’m just generally skeptical about the situation.  There is nothing inauthentic in the article, and barely a mention of politics at all, except for some indirect financial studies and a bemoaning of a misrepresentation of palliative care in the ACA as “Death-Panels.” Just because of the proximity to government and the ACA doesn’t mean he is wrong or unjustified or writing from a platform that shouldn’t exist.  In fact, this is ideal governance, if it is the case, and I’m grateful it was executed.

This article won the 2011 Magazine Award for Reporting in the Public Interest.  An amended version has become Chapter 6 in Gawande’s book, Being Mortal, published in 2014.

Reaction

The closest article to being a rebuttal I’d found was written by Kimberly Alters at The Week. Click here

Ed Yong analyzes the structure of the article, quite deeply, for Discover Magazine. Click here

Dan Nguyen, professor at Stanford University, compares to two other articles written in the same vein for his blog, danwin.com. Click here

Zosia Chustecka reports the story and its impact more deeply for Medscape. Click here

Jennifer Popa, professor of English at University of Alaska at Fairbanks, assigned this reading for her class, and publishes the online commentary from her students.  Click here

Andrew Kneler recalls a study he conducted on sick patients on end-of-life treatment for Huffington Post. Click here

John Thorndike, of Last of his Mind blog about his father and life, writes about the article. Click here

UCLA conducted a roundtable discussion in 2016 on the article and its impact. Click here

Mary Ann, of thelastvisit.com, discusses the zen aspect of the article. Click here