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    How We Die: Reflections on Life's Final Chapter
    Unavailable
    How We Die: Reflections on Life's Final Chapter
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    How We Die: Reflections on Life's Final Chapter
    Audiobook (abridged)2 hours

    How We Die: Reflections on Life's Final Chapter

    Published by Penguin Random House Audio

    4/5

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    Currently unavailable

    Currently unavailable

    About this audiobook

    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.

    LanguageEnglish
    PublisherPenguin Random House Audio
    Release dateFeb 27, 2007
    ISBN9780739354391
    Unavailable
    How We Die: Reflections on Life's Final Chapter

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    Reviews for How We Die

    4/5

    237 ratings19 reviews

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    • 4/5
      In When Breath Becomes Air, Paul Kalanithi recommended this book so I sought it out and read it.

      Taking a tour of heart disease, Alzheimer's, AIDS and cancer, Dr. Nuland presents a dispassionate, yet compassionate, review of what doesn't make us stronger.

      It was good to learn that my late father's always-joke was pretty much true. When asked for anyone's cause of death, he would invariably say, "they stopped breathing."

      I can't really put my finger on my recent interest in death, its mechanics, its impact although I'm guessing my father has plenty to do with it. Still, this demystification of our necessary ends is oddly comforting and bracing.
    • 5/5
      I can't remember the last time a nonfiction book left me teary-eyed. There is profound wisdom in this 1994 book borne by the author's many years of observing people die. He says that death and dying is grim, and the idealized peaceful and quiet good death is rare, and more so these days because biomedical science has foisted upon people false therapeutic hope that leave them dying alone in hospitals among medical personnel who are strangers. Solitary death, the author says, is now the way most of us die because of this false therapeutic hope inadvertently peddled by doctors who are emotionally unprepared to be more truthful to their patients about the inevitability of death.
    • 2/5
      Short book, author describes death as a natural
      process. He’s a pro-choicer for those wishing to commit medical suicide. Nothing profound here. Not worth an audio credit. Writing was ok, but it’s missing more detail and neutrality. Not a piece of work that strikes you; rather a discussion on an interesting topic full of opinions and not much biological detail.

      1 person found this helpful

    • 4/5
      Reflections on Life's Final Chapter - we don't have full reader's rights with the "book" Nuland discusses. Once it's started, it has to be finished. Dr. Nuland shows his breadth of knowledge in his many quotes and is himself highly quotable. He knows how to turn a phrase, as in "the operative obscurities" and "the Riddle (cause of disease) is the doctor's lodestone as an applied scientist; it is his albatross as a humane caregiver." It's good to see more people looking squarely at the issues surrounding death and dying.
    • 2/5
      How We Die is a non-fiction book whose title accurately describes it's content. Each chapter of the book is devoted to one of the handful of most common ways Americans die (some illnesses have two chapters devoted to them), including heart disease, cancer, old age -- which included quite a bit of information about strokes -- murder and suicide, accidents, AIDS, Alzheimers, etc. The last chapter talks about the lessons learned and has some nicely worded messages about preparing for death. Overall, I think it's good this book exists for those who are curious about these common diseases. I would caution, though, that it was written in the 90s and science changes rapidly -- most notably the Alzheimers chapter(s) appear outdated as they refer to DNA tests that will be available in the future, but those tests are available now. Also, it's ungodly depressing reading if you aren't seeking it out (I read it for book club) because you have an interest. Because the writing felt choppy and was over-laden with scientific jargon the normal reader would have a hard time wading through, I'm giving it a 'meh-minus' rating of 2 and 1/2.
    • 4/5
      Not the most pleasant of subjects to address, but sooner or later we will all share the common unpleasant experience. Dr. Nuland takes us through a number of interesting and in some aspects stark realities of how we die and some of the controversies surrounding it. Dr. Nuland covers a fairly wide range of topics one being the somewhat romanticized version of drawing our last breath peacefully surrounded by our loved ones. Most cases in reality he says are nothing of the sort as the long drawn out pain and suffering comes to an end for the individual and shock of the witnessing loved ones. Not a pleasant scene to look forward to. If ones death can be framed that way.Another aspect he delves into is the doctor and his relentless pursuit of saving the patient, not to mention the tab that is rolled up. Hope against hope we are pushed through the process of every last measure to our needless prolonged suffering in the cause of medicine. To me it seems barbaric but maybe I will have a different opinion at the time, but it is state of the art for now.The inevitability of death and taxes is real and we must be prepared to face it as best we can. The book sheds light on things we need to consider now before are time has come. It is my hope that as us large group of Baby Boomer heads down this road the laws and ethical considerations of the easy way our will be addressed better. We should have more choice in bringing the end when it is certain. It seems absurd to me that so many are forced to endure the suffering and pain of their demise, yet convicted murderers sentenced to death exit in a dreamlike sleep.

