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How We Die: Reflections on Life's Final Chapter

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Title: How We Die: Reflections on Life's Final Chapter
by Sherwin B. Nuland
ISBN: 0-679-74244-1
Publisher: Vintage Books USA
Pub. Date: 01 January, 1995
Format: Paperback
Volumes: 1
List Price(USD): $14.00
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Average Customer Rating: 4.61 (41 reviews)

Customer Reviews

Rating: 5
Summary: Frank yet compassionate book about death & dying.
Comment: What actually happens during "clinical death"? Why do we age, and what happens to the body? This National Book Award winner Particularly recommended for anyone in a position to explain these difficult processes to others. This award-winning account describes in frank yet compassionate detail just what most of us are likely to face when the time comes, Sherwin B. Nuland's How We Die combines erudition and eloquence in a refreshingly unsentimental look at the processes of death. A distinguished surgeon and gifted writer, Nuland illuminates the mechanisms of cancer, heart attack, AIDS, and Alzheimer's disease with precision and compassionate awareness.

Why read such a book? Taking away the fear of the unknown can bring courage and peace in the face of a difficult time. This book presents unpleasant facts in simple language that anyone can understand.

Chapters cover different types of death, making clear the physiological changes and medical choices that go along with each one. It addresses both medical and emotional realities of common conditions such as cancer, heart disease, AIDS, Alzheimer's, severe trauma, and just plain wearing out. (Be prepared to cry, since reading this book may make you experience feelings associated with people you love.)

What makes this book such compelling reading is that Nuland brings to this subject all of the depth and breadth of his background AND his deep concern for the human condition. His long career at a high-powered academic medical center (Yale), his knowledge of the history of medicine, of literature and philosophy, and his own personal losses are all woven into his thesis. He is thus highly convincing when he criticizes physicians for becoming seduced by the intellectual challenge of solving "The Riddle" and making recommendations not in the best interests of the patient/family.

But the power of the book is in its intensely personal depiction of these events and in the lessons which Nuland draws from his experiences. The message is twofold: very few will "die with dignity" so that (1) it behooves us to lead a productive LIFE of dignity, (2) physicians, patients, and families should behave appropriately to allow nature to take its course instead of treating death as the enemy to be staved off at any cost. Only then will it be possible for us to die in the "best" possible way--in relative comfort, in the company of those we love/who love us.

A "must read" for those of us in the baby-boomer generation who, unfortunately, are going to have to deal with a lot of what's covered in this book over the remainder of our lives.

Rating: 5
Summary: An important and sobering work about a difficult subject
Comment: This book by physician Sherwin B. Nuland is both important and sobering. In the first half, Nuland tels from a physician's eye (but with laymen's language) what happens when a person dies from cardiac failure, cancer, "old age", and other maladies. This sets up the two-part argument of the second half: (1) that death is a reality that must be acknowledged and squarely faced; and (2) that much "critical" care given to the terminally ill is the product of the physician's intellectual battle with disease (he names the diagnostician's challenge "The Riddle") and emotional reasoning on the part of both patient and family. His point -- and he makes it extremely well -- is that the dying and their families, while faced with certain grim realities, have choices concerning their final days, and some choices (both premature suicide as advocated by The Hemlock Society, and heroic efforts to prolong life) do little good and great harm. As I read this book, I thought a lot about my aging mother, now in good health, and the wrenching difficulties her final days (or years) will likely bring. Will she (and her family) have the courage to say to the doctors "no more", when the young oncologist or cardiac specialist recommends as a last resort a "promising" but excruciating course of treatment? What if her illness/disease robs her of the powers of reason and decision-making? Those in the "healing" professions should read this book, as well as those -- and I suppose that means all of us -- with elderly or ill family or loved ones. While the subject matter is depressing, Nuland's final arguments are not. Also, my goodness, can this man write!

Rating: 1
Summary: Not for the faint-hearted
Comment: This book should come with a warning label: "NOT TO BE READ BY THOSE RECENTLY BEREAVED." It is a very macabre book and will only worsen the grief.

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