*Starred Review* Distressed by how the waning days of our lives are given over to treatments that addle our brains and sap our bodies for a sliver's chance of benefit, surgeon Gawande (The Checklist Manifesto, 2010) confronts the contemporary experience of aging and dying. Culture and modern medicine encourage an end-of-life approach that focuses on safety and protection but is sadly shallow. He frets that residents of nursing homes are often lonely and bored. Physicians are keen on intervening whenever a body is diseased or broken. Yet this medical imperative applied to terminally ill individuals can be frustrating, expensive, and even disastrous. Gawande suggests that what most of us really want when we are elderly and incapable of taking care of ourselves are simple pleasures and the autonomy to script the final chapter of life. Making his case with stories about people who are extremely frail, very old, or dying, he explores some options available when decrepitude sets in or death approaches: palliative care, an assisted living facility, hospice, an elderly housing community, and family caregivers. One of these stories is the impassioned account of his father's deterioration and death from a tumor of the spinal cord. As a writer and a doctor, Gawande appreciates the value of a good ending.-- Tony Miksanek Copyright 2014 Booklist
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