This year’s BBC Reith Lecturer is the American writer and surgeon Atul Gawande. Gawande, who works at Brigham and Women’s Hospital in Boston and is also a staff writer for the New Yorker, has chosen as his topic “The Future of Medicine”. His lectures will “examine the nature of progress and failure in medicine, a field defined by what he calls ‘the messy intersection of science and human fallibility’.” They are complemented by Gawande’s latest book, his fourth, which is entitled “Being Mortal: Illness, Medicine, and what Matters in the End.”
I met Gawande in London recently and talked to him about ageing, death and the need for medical practitioners to think harder about the nature of human wellbeing.
JD: Your 2002 book Complications: A Surgeon’s Notes on an Imperfect Science was about what surgeons and other medical practitioners can know with certainty. It was, you might say, a work of medical epistemology. Being Mortal, on the other hand, is a book about what it means to human, to be mortal. And also about how we—the medical profession in particular—manage mortality. You might say its focus is on metaphysics and/or ethics.
AG: Right. And I didn’t expect it to go there. I thought it was going to be about how you manage this very conflicted point—which is the decision point as you near death. But once I realised that people have priorities in their life that are bigger than just surviving and living longer, it extended a lot further… I came to see that our whole idea of what a good life is has begun to revolve around the notion that the only good life is a healthy and independent one. That was not the way people saw it in the 19th century and earlier, when your health was always at risk, when life was always fragile.
You’ve just drawn a distinction between the way we did our dying in the 19th century and the way we do it today. You also, in the book, draw a geographical distinction in these matters between the west and India, for example. Could you say a bit about that?
As I visited family and then did more formal investigation in India of what people are going through, I got to see happening…