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How We Die: Reflections of Life's Final Chapter, New Edition, by Sherwin B. Nuland
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New Edition: With a new chapter addressing contemporary issues in end-of-life care
A runaway bestseller and National Book Award winner, Sherwin Nuland's How We Die has become the definitive text on perhaps the single most universal human concern: death. This new edition includes an all-embracing and incisive afterword that examines the current state of health care and our relationship with life as it approaches its terminus. It also discusses how we can take control of our own final days and those of our loved ones.
Shewin Nuland's masterful How We Die is even more relevant than when it was first published.
- Sales Rank: #15405 in Books
- Brand: Vintage
- Published on: 1995-01-15
- Released on: 1995-01-15
- Original language: English
- Number of items: 1
- Dimensions: 8.00" h x .60" w x 5.20" l, .53 pounds
- Binding: Paperback
- 278 pages
- Great product!
From Publishers Weekly
The 1994 NBA nonfiction winner, Yale physician Nuland's study of the clinical, biological and emotional details of dying was a 14-week PW bestseller.
Copyright 1994 Reed Business Information, Inc.
From Booklist
Drawing upon his own broad experience and the characteristics of the six most common death-causing diseases, Nuland examines what death means to the doctor, patient, nurse, administrator, and family. Thought provoking and humane, his is not the usual syrup-and-generality approach to this well-worn topic. Fundamental to it are Nuland's experiences with the deaths of his aunt, his older brother, and a longtime patient. With each of these deaths, he made what he now sees as mistakes of denial, false hope, and refusal to abide by a patient's wishes. Disease, not death, is the real enemy, he reminds us, despite the facts that most deaths are unpleasant, painful, or agonized, and to argue otherwise is to plaster over the truth. The doctor, Nuland stresses, should instill in dying patients the hope not for a miraculous cure but for the dignity and high quality of the remainder of their lives as well as of what they have meant--and will continue to mean--to family, friends, and colleagues. Nuland also has strong feelings about suicide and "assisted death": the doctor should be prepared psychologically and practically to help the longtime patient slip off the scene in relative comfort. William Beatty
From Kirkus Reviews
A sobering look at the clinical reality of death by a physician who wants it known that ``we rarely go gentle into that good night.'' Nuland (Yale Medical School; Doctors, 1988) takes the position that if we know the truth about the physical process of dying, we can rid ourselves of both our fears and our false expectations. By becoming familiar with the common patterns of illness, he says, we'll be better prepared to make appropriate decisions about continuing treatment or calling it quits. Nuland selects several common causes of death--heart attack, old age, Alzheimer's, violence, AIDS, and cancer--and, with unrelenting honesty and unsettling detail, shows precisely what happens to the body involved. His account of the decline and death of his grandmother--with whom he shared a bedroom until he was in his late teens and she in her late 90s--is unforgettable, as is his story of his well-intentioned mismanagement of the care of his older brother when he was dying of cancer. The emotional impact of these stories is quite different from that produced by the author's coldly clinical accounts (``a specific sequence of events takes place in people who bleed to death. At first, they will usually hyperventilate...''); but by demonstrating that dying is usually a messy business, Nuland succeeds in demythologizing death. His message is that the dignity we seek in dying must be found not in our final weeks, days, or moments--but in how we've lived our lives. Strong stuff: not for those who prefer to cling to comforting illusions about life's end. -- Copyright ©1993, Kirkus Associates, LP. All rights reserved.
Most helpful customer reviews
193 of 202 people found the following review helpful.
Frank yet compassionate book about death & dying.
By David J. Gannon
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.
1 of 1 people found the following review helpful.
Insightful and hopeful
By Julikins
I bought this book to help me understand so that I could better assist my sister who was diagnosed with stage four metastatic lung cancer. Dr. Nuland so accurately described the behavior of physicians when they come to the realization that there's nothing more that can be done for their patient. I have seen it with the treatment of my sister by her oncologist whom she has worked with the past six years looking to find effective treatment to provide my sister with a few more years of a productive life. When the therapy worked, my sister was a miracle case, now that it is not, my sister is scheduled with an assistant and when she does see her oncologist it is for a fleeting period.
I say hopeful because Dr. Nuland not only identifies the existing problem, but examines ways in which our health care system can be overhauled.
This was an excellent book not only from the perspective of a physician, but a humane and empathetic way to look at the process of dying.
2 of 2 people found the following review helpful.
Peace in living peace in dying
By bulent
The book needs to be taken very seriously I have personally lived a tragedy recently I have lost my beloved wife during the 15 months of desperate fight against the great killer she and us has suffered all the terrible medical interventions with no benefit at all Medicine needs a totally different approach for terminal ilnesses
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