A revealing look into a troubling world, and a valuable contribution to our understanding of the forces at work behind the...
How doctors, nurses, patients, and their families experience hospital deaths—and how hospital systems move such matters along through set pathways.
In 1997 and again in 1999, Kaufman (Medical Anthropology/Univ. of Calif., San Francisco) put her professional research tools to good use at three California community hospitals. She followed the course of over a hundred critically ill patients, speaking frequently with their families as they waited for a relative to die, observing and interviewing the various health professionals involved, and attending rounds, staff meetings, and family-staff conferences. From tapes and verbatim notes, she has reconstructed the death scenarios of 27 patients whose stories represent a range of problematic experiences. Kaufman finds that the deathwatch of former times has been transformed into a time of waiting for procedures to be performed and for decisions to be made about what to do next. The very old and very ill are commonly placed on one of two pathways: the heroic intervention pathway or the revolving door one. In the latter, patients are repeatedly shuttled from home or nursing home to hospital and back again in the weeks or months before they die. Kaufman examines the complex practices surrounding life support, how various interpretations of the patient’s suffering, dignity, and quality of life are invoked to control and arrange death by either promoting or stopping aggressive treatment. When the hospital system directs that it’s time to switch pathways, patients and families, she says, are expected to conform to the change—to move from prolonging life to preparing for death. These stories of individual patients illustrate the strains and tensions inherent for everyone involved and demonstrate why the goal of “death with dignity” is so illusive. (Kaufman also looks at those patients hovering in a “zone of indistinction,” such as a coma or a persistent vegetative state.)
A revealing look into a troubling world, and a valuable contribution to our understanding of the forces at work behind the culture of hospital death.Pub Date: April 1, 2005
ISBN: 0-7432-6476-2
Page Count: 416
Publisher: Scribner
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Jan. 1, 2005
This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”
The powerful story of a father’s past and a son’s future.
Atlantic senior writer Coates (The Beautiful Struggle: A Father, Two Sons, and an Unlikely Road to Manhood, 2008) offers this eloquent memoir as a letter to his teenage son, bearing witness to his own experiences and conveying passionate hopes for his son’s life. “I am wounded,” he writes. “I am marked by old codes, which shielded me in one world and then chained me in the next.” Coates grew up in the tough neighborhood of West Baltimore, beaten into obedience by his father. “I was a capable boy, intelligent and well-liked,” he remembers, “but powerfully afraid.” His life changed dramatically at Howard University, where his father taught and from which several siblings graduated. Howard, he writes, “had always been one of the most critical gathering posts for black people.” He calls it The Mecca, and its faculty and his fellow students expanded his horizons, helping him to understand “that the black world was its own thing, more than a photo-negative of the people who believe they are white.” Coates refers repeatedly to whites’ insistence on their exclusive racial identity; he realizes now “that nothing so essentialist as race” divides people, but rather “the actual injury done by people intent on naming us, intent on believing that what they have named matters more than anything we could ever actually do.” After he married, the author’s world widened again in New York, and later in Paris, where he finally felt extricated from white America’s exploitative, consumerist dreams. He came to understand that “race” does not fully explain “the breach between the world and me,” yet race exerts a crucial force, and young blacks like his son are vulnerable and endangered by “majoritarian bandits.” Coates desperately wants his son to be able to live “apart from fear—even apart from me.”
This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”Pub Date: July 8, 2015
ISBN: 978-0-8129-9354-7
Page Count: 176
Publisher: Spiegel & Grau
Review Posted Online: May 5, 2015
Kirkus Reviews Issue: July 1, 2015
BOOK REVIEW
BOOK REVIEW
SEEN & HEARD
BOOK TO SCREEN
BOOK TO SCREEN
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
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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