An important contribution to a serious discussion of profound life-and-death issues.

MODERN DEATH

HOW MEDICINE CHANGED THE END OF LIFE

An examination of “our ongoing battle with aging, disease, and death.”

Notwithstanding the dramatic increase in life expectancy over the past century, death has become a taboo subject in polite society. “Never has death been as feared as it is today,” writes Warraich, a cardiology fellow at Duke University Medical Center who expresses the hope that his book will play a part in encouraging a more “honest and open conversation about death” among physicians and among patients and their family members. He explains how advances in the understanding of cellular functioning, coupled with improvements in end-of life treatment such as the ability to resuscitate people with cardiac arrest, have essentially blurred the line between life and death. Consequently, thorny new practical and ethical considerations have arisen regarding quality of life and the right to die: when is it appropriate to terminate the life of a patient in a vegetative coma? Does such a patient have a right to die? If so, who should be empowered to decide when life support should be terminated? Warraich describes how doctors are frequently forced to make such on-the-spot decisions for unconscious patients when relatives are unavailable and in instances where family members disagree. He explains that their training predisposes them to favor life extension even when the prospects of recovery are minimal. The author reviews the well-publicized case of Karen Ann Quinlan to illustrate the conflicts that may arise between doctors and relatives, and he takes an unflinching look at the problem for family caregivers when patients remain at the point of death for prolonged periods. This leads him to a compassionate consideration of physically assisted suicide, instituted when a patient expresses the desire to terminate his or her life rather than suffer a terminal illness. Warraich concludes this sensitive review of a painful subject with guarded optimism that a cultural shift toward open discussion is now occurring.

An important contribution to a serious discussion of profound life-and-death issues.

Pub Date: Feb. 7, 2017

ISBN: 978-1-250-10458-8

Page Count: 336

Publisher: St. Martin's

Review Posted Online: Dec. 7, 2016

Kirkus Reviews Issue: Dec. 15, 2016

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A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...

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WHEN BREATH BECOMES AIR

A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.

Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”

A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.

Pub Date: Jan. 19, 2016

ISBN: 978-0-8129-8840-6

Page Count: 248

Publisher: Random House

Review Posted Online: Sept. 30, 2015

Kirkus Reviews Issue: Oct. 15, 2015

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Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.

GOOD ECONOMICS FOR HARD TIMES

“Quality of life means more than just consumption”: Two MIT economists urge that a smarter, more politically aware economics be brought to bear on social issues.

It’s no secret, write Banerjee and Duflo (co-authors: Poor Economics: A Radical Rethinking of the Way To Fight Global Poverty, 2011), that “we seem to have fallen on hard times.” Immigration, trade, inequality, and taxation problems present themselves daily, and they seem to be intractable. Economics can be put to use in figuring out these big-issue questions. Data can be adduced, for example, to answer the question of whether immigration tends to suppress wages. The answer: “There is no evidence low-skilled migration to rich countries drives wage and employment down for the natives.” In fact, it opens up opportunities for those natives by freeing them to look for better work. The problem becomes thornier when it comes to the matter of free trade; as the authors observe, “left-behind people live in left-behind places,” which explains why regional poverty descended on Appalachia when so many manufacturing jobs left for China in the age of globalism, leaving behind not just left-behind people but also people ripe for exploitation by nationalist politicians. The authors add, interestingly, that the same thing occurred in parts of Germany, Spain, and Norway that fell victim to the “China shock.” In what they call a “slightly technical aside,” they build a case for addressing trade issues not with trade wars but with consumption taxes: “It makes no sense to ask agricultural workers to lose their jobs just so steelworkers can keep theirs, which is what tariffs accomplish.” Policymakers might want to consider such counsel, especially when it is coupled with the observation that free trade benefits workers in poor countries but punishes workers in rich ones.

Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.

Pub Date: Nov. 12, 2019

ISBN: 978-1-61039-950-0

Page Count: 432

Publisher: PublicAffairs

Review Posted Online: Aug. 29, 2019

Kirkus Reviews Issue: Sept. 15, 2019

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