On being Mortal - Guess what? You're dying

book-notes
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Bad news, you’re dying, so is everyone else. Good news, if we didn’t die we’d run out of resources, and our kids would be screwed. Bad news, our health care system is optimized for keeping you alive, not for maximizing the enjoyable time you have on earth. Good news, knowing is half the battle - armed with this knowledge you can decide how you want to die, which is ultimately how you want to live.

This is my summary of on being mortal by Atul Gawande, also author of the Checklist manifesto.

My last year

Before we get into it, lets see my aspirations for my last year.

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The book

Introduction

The Independent Self

Things Fall Apart

Dependence

This is the most depressing chapter of any book I’ve ever read. It’s the only attempt I’ve ever seen to describe the act of body falling apart in death. Here’s the opening paragraph - and it gets more and more engaging and believable for the next 30 pages:

*It is not death that the very old tell me they fear. It is what happens short of death—losing their hearing, their memory, their best friends, their way of life.

Old age is continuous series of losses. Old age is not a battle, it is a massacre.

With luck and fastidiousness—eating well, exercising, keeping our blood pressure under control, getting medical help when we need it—people can often live and manage a very long time. But eventually the losses accumulate to the point where life’s daily requirements become more than we can physically or mentally manage on our own. As fewer of us are struck dead out of the blue, most of us will spend significant periods of our lives too reduced and debilitated to live independently. We do not like to think about this eventuality. As a result, most of us are unprepared for it. We rarely pay more than glancing attention to how we will live when we need help until it’s too late to do much about it.*

Assistance

A Better Life

Letting Go

Hard Conversations

Health span vs lifespan

Courage

Courage is strength in the face of knowledge of what is to be feared or hoped. Wisdom is prudent strength. At least two kinds of courage are required in aging and sickness. The first is the courage to confront the reality of mortality—the courage to seek out the truth of what is to be feared and what is to be hoped. Such courage is difficult enough. We have many reasons to shrink from it. But even more daunting is the second kind of courage—the courage to act on the truth we find. The problem is that the wise course is so frequently unclear. For a long while, I thought that this was simply because of uncertainty. When it is hard to know what will happen, it is hard to know what to do. But the challenge, I’ve come to see, is more fundamental than that. One has to decide whether one’s fears or one’s hopes are what should matter most.

Statistics

Death Rates by Cause

  • Baseline morality rate 0.9%
  • US deaths/year 2.8M Heart: 23%, Cancer: 22%, Accident: 6%, Suicide: 1.5%
  • US deaths/day: 8,000
  • Rating From 25-35: Accidents; Homicide; Suicide
  • Global deaths/year: 56M
  • Global deaths/day: 150K

2017 Cause Of Death By Age Summary, Data Notes:

  • Other is 30% of deaths, and not included
  • Infants are excluded
  • Age is range between previous and current e.g. 24 implies 15-24
  • You can download the excel yourself, and play with it as you wish.

Get the raw data from:

Probability of death given current age

Death

When I get old

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Quotes

  • Grandfather dies, Father dies, Son dies - A very true blessing.
  • “Saving your money for retirement” is like saying “save your sex for retirement”.

Other resources