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DYING WELL

THE PROSPECT FOR GROWTH AT THE END OF LIFE

A hospice doctor's wrenching stories of dying patients and their families, which dramatically illustrate his belief that the transition to death can be one of life's most meaningful experiences. Byock, a specialist in palliative care who directs a hospice in Missoula, Mont., has chosen stories that represent a wide range of experiences, each focusing on some aspect of human growth. Pseudonymns are used throughout except for Byock's moving account of his own father's death and the story of the Merseal family, whose dying son was the subject of a 1996 HBO documentary. What is crystal clear in all of them is that the full experience of dying is not captured from a purely medical perspective. Without proper medical care, dying can be agonizing, but relief of physical pain, which Byock contends is always possible, is by no means the whole picture. In his experience, emotional pain is more intense and requires more skillful intervention. Dying well, says Byock, involves reaching certain landmarks, which he encourages his patients to achieve: asking forgiveness, accepting forgiveness, expressing love, acknowledging self-worth, and saying good-bye. One of the hardest to read of Byock's stories describes the death of Terry, a 31-year-old mother with cancer who cannot reach these landmarks and suffers greatly. Her story also illustrates the fine distinction between hastening death and ensuring comfort. Byock, who argues that the euthanasia debate has distracted our attention from more logical and humane approaches, is not afraid to give his considered opinions about assisted suicide, vegetative states, and feeding tubes. Often reminiscent of Michael Kearney's recent Mortally Wounded (p. 1029), which described that doctor's work with patients in an Irish hospice, this is another powerful argument in favor of the hospice movement and rejection of the Kevorkian approach.

Pub Date: Jan. 27, 1997

ISBN: 1-57322-051-5

Page Count: 352

Publisher: Riverhead

Review Posted Online: May 19, 2010

Kirkus Reviews Issue: Nov. 15, 1996

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A PEOPLE'S HISTORY OF THE UNITED STATES

For Howard Zinn, long-time civil rights and anti-war activist, history and ideology have a lot in common. Since he thinks that everything is in someone's interest, the historian—Zinn posits—has to figure out whose interests he or she is defining/defending/reconstructing (hence one of his previous books, The Politics of History). Zinn has no doubts about where he stands in this "people's history": "it is a history disrespectful of governments and respectful of people's movements of resistance." So what we get here, instead of the usual survey of wars, presidents, and institutions, is a survey of the usual rebellions, strikes, and protest movements. Zinn starts out by depicting the arrival of Columbus in North America from the standpoint of the Indians (which amounts to their standpoint as constructed from the observations of the Europeans); and, after easily establishing the cultural disharmony that ensued, he goes on to the importation of slaves into the colonies. Add the laborers and indentured servants that followed, plus women and later immigrants, and you have Zinn's amorphous constituency. To hear Zinn tell it, all anyone did in America at any time was to oppress or be oppressed; and so he obscures as much as his hated mainstream historical foes do—only in Zinn's case there is that absurd presumption that virtually everything that came to pass was the work of ruling-class planning: this amounts to one great indictment for conspiracy. Despite surface similarities, this is not a social history, since we get no sense of the fabric of life. Instead of negating the one-sided histories he detests, Zinn has merely reversed the image; the distortion remains.

Pub Date: Jan. 1, 1979

ISBN: 0061965588

Page Count: 772

Publisher: Harper & Row

Review Posted Online: May 26, 2012

Kirkus Reviews Issue: Jan. 1, 1979

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WHEN BREATH BECOMES AIR

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

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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. 29, 2015

Kirkus Reviews Issue: Oct. 15, 2015

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