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.

    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.

    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.

    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.

    She elected to specialize in critical care--to become an ICU physician--and imagined herself swooping in to rescue patients from the brink of death. But then during her first code she found herself cracking the ribs of a patient so old and frail it was unimaginable he would ever come back to life. She began to question her choice. Extreme Measures charts Zitter's journey from wanting to be one kind of hero to becoming another--a doctor who prioritizes the patient's values and preferences in an environment where the default choice is the extreme use of technology. In our current medical culture, the old and the ill are put on what she terms the End-of-Life Conveyor belt. They are intubated, catheterized, and even shelved away in care facilities to suffer their final days alone, confused, and often in pain. In her work Zitter has learned what patients fear more than death itself: the prospect of dying badly. She builds bridges between patients and caregivers, formulates plans to allay patients' pain and anxiety, and enlists the support of loved ones so that life can end well, even beautifully.

    With more than one in every five people over the age of fourteen addicted, drug abuse has been called the most formidable health problem worldwide. If we are not victims ourselves, we all know someone struggling with the merciless compulsion to alter their experience by changing how their brain functions.Drawing on years of research--as well as personal experience as a recovered addict--researcher and professor Judy Grisel has reached a fundamental conclusion: for the addict, there will never be enough drugs. The brain's capacity to learn and adapt is seemingly infinite, allowing it to counteract any regular disruption, including that caused by drugs. What begins as a normal state punctuated by periods of being high transforms over time into a state of desperate craving that is only temporarily subdued by a fix, explaining why addicts are unable to live either with or without their drug. One by one, Grisel shows how different drugs act on the brain, the kind of experiential effects they generate, and the specific reasons why each is so hard to kick.Grisel's insights lead to a better understanding of the brain's critical contributions to addictive behavior, and will help inform a more rational, coherent, and compassionate response to the epidemic in our homes and communities.

    Kathryn Mannix has studied and practiced palliative care for thirty years. In With the End in Mind , she shares beautifully crafted stories from a lifetime of caring for the dying, and makes a case for the therapeutic power of approaching death not with trepidation, but with openness, clarity, and understanding. Weaving the details of her own experiences as a caregiver through stories of her patients, their families, and their distinctive lives, Dr. Mannix discusses the universal, but deeply personal, process of dying. With meditations on life, death, and the space between them, With the End in Mind describes the possibility of meeting death gently, with forethought and preparation, and shows the unexpected beauty, dignity, and profound humanity of life coming to an end.

    I have loved and been loved. I have been given much and I have given something in return. Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.” —Oliver SacksNo writer has succeeded in capturing the medical and human drama of illness as honestly and as eloquently as Oliver Sacks. During the last few months of his life, he wrote a set of essays in which he movingly explored his feelings about completing a life and coming to terms with his own death. “It is the fate of every human being,” Sacks writes, “to be a unique individual, to find his own path, to live his own life, to die his own death.”Together, these four essays form an ode to the uniqueness of each human being and to gratitude for the gift of life.

    In addition to the practical and compassionate guidance that have made The 36-Hour Day invaluable to caregivers, the fourth edition is the only edition currently available that includes new information on medical research and the delivery of care.The new edition includes:-new information on diagnostic evaluation-resources for families and adult children who care for people with dementia-updated legal and financial information-the latest information on nursing homes and other communal living arrangements-new information on research, medications, and the biological causes and effects of dementiaAlso available in a large print editionPraise for The 36-Hour Day:

    Operations on the brain carry grave risks. Every day, leading neurosurgeon Henry Marsh must make agonizing decisions, often in the face of great urgency and uncertainty.If you believe that brain surgery is a precise and exquisite craft, practiced by calm and detached doctors, this gripping, brutally honest account will make you think again. With astonishing compassion and candor, Marsh reveals the fierce joy of operating, the profoundly moving triumphs, the harrowing disasters, the haunting regrets, and the moments of black humor that characterize a brain surgeon's life.Do No Harm provides unforgettable insight into the countless human dramas that take place in a busy modern hospital. Above all, it is a lesson in the need for hope when faced with life's most difficult decisions.

    He was a successful psychologist and writer, with books to his name and bylines in major magazines. But none of that mattered. The impulse to take his own life remained. At times it felt all but inescapable.   Bering survived. And in addition to relief, the fading of his suicidal thoughts brought curiosity. Where had they come from? Would they return? Is the suicidal impulse found in other animals? Or is our vulnerability to suicide a uniquely human evolutionary development? In Suicidal, Bering answers all these questions and more, taking us through the science and psychology of suicide, revealing its cognitive secrets and the subtle tricks our minds play on us when we’re easy emotional prey. Scientific studies, personal stories, and remarkable cross-species comparisons come together to help readers critically analyze their own doomsday thoughts while gaining broad insight into a problem that, tragically, will most likely touch all of us at some point in our lives. But while the subject is certainly a heavy one, Bering’s touch is light. Having been through this himself, he knows that sometimes the most effective response to our darkest moments is a gentle humor, one that, while not denying the seriousness of suffering, at the same time acknowledges our complicated, flawed, and yet precious existence.   Authoritative, accessible, personal, profound—there’s never been a book on suicide like this. It will help you understand yourself and your loved ones, and it will change the way you think about this most vexing of human problems.

    But as the twins approached adolescence, Pamela began to succumb to schizophrenia, hearing disembodied voices and eventually suffering many breakdowns and hospitalizations.Divided Minds is a dual memoir of identical twins, one of whom faces a life sentence of schizophrenia, and the other who becomes a psychiatrist, after entering the spotlight that had for so long been focused on her sister. Told in the alternating voices of the sisters, Divided Minds is a heartbreaking account of the far reaches of madness, as well as the depths of ambivalence and love between twins. It is a true and unusually frank story of identical twins with very different identities and wildly different experiences of the world around them.

    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.

    That means most people alive today will spend more years in elderhood than in childhood, and many will be elders for 40 years or more. Yet at the very moment that humans are living longer than ever before, we've made old age into a disease, a condition to be dreaded, denigrated, neglected, and denied. Reminiscent of Oliver Sacks, noted Harvard-trained geriatrician Louise Aronson uses stories from her quarter century of caring for patients, and draws from history, science, literature, popular culture, and her own life to weave a vision of old age that's neither nightmare nor utopian fantasy--a vision full of joy, wonder, frustration, outrage, and hope about aging, medicine, and humanity itself. Elderhood is for anyone who is, in the author's own words, "an aging, i.e., still-breathing human being."

    Then, slowly, a mist settled deep inside the mind she once knew so well, blurring the world around her. She didn't know it then, but dementia was starting to take hold. In 2014, at age fifty-eight, she was diagnosed with young-onset Alzheimer's.Mitchell shares the heartrending story of her cognitive decline and how she has fought to stave it off. What lay ahead of her after the diagnosis was scary and unknowable, but Mitchell was determined and resourceful, and she vowed to outwit the disease for as long as she could.As Mitchell learned to embrace her new life, she began to see her condition as a gift, a chance to experience the world with fresh eyes and to find her own way to make a difference. Even now, her sunny outlook persists: She devotes her time to educating doctors, caregivers, and other people living with dementia, helping to reduce the stigma surrounding this insidious disease.Still living independently, Mitchell now uses Post-it notes and technology to remind her of her routines and has created a "memory room" where she displays photos--with labels--of her daughters, friends, and special places. It is a room where she feels calm and happy, especially on days when the mist descends.