HOW WE DIE SHERWIN NULAND PDF

How do you decide when to give up the fight and focus on making the time you have left meaningful? Nuland, M. We should disabuse ourselves of the notion that there are definite physical or emotional symptoms which can predict with certainty that further hope of recovery is in vain. But in spite of the absence of such fool-proof substantiation of futility, there nevertheless are certain kinds of strongly suggestive evidence that almost always appear, as we are approaching the point where good sense urges that the struggle be discontinued. As time and treatment evolve in the late stages of a disease, there will come a point when our bodies begin to tell us that the benefit of the therapeutic method being used is proving itself to be less than has been predicted by the doctors. A variant of this situation is the recognition that the added suffering caused by the treatment is not justified by its meagre results.

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Yes, tool box seems like an appropriate metaphor because chemo therapy with the way it devastates the body gives the whole process of treatment a clunky rattling sense to it. Even in the best of treatment centers with the caring technicians, nurses and doctors, the process of getting well is not very pretty, doling out its share of suffering and pain.

Doctor Nuland knows this only too well and his sensitive prose explores that point in such treatment when it is best to start exploring other options, such as hospice care. It was after she was released and returned home, to die shortly after the last treatment at the cancer center, that the oncologists seem to lose interest. It takes the piss out of heroics, and science, and the Dignified Death; it harshly regards the coldness of medical personnel dedicated to solving what the author calls the Riddle and ignoring the needs of the person that provides it.

He is hard on doctors, and hard on himself. Some books please, some entertain, some disappoint. Few,though, change you, and If you are alive, and might someday die, or know anyone who is alive and might someday die, this might be one of those books you have to read.

Few,though, change you, and this is one of them. It came at a time when I needed it, when I was in the process of losing a dear family member. It made me value her life more and, also, my own.

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Sherwin B. Nuland

Like the Victorians with their hypocritical fascination with sex - that could not be talked about - Death is our modern taboo. This book is probably the best panacea for that widespread self-deception. Several chapters describe the major threats that are likely to kill most of us. None-the-less, readers can learn to be braver and age with dignity, from reading this rare book.

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