Saturday, January 5, 2019

My review of Being Mortal: Medicine and What Matters in the End


In Being Mortal: Medicine and What Matters in the End, Atul Gawande, M.D., makes a powerful case for improving quality of life in our final years. Drawing on scientific studies, he points out that people facing the finitude of life want meaning. In sharp contrast are case studies of terminally ill or simply aging people caught in a medical system focused on curing what in reality cannot be cured. This results in a person’s last days or years being painfully full of treatment side effects that prevent him from enjoying what matters most to him.

Gawande begins the journey that became this book by questioning whether his medical training had adequately prepared him to help patients with their physical decline and mortality. He looks at how differently a geriatrician and a “regular” physician approach an elderly patient. Older folks are clearly better served by the geriatrician considering the whole person with multiple irrevocable issues natural to aging. Yet this field is lower paying than other medical fields, and not nearly enough doctors train for it.

To begin with, assigning aging to our medical system, as we do in the United States, is a core problem. Gawande posits that it doesn’t belong there. Aging is not about only safety and survival, medicine’s focus. He sets out on a journey to explore how we might change and until the system changes, how he might change to give his patients more control, options, and meaning. “What makes life worth living when we are old and frail and unable to care for ourselves?” [page 92 in my edition]

In conversational style he recounts stories of his elderly relatives, his own patients, and other people with terminal cancer. He looks at the quality of their last days/years when medicine railroads them into trying every procedure and medicine available to prolong their lives, or requires safety above all. He contrasts that with the last days/years of people who weigh their risks, decide what matters most to them (eating chocolate ice cream, visiting with friends, as examples), and choose the medical options that best enable that outcome. He adds to these anecdotes the results of scientific studies on the subject and the wisdom of hospice experts.

Gawande’s journey brings him to understand that the questions he asks a patient facing death are critical. One doctor-patient relationship style is the doctor telling the patient what to do. On the other end of the spectrum is an informative style in which the doctor explains options. Gawande discovers, “In truth, neither type is quite what people desire. We want information and control, but we also want guidance. The Emanuels [medical ethicists] described a third type of doctor-patient relationship, which they called ‘interpretive.’ Here the doctor’s role is to help patients determine what they want. Interpretive doctors ask, ‘What is most important to you? What are your worries?’ Then, when they know your answers, they tell you about the red pill and the blue pill and which one would most help you achieve your priorities.” [page 201] A doctor’s time and words matter. Gawande begins to move from informative to interpretive in his personal doctoring style. This changes choices for both patient and physician.

This book evoked a range of emotions as I read it. I was fascinated to learn the history of nursing homes and assisted care facilities. I felt excited to hear of facilities whose founders really thought outside the box in order to give more meaning to residents’ lives. Maybe I could find one of these places when the time comes for me. My mother’s nursing home does many things to enrich residents’ lives, and I feel glad to know this. Reading this book also helped me trust my gut sense of how to keep my mother from being railroaded by the medical system. I felt sobered learning the devastating trials of patients cited in the book. What difficult choices they had to make. I felt sad for them and their families. I felt vulnerable and oh so mortal. I felt heartened to see instances of the human body triumphing and persevering, at least temporarily, against unbelievable odds. I felt tickled by the sweet simplicity of people’s last requests. I felt awed by the sophistication of modern medicine. And I felt like jumping up and down and cheering for the profound beauty of hospice care.

Atul Gawande takes an uncomfortable topic, end of life, and makes it interesting. I recommend this book for anyone pondering life’s finitude—measuring his horizons in the here and now—and for anyone in any medical field. Gawande’s scientific sources for Being Mortal: Medicine and What Matters in the End are included in a bibliography.

 

Wednesday, December 26, 2018

Louise Miller's novel The Late Bloomers' Club ~ my review

The Late Bloomers' ClubThe Late Bloomers' Club by Louise  Miller

My rating: 5 of 5 stars


Oh how I ached for good things to happen for Nora Huckleberry, the responsible older sister in Louise Miller’s The Late Bloomers’ Club. I strongly wished Nora’s sister Kit would stop looking to Nora to bail her out of foolish predicaments. How I longed to have community like that in Nora’s homey diner in picturesque Guthrie, Vermont. I cared whether the sisters sold their inherited land to a big-box-store developer, and what the developer’s rep Elliott would do. Add to that the tension of Peggy the Cake Lady’s dog Freckles on the loose, and The Late Bloomers’ Club was a real page turner for me.

Novel Writing 101 advice is to keep throwing stuff at your main character and showing how she handles it. Well, Louise Miller throws plenty of adversity at Nora, who turns out to be a heroine well worth cheering for. In addition, Miller adds interest to the story by creating multifaceted characters with unexpected nuances and satisfying epiphanies. I loved reading The Late Bloomers’ Club.




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Monday, December 24, 2018

My review of Louis de Bernières' Notwithstanding

NotwithstandingNotwithstanding by Louis de Bernières

My rating: 4 of 5 stars


Delightful array of loosely interwoven stories of characters populating the British village of Notwithstanding. Some of their quirky situations are lighthearted, some poignant or sad. A master storyteller, author Louis de Bernières captures small moments of life with humor ~ a playful dog that is a menace on the golf course, a young boy’s triumph catching a big fish, budding young love among people confiding in a large spider, a talking rook, crazy-driving nuns, delusions of old soldiers, and the hedging and ditching man unearthing all sorts of garbage. I loved both the writing and the stories.



