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Chapter 8
Themes
Key
LitCharts assigns a color and icon to each theme in Being Mortal, which you can use to track the themes throughout the work.
Medicine, Survival, and Well-being
Safety vs. Autonomy
Destigmatizing Death and Illness
The Evolution of End-of-Life Care
Summary
Analysis
Being mortal is about the struggle to cope with the limits of our biology. Medicine helps push these limits, but the job of medicine is not just to ensure survival: it is to enable well-being. The important part of evaluating well-being is to understand one’s hopes, fears, and trade-offs and choose the best course of action accordingly.
In his conclusion, Gawande underscores once more how medicine should focus on well-being rather than survival—and often that means confronting death and having difficult conversations about it.
Themes
Palliative care helps bring this kind of thinking to dying patients, but every doctor should help patients think in this way. Whatever risks and sacrifices that doctors offer are only justified if they serve the larger aims of a person’s life. Otherwise the suffering can be immense. Gawande’s most meaningful experiences came from helping others understand what medicine cannot do—like Jewel Douglass, Peg, or his father.
Gawande again illustrates how palliative care is crucial to helping people achieve the kinds of end of life that they want. While death never becomes comfortable, facing these difficult topics is part of Gawande’s most meaningful work, and the book’s project is to help other people be more prepared for death, illness, and aging as well.
Themes
Gawande’s father died without sacrificing his priorities, and he left clear instructions for what to do after his death. According to Hindu mythology, when a person’s remains touch the Ganges River, they are assured eternal salvation, and so Gawande, his sister, and his mother took a boat and spread his ashes in the middle of the river according to Hindu customs. Gawande is grateful to have done this for his father, and that the rituals connect his father to something bigger than himself.
Recounting his experience spreading his father’s ashes, Gawande acknowledges again the value of good endings, and the importance of honoring people’s wishes about their own deaths. But acknowledging history also alludes to Gawande’s own death, as he knows that he, too, will one day have to confront aging and death and become a part of that same history.
Themes
Gawande’s father taught Gawande not to accept limitations as a child. But in Gawande’s father’s final years, he had to shift from pushing against limits to making the best of them. Sometimes the cost of pushing exceeds its value. Gawande feels lucky to have helped his father through this struggle, and to have gotten to say goodbye. His father let his family know he was at peace, and this let his family be at peace, too. After Gawande finishes spreading his father’s ashes in the Ganges, Gawande, his sister, and his mother return to shore.
Being able to confront death helps people have more peaceful deaths, as they are more ready to acknowledge when they should stop pushing against the inevitable. And in addition, it helps Gawande feel more at peace with how his father died. Additionally, the final image of the boat recalls the Greek myth of Charon, who ferried the souls of the dead across the River Styx. Similarly, Gawande makes it part of his own project to help ferry his patients through the process of aging and dying.
Themes
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