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"People with serious illness have priorities besides simply prolonging their lives. Surveys find that their top concerns include avoiding suffering, strengthening relationships with family and friends, being mentally aware, not being a burden on others, and achieving a sense that their life is complete. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The question therefore is not how we can afford this system’s expense. It is how we can build a health care system that will actually help people achieve what’s most important to them at the end of their lives.”

p155, '6 Letting Go' , 'Being Mortal', Profile Books, ISBN 978-1846685828 ― Atul Gawande

— being mortal by Atul Gawande (Page 155)

“Loyalty, said [Josiah] Royce, “solves the paradox of our ordinary existence by showing us outside of ourselves the cause which is to served, and inside of ourselves the will which delights to do this service, and which is not thwarted but enriched and expressed in such service.” (Josiah Royce, 1908, The Philosophy of Loyalty)” p126, '5 A Better Life' , 'Being Mortal', Profile Books, ISBN 978-1846685828 ― Atul Gawande

— being mortal by Atul Gawande (Page 126)

"The only way death is not meaningless is to see yourself as part of something greater: a family, a community, a society. If you don’t, mortality is only a horror. But if you do, it is not.”

p126, '5 A Better Life' , 'Being Mortal', Profile Books, ISBN 978-1846685828 ― Atul Gawande

— being mortal by Atul Gawande (Page 126)

“Gradually people started to accept that filling Chase [Memorial Nursing Home] with life was everyone’s task And they did so not because of any rational set of arguments or compromises but because the effect on residents soon became impossible to ignore: the residents began to wake up and come to life.”

p122, '5 A Better Life' , 'Being Mortal', Profile Books, ISBN 978-1846685828 ― Atul Gawande

— being mortal by Atul Gawande (Page 122)

"[Bill] Thomas laid out the thinking behind his Proposal. The aim he said, was to attack what he termed the Three Plagues of nursing home existence: boredom, loneliness, and helplessness. To attack the Three Plagues they needed to bring in some life. They'd put green plants in every room. They’d tear up the lawn and create a vegetable and flower garden. And they’d bring in animals."

p116, '5 A Better Life' , 'Being Mortal', Profile Books, ISBN 978-1846685828 ― Atul Gawande

— being mortal by Atul Gawande (Page 116)

So this is the way it unfolds. In the absence of what people like my grandfather could count on—a vast extended family constantly on hand to let him make his own choices—our elderly are left with a controlled and supervised institutional existence, a medically designed answer to unfixable problems, a life designed to be safe but empty of anything they care about.

p109, '4 Assistance' , 'Being Mortal', Profile Books, ISBN 978-1846685828 ― Atul Gawande

— being mortal by Atul Gawande (Page 109)

At the center of [Keren Brown] Wilson’s work was an attempt to solve, a deceptively simple puzzle: what makes life worth living whey we are old and frail and unable to care for ourselves?

p92, '4 Assistance' , 'Being Mortal', Profile Books, ISBN 978-1846685828 ― Atul Gawande

— being mortal by Atul Gawande (Page 92)

"“We end up with institutions that address any number of societal goals from freeing up hospital beds to taking burdens off families’ hands to coping with poverty among the elderly—but never the goal that matters to the people who reside in them: how to make life worth living when we’re weak and frail and can’t fend for ourselves anymore. ” ― Atul Gawande, (p77, '3. Dependence' , 'Being Mortal', Profile Books, ISBN 978-1846685828)"

— being mortal by Atul Gawande (Page 77)

"“Decline remains our fate; death will someday come. But until that last backup system inside each of us fails, medical care can influence whether the path is steep and precipitate or more gradual, allowing longer preservation of the abilities that matter most in your life. Most of us in medicine don’t think about this. We’re good at addressing specific, individual problems, colon cancer, high blood pressure, arthritic knees. Give us a disease, and we can do something about it. But give us an elderly woman with high blood pressure, arthritic knees, and various other ailments besides—an elderly woman at risk of losing the life she enjoys—and we hardly know what to do and often only make matters worse.” ― Atul Gawande, (p44, '2. Things Fall Apart' , 'Being Mortal', Profile Books, ISBN 978-1846685828)"

— being mortal by Atul Gawande (Page 44)

"“There remains one problem with this way of living. Our reyerence for independence takes no account of the reality of what happens in life: sooner or later, independence will become impossible. Serious illness or infirmity will strike. It is as inevitable as sunset. And then a new question arises: If independence is what we live for, what do we do when it can no longer be sustained?” ― Atul Gawande, (p22/23, '1. The Independent Self' , 'Being Mortal', Profile Books, ISBN 978-1846685828)"

— being mortal by Atul Gawande (Page 22 - 23)

"“This is a book about the modern experience of mortality about what it’s like to be creatures who age and die, how medicine has changed the experience and how it hasn’t, where our ideas about how to deal with our finitude have got the reality wrong. As I pass a decade in surgical practice and become middle aged myself, I find that neither I nor my patients find our current state tolerable. But I have also found it unclear what the answers should be, or even whether any adequate ones are possible. I have the writer’s and scientist’s faith, however, that by pulling back the veil and peering in close, a person can make sense of what is most confusing or strange or disturbing.” ― Atul Gawande, (p9, 'Introduction', 'Being Mortal', Profile Books, ISBN 978-1846685828)"

— being mortal by Atul Gawande (Page 9)

"The period of history during which photographs have been around has seen great social, economical and spiritual changes. Photography has been found to be the most effective way of chronicling that period by reflecting the prosaic and the dramatic, the mysterious and the ordinary - and the joys and sorrows that affect us all.” ― Paul Hill, (‘Chapter Nine: Radical Changes and the Imaging Future’, Approaching Photography, 2nd Edition, 2004, Photographers' Institute Press, ISBN 1 86108 323 8, p163)

— Approaching Photography by Paul Hill (Page 163)