      1 person found this helpful

    • 5/5
      This is a fantastic book. The author's purpose (in my opinion) is to de-mystify both the causes and process of death. A great deal of the book is is devoted to discussion of the chemical and molecular processes that happen when mortal illnesses, such as cancer and AIDS, arise. By doing this, the author removes the emotional aspect of death and reduces it to merely another process in nature.

      Having presented the clinical perspective of death, the author than reintroduces the emotional perspective. He does an incredible job of examining the tension that often exists between the physician (and sometime loved ones) who are completely focused on "defeating" death and the patient. If the patient is complicit in the desire to extend life at any cost, this tension is minimal at most. If the patient has accepted the imminence of their death, this tension can be great. The author illustrates the latter situation with several personal examples.

      I would highly recommend this book to everyone. Death is not optional, and the better we prepare for the eventuality of it with ourselves and especially our loved ones, the easier the process will be for all concerned.
    • 5/5
      This book is an invaluable guide to deciding on how to care for we love as they approach death, and to thinking about (and planning for) our own deaths. I first read it back in the 1980's, and found it both fascinating and frightening. Dr. Nuland illustrated very clearly that most of us are unlikely to go gentle into that good night, and discussed very movingly how that fact conditions the choices we will have to make . At the time, however, this did not seem terribly relevant to me -- I was, after all, just moving into middle age. . Now, however, I am over 70, and it is an extraordinarily relevant book. Last month, I reread it in the revised edition, as a dear friend for whom I have been responsible came to the end of her life. I only wish that I had read it earlier in this process. What Dr. Nuland said in the 1980's, and again in the 1990's, is still true. All too often, the American medical system still doesn't recognize that some illnesses cannot be cured. A dying patient may be subjected to procedure after procedure, and treatment after treatment, in a vain effort to avoid the inevitable. Hospice may not be called in until the very end, because the doctors and the patient and the patient's family are still focussed on treating the illness rather than the patient. The result is pain, discomfort and disorientation that might have been avoided. Had I realized just how entrenched this bias still is, I would have insisted that chemotherapy be cut off sooner than it was, and that my friend go on hospice sooner than she did. For the future, this book -- and my recent experience -- convince me that if I am diagnosed with a cancer that is likely to kill me, I will enlist a palliative care doctor on my medical team from the start. I only hope that I will find one with a fraction of Dr. Nuland's empathy and understanding.
    • 5/5
      This is partly a biological description of the process of dying, partly a memoir of his personal experience with death, partly an expose of the medical system, and partly a philosophical musing. All aspects are very well done. It's not exactly comforting other than the comfort of truth.
    • 4/5
      This is an excellent, compassionate and helpful book. It was a bit hard to take at times in the beginning: it is unsparing in making its readers confront our greatest fear. But in the end the clinical detail is helpful, and I found the accumulation actually almost soothing. It "tells it like it is" and at the end you feel more prepared.I read it during a close relative's probably terminal illness, and I found it clarifying and comforting. Thank you, Dr. Nuland.
    • 4/5
      I quit smoking after reading this book, so if you are trying to give up you may want to consider it :-)

      Nuland writing is very easy and entertaining, and he goes over the main causes of death which are more likely to see us out - no, it is quite unlikely that we will pass away peacefully in our sleep.

