Book Review by Cosmic Egg: How We Die (by Sherwin B Nuland)

 

How We Die (by Sherwin B Nuland)

I like to take my time reading when it comes to non-fiction and it was no different with this book: How We Die (Reflections on Life’s Final Chapter) by Sherwin B Nuland. A well-known American surgeon Nuland was at the top of his game when he wrote this book in 1993; the book that had to be written because it didn’t exist yet.

Whilst there is, by now, a fair body of work on grief there had, until that point, not been a single book on the actual physical process of dying. Written in an engaging, philosophical and honest style this is a book for the layperson as well as medical professional. Nuland covers the causes of death in the aged, some 85% of whom will die from the complications of one of the seven major entities: 

Atherosclerosis, hypertension, adult-onset diabetes, obesity, mental depressing states such as Alzheimer’s and other dementias, cancer, and decreased resistance to infection.

For the rest he covers death from murder, accidents, suicide, euthanasia and AIDS. I’d like to think that had Covid-19 existed then it would have had its very own chapter.

In the last chapter ‘The Lessons Learned’ he explains the mentality of doctors and medical specialists and why and when they give up and lose interest in ‘the case’ aka the patient. He explains the difference between the dying process and actual death and why so few of us will be granted the dying we hope for. Arising from that discussion he issues a heartfelt plea to the general public to take responsibility for their health, have some basic understanding of how their body works in health (so that they can understand the disease process), understand that a doctor has their limits and to be clear about one’s own values and spiritual needs so that one can say ‘no’ to treatments that might keep the doctor busy but add no value to one’s remaining life span.

It’s an honest and courageous account of 35+ years of medical practice, written with clarity, sensitivity and humility – a rare gem of a book. I’ll rate it 10/10.