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Friday, November 30, 2018

Joy School by Elizabeth Berg ~ my review

Joy School (Katie Nash, #2)Joy School by Elizabeth Berg

My rating: 4 of 5 stars


Honest. Clever. Guileless. Did I mention honest? Joy School's heroine is as winsome as they come. Elizabeth Berg's twelve-year-old Katie is a child so sincerely trying to grow up, get by, do the right thing, be liked, love and be loved, I cannot help but be in her corner. Katie is smart, observant, sensitive, and funny. From her hilarious descriptions of her high school teachers to her desire to know how to kiss when the time comes, this novel entertains. And helps me laugh at what I probably felt at twelve but never articulated nearly as well as Katie does. Joy School also tugs at heartstrings. Katie is lonely and learns who she wants to be through ups and downs of friendships and her first big crush. Elizabeth Berg masterfully crafts all the characters. I enjoyed Joy School more than a decade ago and thoroughly enjoyed it again this time.



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Wednesday, November 14, 2018

Jan Karon's Mitford novel, To Be Where You Are ~ my review

To Be Where You Are (Mitford Years #14)To Be Where You Are by Jan Karon

My rating: 3 of 5 stars


Fans of Jan Karon’s Mitford series will be pleased to know this 2017 novel, To Be Where You Are, continues the stories. Chapters alternate between Meadowgate Farm with Dooley’s and Lace’s family/veterinary practice and the town itself with Father Tim and the motley Mitford crew. Briefly, Dooley and Lace face financial and artistic challenges in the process of adopting Jack as their own son. Father Tim and townsfolk rally around some who need help with a variety of problems.

When I read a Mitford novel, I appreciate Karon’s light touch with life’s highs and lows. The plot in this novel feels like real life. I hold my breath with the characters’ pains and sorrows, breathe easy with their joys and celebrations, and laugh with their silly human foibles. But I do not wig out over anything, because Karon infuses the plot with an “It is well with my soul” mentality.

Although I feel grounded in a Mitford story’s realness, I also feel challenged. I could appreciate and trust God more in order to approach life’s realities with more thankfulness and certainty that “It is well with my soul.” I could show up with a casserole or cake more often when I know a family is having a hard time. One attraction of a Mitford novel might be that it inspires readers to aspire to make the world a better place, one small kindness at a time.

Just as Dooley and Lace were adopted in previous novels, in this one, they adopt Jack. In To Be Where You Are Karon repeats the adoption concept and describes again what they were adopted out of and into. It’s an apt picture of Jesus’ inviting us to be with Him now and forever just by admitting we are sinners needing to be saved by grace and wanting to be with Him now and forever.

I liked a few sweet moments when a character said to a loved one that all he or she wanted was “to be where you are.” That’s love.




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Monday, November 5, 2018

Macaron madness


So, blog post here is pretty similar to my Facebook post yesterday. My dear friend Connie and I made macarons. After perusing four recipes, two of which I had tried before, we landed on one from The Daily Herald. It was the winning recipe after the local cook had experimented twelve times. After doing it twice, I understood why it took her twelve times to get it right. So after yesterday, I’ve done it three times, and I can tell you right now, I will not make it to twelve times. I won’t even aspire to twelve! Macarons are lovely little delicacies. When savoring one, you know you have had a treat. Macaron making, however, has variables way beyond me.

Ladurée, look out! Connie Macaron Komora (yes, she has officially changed her middle name to Macaron) and I, Jane Ganache Hoppe, will be stiff competition. Well, maybe not today but someday soon, we will move right next door to your famous bakery in Paris and give you a run for your money. Granted, Ladurée, you sell 15,000 gorgeous, perfectly domed, exquisitely colored, 36-flavored, luxurious macarons PER DAY, and Connie and I spent four hours TODAY making 48 lopsided, misshapen, cracked-meringue macarons in both vanilla and chocolate flavors (count ’em, two), both with a sublime dark chocolate ganache filling (count it, one flavor).

But you know what, Ladurée, I bet Connie and I had more fun. We laughed when we accidentally poked holes in the meringue. This happened a lot. We laughed when the macarons were so bulgy, they rolled around on the plate instead of sitting flat. Yes, we had a great time. And you know what, our macarons melt in the mouth, same as yours. Maybe we’ll stay right here and let you have the international macaron market.

Thanks to my French friend Françoise for giving me the fun macaron tablier et torchon—apron and dish towel—a few years ago after I went crazy for these cookies in France. Although Parisian bakeries' macarons are more famous, my taste buds favored macarons from Ortholan in Montpellier.




Tuesday, October 9, 2018

Freefall to Fly: A Breathtaking Journey Toward a Life of Meaning

Freefall to Fly: A Breathtaking Journey Toward a Life of MeaningFreefall to Fly: A Breathtaking Journey Toward a Life of Meaning by Rebekah Lyons

My rating: 3 of 5 stars


Rebekah Lyons' memoir, Freefall to Fly, contains some nuggets of wisdom for women especially. She asks insightful questions about, for example, where we nurture others but not ourselves to the point where we are unable to dream big for ourselves. Only read this book if you will ponder those important questions. I bookmarked seven of her questions that I want to explore further in order to make some changes. The memoir itself is a quick read, but the pondering will take longer ~ and be worth it.



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