      Nuland goes over this by looking at specific cases he was involved in as a clinician, in a balanced way. His intention is not to scare us (if anything, he entartains the reader), and simply tells it as it is. We'll have to go through this, and there may be things each of us can do to make our demise less painful and uncorfortable.

      Informative, engaging and surprisingly enjoyable.
    • 3/5
      Sherwin Nuland vividly describes the various modes of death. He writes well and injects some emotion into the narrative by examples from his personal history. The last one-third of the book I found disappointing. I think he is missing the point in arguing for less focus on science and more on humanity. The futile attempts at control of cancer by chemotherapy he describes in the 80s were necessary precursors to the successful control of many cancers by chemotherapy today. The rise of multidisciplinary teams in the last few decades has led to a much better outcome for many cancer sufferers than patients of a dedicated humane physician in the past would have had. Pallliative care and hospices have taken the suffering out of dying for many patients. Medicine is in transition and science is driving the changes. Medicine, like most human knowledge, progresses by fits and starts, by experimentation, by serendipity. I think Nuland underestimates the good in heroic attempts to sustain life because the good is often obtained by future patients rather than present ones. Surely suffering in death, as in life, is less now than it has ever been in the past.
    • 4/5
      Excellent overview of what happens to all of eventually. Who would not be interested,if not in denial. He opposes heroic methods at end of life.
    • 5/5
      How We Die groups the myriad of biomedical ways each of us find death into categories that best explain the manner by which our bodies eventually fail. Heart failure, old age, Alzheimer's, suicide & euthanasia, AIDs and cancer are discussed in perfectly written (and translated) medical terms. Each major category comes with a handful of patient anecdotes that vividly illustrate his point. Nuland not only writes of the importance of humane treatment of patients and their families, but also of how the disease that has affected them was originally discovered, providing quite a bit of medical history.Nuland is an excellent writer and offers a book so well crafted that the result is a thought-provoking, poignant, and educational volume on death, which is "not a confrontation. It is simply an event in the sequence of nature's ongoing rhythms." (10)
    • 4/5
      Clearly written examination of the actual mechanics of human death from various common causes--heart disease, stroke, cancer, trauma, Alzheimer's Disease, and the myriad diseases that incrementally kill AIDS patients.The author also provides relevant anecdotes from medical history and thoughtful examinations of the social, ethical, and existential impact of death, dying, and suffering.I enjoyed it, but this book might be too grim for some readers, especially those with health problems.
    • 4/5
      Interesting book about the end of life, about what waiting for all of us. The medical descriptions great but when it comes to ethics or morals, it's much more weaker and arguable.
    • 4/5
      Scientific and precise but not coldly clinical or macabre. A thoughtful look at the end of life.
    • 5/5
      A phenomenal achievement - one that asks the medical profession to stop denying the reality of dying and to incorporate it into their practice. There is enough here to go around, including factoids explaining why no one has died of natural causes since 1945, and that death is caused by one thing - a lack of oxygen to a vital organ.This book led me to evaluate my relationship with my health care provider. Was a simply a bag of symptoms when I saw him? Or was this someone who focused on the whole of me? With the wisdom gained from Dr. Nuland's book, I switched to a nurse practitioner at what - in hindsight - turned out to be a highly opportune time.
    • 4/5
      I was accused of being morbid for enjoying this book so much. It's a surprisingly well written treatise on the various biological processes that occur when we die, for various causes of death. It's the kind of book that makes you want to talk about it, but I caution you -- almost any time you bring it up in conversation, you will be accused of making "the worst segue *ever*". Be warned, this book will prove difficult to put down, and it's really difficult to explain on your bedside.