This new edition includes an all-embracing and incisive afterword that examines the current state of health care and our relationship with life as it approaches its terminus. It also discusses how we can take control of our own final days and those of our loved ones.Shewin Nuland's masterful How We Die is even more relevant than when it was first published.

    But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering.Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families. Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person's last weeks or months may be rich and dignified.

    What she did not count on was how much death would be a part of her work. Almost immediately, Chen found herself wrestling with medicine’s most profound paradox, that a profession premised on caring for the ill also systematically depersonalizes dying. Final Exam follows Chen over the course of her education, training, and practice as she grapples at strikingly close range with the problem of mortality, and struggles to reconcile the lessons of her training with her innate knowledge of shared humanity, and to separate her ideas about healing from her fierce desire to cure.From her first dissection of a cadaver in gross anatomy to the moment she first puts a scalpel to a living person; from the first time she witnesses someone flatlining in the emergency room to the first time she pronounces a patient dead, Chen is struck by her own mortal fears: there was a dying friend she could not call; a young patient’s tortured death she could not forget; even the sense of shared kinship with a corpse she could not cast aside when asked to saw its pelvis in two. Gradually, as she confronts the ways in which her fears have incapacitated her, she begins to reject what she has been taught about suppressing her feelings for her patients, and she begins to carve out a new role for herself as a physician and as human being. Chen’s transfixing and beautiful rumination on how doctors negotiate the ineluctable fact of death becomes, in the end, a brilliant questioning of how we should live.Moving and provocative, motored equally by clinical expertise and extraordinary personal grace, this is a piercing and compassionate journey into the heart of a world that is hidden and yet touches all of our lives. A superb addition to the best medical literature of our time.

    It will inspire the necessary and difficult conversations we all need to have with loved ones as it illuminates a path to a better way of death.Like so many of us, award-winning writer Katy Butler always assumed her aging parents would experience healthy, active retire­ments before dying peacefully at home. Then her father suffered a stroke that left him incapable of easily finishing a sentence or showering without assistance. Her mother was thrust into full-time caregiving, and Katy became one of the 24 mil­lion Americans who help care for aging parents. In an effort to correct a minor and non–life threatening heart arrhythmia, doctors outfitted her father with a pacemaker. The device kept his heart beating but did nothing to prevent his slide into dementia, incontinence, near-muteness, and misery. After several years, he asked his wife for help, telling her, "I am living too long." Mother and daughter faced a series of wrench­ing moral questions: When does death cease being a curse and become a blessing? Where is the line between saving life and prolonging a dying? When is the right time to say to a doctor, "Let my loved one go"? When doctors refused to disable the pace­maker, sentencing her father to a protracted and agonizing death, Katy set out to understand why. Her quest had barely begun when her mother faced her own illness, rebelled against her doctors, refused open-heart surgery, and instead met death head-on. Knocking on Heaven's Door, a revolution­ary blend of memoir and investigative reporting, is the fruit of the Butler family's journey. With a reporter's skill, a poet's eye, and a daughter's love, Butler explores what happens when our terror of death collides with the tech­nological imperatives of modern medicine. Her provocative thesis is that advanced medicine, in its single-minded pursuit of maximum longevity, often creates more suffering than it prevents. Butler lays bare the tangled web of technology, medicine, and commerce that modern dying has become and chronicles the rise of Slow Medicine - a growing movement that promotes care over cure. Knocking on Heaven's Door is a visionary map through the labyrinth of a broken and morally adrift medical system. It will inspire the necessary and difficult conversations we all need to have with loved ones as it illuminates a path to a better way of death.

    Informed by her many years working as a nurse, with more than a decade in palliative care, Tisdale provides a frank and compassionate meditation on the inevitable.From the sublime (the faint sound of Mozart as you take your last breath) to the ridiculous (lessons on how to close the sagging jaw of a corpse), Tisdale leads readers through the peaks and troughs of death with a wise and humorous hand. This is more than a how-to manual or a spiritual bible: it is a graceful compilation of honest and intimate anecdotes based on the deaths Tisdale has witnessed in her work and life, as well as stories from cultures, traditions, and literature around the world.

    From Zoroastrian sky burials to wish-granting Bolivian skulls, she investigates the world’s funerary customs and expands our sense of what it means to treat the dead with dignity. Her account questions the rituals of the American funeral industry—especially chemical embalming—and suggests that the most effective traditions are those that allow mourners to personally attend to the body of the deceased. Exquisitely illustrated by artist Landis Blair, From Here to Eternity is an adventure into the morbid unknown, a fascinating tour through the unique ways people everywhere confront mortality.

    His beat is a nursing home in Miami that some would dismiss as “God’s waiting room.” Nothing in the young doctor’s medical training had quite prepared him for what he was to discover there. As Agronin first learned from ninety-eight-year-old Esther and, later, from countless others, the true scales of aging aren’t one-sided—you can’t list the problems without also tallying the hopes and promises. Drawing on moving personal experiences and in-depth interviews with pioneers in the field, Agronin conjures a spellbinding look at what aging means today—how our bodies and brains age, and the very way we understand aging.

