“Being Mortal:” An Essential (But Neglected) Discussion in the Recovery of Christian Humanism

Having pastored a couple of churches in a big city for a number of years, I spend a lot of time visiting folks in the hospital and conducting my fair share of funerals and memorial services. Walking with people through illness and death is, for me, one of the most emotionally taxing experiences a person can negotiate. The worst of it, though, was working with people–including doctors and medical staff–who seemed to me to have too high a view of medicine and medical technology.

Don’t get me wrong. I’m as thankful as the next guy for the outstanding medical advancements that have been made in the West. I wouldn’t want to live at any other period in history on this account. But in my role as a pastor, I sometimes witnessed what seemed to me to be complications directly associated with the extreme pursuit of a new pill or another surgery.

Certainly, there are times where an unexpected injury or illness will force someone to spend their last days in the hospital doing everything they can to save the patient. But on more than one occasion, I walked with families who spent their last days in the hospital trying one more treatment, hoping for a miracle, when it would have been better to live out their final days at home surrounded by loved ones.

Whatever advancements have been made, the fact remains no matter how much hope, effort or medicine is given, everyone will eventually die, and it’s difficult to know when proceeding with or stopping treatment is the right choice. Is it right to prolong the inevitable in order to gain a few extra days or months of existence if that existence will be utterly miserable and unnecessarily taxing on the family? Of course, there is the matter of the person’s eternal state that must be considered. I don’t want to minimize that. But setting that aside for a different discussion, when do we stop trying to keep a person alive?

In his New York Times bestseller, Being Mortal, practicing surgeon, Atul Gawande, takes a fresh look at this perennial issue of aging and dying. And I can’t help but think his central premise is a helpful cure for the dying: remember medicine does not equal health care!

Medicine is a tool that belongs in every doctor’s medical bag, for sure. But medicine is only that, a tool the doctor can use to care for the health and well-being of their patients. No doctor and no amount of medicine can keep a person alive forever. And, that’s where we often get it wrong.

A phenomenon C. S. Lewis vehemently contended with during his lifetime, called scientism, is an “excessive belief in the power of scientific knowledge and techniques.” This idol has deceived many a modern man into believing medicine can save him—or at least give him 10 or 20 more years of a decent or manageable life after he’s been diagnosed as terminally ill.

But even in best-case scenarios that is not usually the case, argues Gawande. Believing this way is like resting the financial security of your family on the near-impossible odds of winning the lottery. It’s a high-stakes bet against the reasonable and humane end-of-life care. To add insult to injury, while the patient often antes into the game for a possible 10-20 year lease on life, the doctor is hoping for just a few months at best.

Gawande raises the concern that doctors too often default to betting on medicine or surgery to avoid having hard conversations with their patients. On his website, he explains, “Medicine has triumphed in modern times, transforming the dangers of childbirth, injury, and disease from harrowing to manageable. But when it comes to the inescapable realities of aging and death, what medicine can do often runs counter to what it should.”

He argues in his book that medical advancements have actually complicated old age in ways doctors have not been trained to deal with, properly. In her 2014 New York Time review of his book, Sheri Fink summarizes Gawande’s claim that,

Medical professionals are the ones who are largely in control of how we spend our “waning days,” … yet they are focused on disease, not on living. “Medicine has been slow to confront the very ­changes that it has been responsible for — or to apply the knowledge we have about how to make old age better.” The experts quoted here argue that doctors should not only treat disease but also concern themselves with people’s functional abilities, and that most medical trainees should learn about geriatrics.

As a Christian humanist, I don’t come to all the same conclusions as Gawande–particularly on the issue of assisted suicide in some remote and extremely aggravated cases; nevertheless, in that we both advocate for the flourishment of the human being rather than simply extending his existence at all costs, his argument “that the medical profession’s job is to ‘enable well-being,’ not just strive for survival,” is an essential argument in the recovery of Christian humanism.

Additionally, the questions Gawande teaches people to ask when facing the possibility of death are worth the price of the book alone. For me, these features put the book in the everyone-must-read-this-today category. I hope you will check it out.