How We Die: Reflections on Life's Final Chapter

From Publishers Weekly A physician who teaches at the Yale School of Medicine, Nuland writes gracefully about a topic most of us would rather not dwell on--our impending deaths. He demystifies the process of dying by providing straightforward information on the clinical, biological and emotional details of deaths resulting from heart disease, stroke, cancer, AIDS, Alzheimer's disease, old age, accidents, suicide, euthanasia and murder or violent physical assault. Crammed with intriguing scientific findings and useful facts, as well as case histories of dying patients whom Nuland ( Doctors: The Biography of Medicine ) has treated, his report is imbued with wisdom rooted in a belief that the dignity we seek in dying must be found in the art of living life to the fullest. 50,000 first printing. Copyright 1994 Reed Business Information, Inc. From Booklist Drawing upon his own broad experience and the characteristics of the six most common death-causing diseases, Nuland examines what death means to the doctor, patient, nurse, administrator, and family. Thought provoking and humane, his is not the usual syrup-and-generality approach to this well-worn topic. Fundamental to it are Nuland's experiences with the deaths of his aunt, his older brother, and a longtime patient. With each of these deaths, he made what he now sees as mistakes of denial, false hope, and refusal to abide by a patient's wishes. Disease, not death, is the real enemy, he reminds us, despite the facts that most deaths are unpleasant, painful, or agonized, and to argue otherwise is to plaster over the truth. The doctor, Nuland stresses, should instill in dying patients the hope not for a miraculous cure but for the dignity and high quality of the remainder of their lives as well as of what they have meant--and will continue to mean--to family, friends, and colleagues. Nuland also has strong feelings about suicide and "assisted death": the doctor should be prepared psychologically and practically to help the longtime patient slip off the scene in relative comfort. William Beatty From Kirkus Reviews A sobering look at the clinical reality of death by a physician who wants it known that ``we rarely go gentle into that good night.'' Nuland (Yale Medical School; Doctors, 1988) takes the position that if we know the truth about the physical process of dying, we can rid ourselves of both our fears and our false expectations. By becoming familiar with the common patterns of illness, he says, we'll be better prepared to make appropriate decisions about continuing treatment or calling it quits. Nuland selects several common causes of death--heart attack, old age, Alzheimer's, violence, AIDS, and cancer--and, with unrelenting honesty and unsettling detail, shows precisely what happens to the body involved. His account of the decline and death of his grandmother--with whom he shared a bedroom until he was in his late teens and she in her late 90s--is unforgettable, as is his story of his well-intentioned mismanagement of the care of his older brother when he was dying of cancer. The emotional impact of these stories is quite different from that produced by the author's coldly clinical accounts (``a specific sequence of events takes place in people who bleed to death. At first, they will usually hyperventilate...''); but by demonstrating that dying is usually a messy business, Nuland succeeds in demythologizing death. His message is that the dignity we seek in dying must be found not in our final weeks, days, or moments--but in how we've lived our lives. Strong stuff: not for those who prefer to cling to comforting illusions about life's end. -- Copyright ©1993, Kirkus Associates, LP. All rights reserved. From the Inside Flap Attempting to demythologize the process of dying, Nuland explores how we shall die, each of us in a way that will be unique. Through particular stories of dying--of patients, and of his own family--he examines the seven most common roads to death: old age, cancer, AIDS, Alzheimer's, accidents, heart disease, and strokes, revealing the facets of death's multiplicity. "It's impossible to read How We Die without realizing how earnestly we have avoided this most unavoidable of subjects, how we have protected ourselves by building a cultural wall of myths and lies. I don't know of any writer or scientist who has shown us the face of death as clearly, honestly and compassionately as Sherwin Nuland does here."--James Gleick From the Trade Paperback edition. Sherwin B. Nuland teaches surgery and the history of medicine at Yale University. Read more