    Writer, M.D. celebrates this rich tradition with a collection of fiction and nonfiction by today’s most beloved physician-writers, including,• Abraham Verghese, on the lost art of the physical exam• Pauline Chen, on the bond between a med student and her first cadaver• Atul Gawande, on the ethical dilemmas of a young surgical intern• Danielle Ofri, on the devastation of losing a patient• Ethan Canin, on love, poetry, and growing oldThese essays and stories illuminate the inner lives of men and women who deal with trauma, illness, mortality, and grief on a daily basis. Read together, they provide a candid, moving, one-of-a-kind glimpse behind the doctor’s mask.

    Cacioppo’s groundbreaking research topples one of the pillars of modern medicine and psychology: the focus on the individual as the unit of inquiry. By employing brain scans, monitoring blood pressure, and analyzing immune function, he demonstrates the overpowering influence of social context—a factor so strong that it can alter DNA replication. He defines an unrecognized syndrome—chronic loneliness—brings it out of the shadow of its cousin depression, and shows how this subjective sense of social isolation uniquely disrupts our perceptions, behavior, and physiology, becoming a trap that not only reinforces isolation but can also lead to early death. He gives the lie to the Hobbesian view of human nature as a “war of all against all,” and he shows how social cooperation is, in fact, humanity’s defining characteristic. Most important, he shows how we can break the trap of isolation for our benefit both as individuals and as a society.

    A few (identities disguised) come from the author’s own clinical encounters.  Every scenario is followed by a brief reflection of how various modern thought leaders (ethicists, philosophers, courts, political commentators, research scientists, and medical professionals) have addressed the underlying issues.

    Entering a room with stainless-steel tables topped by corpses in body bags is shocking no matter how long you've prepared yourself, but a strange thing happened when Montross met her cadaver. Instead of being disgusted by her, she was utterly intrigued-intrigued by the person the woman once was, humbled by the sacrifice she had made in donating her body to science, fascinated by the strange, unsettling beauty of the human form. They called her Eve. This is the story of Montross and Eve-the student and the subject-and the surprising relationship that grew between them. Body of Work is a mesmerizing, rarely seen glimpse into the day-to-day life of a medical student-yet one that follows naturally in the footsteps of recent highly successful literary renderings of the mysteries of medicine such as Atul Gawande's Complications: A Surgeon's Notes on an Imperfect Science. Christine Montross was a poet long before she became a doctor and brings an uncommon perspective to the emotional difficulty of the first year of medical school-the dispiriting task of remaining clinical and detached while in the anatomy lab and the struggle with the line you've crossed by violating another's body once you leave it. Montross was so affected by her experience with Eve that she undertook to learn more about the history of cadavers and the study of anatomy. She visited an autopsy lab in Ireland and the University of Padua in Italy where Vesalius, a forefather of anatomy, once studied; she learned about body snatchers and grave-robbers and anatomists who practiced their work on live criminals. Her disturbing, often entertaining anecdotes enrich this exquisitely crafted memoir, endowing an eerie beauty to the world of a doctor-in-training. Body of Work is an unforgettable examination of the mysteries of the human body and a remarkable look at our relationship with both the living and the dead.

    "What happens when we die? Does the light just go out and that's that—the million-year nap? Or will some part of my personality, my me-ness persist? What will that feel like? What will I do all day? Is there a place to plug in my lap-top?" In an attempt to find out, Mary Roach brings her tireless curiosity to bear on an array of contemporary and historical soul-searchers: scientists, schemers, engineers, mediums, all trying to prove (or disprove) that life goes on after we die.

    From church basements to hospital wards to prison cells, Neumann charts the social, political, religious, and medical landscape to explore how we die today. The Good Death weaves personal accounts with a historical exploration of the movements and developments that have changed the ways we experience death. With the diligence of a journalist and the compassion of a caregiver, Neumann provides a portrait of death in the United States that is humane, beautifully written, and essential to our greater understanding of the future of end-of-life care.

    Night Falls Fast is tragically timely: suicide has become one of the most common killers of Americans between the ages of fifteen and forty-five.An internationally acknowledged authority on depressive illnesses, Dr. Jamison has also known suicide firsthand: after years of struggling with manic-depression, she tried at age twenty-eight to kill herself. Weaving together a historical and scientific exploration of the subject with personal essays on individual suicides, she brings not only her remarkable compassion and literary skill but also all of her knowledge and research to bear on this devastating problem. This is a book that helps us to understand the suicidal mind, to recognize and come to the aid of those at risk, and to comprehend the profound effects on those left behind. It is critical reading for parents, educators, and anyone wanting to understand this tragic epidemic.

    She finds that you cannot immunize your child, or yourself, from the world.In this bold, fascinating book, Biss investigates the metaphors and myths surrounding our conception of immunity and its implications for the individual and the social body. As she hears more and more fears about vaccines, Biss researches what they mean for her own child, her immediate community, America, and the world, both historically and in the present moment. She extends a conversation with other mothers to meditations on Voltaire's Candide, Bram Stoker's Dracula, Rachel Carson's Silent Spring, Susan Sontag's AIDS and Its Metaphors, and beyond.On Immunity is a moving account of how we are all interconnected-our bodies and our fates.