Mar 17, 2016

John's Immortal Evening

men's book club group discussion review Being Mortal Atul Gawande
Acknowledgments
The meal John prepared on Tuesday would rank among our top five--if we had such rankings.  Aided by Dean, Tom, and Mark, John prepared and named the following courses, each reflecting a different sentiment evoked by our book:

Blood, heart, and liver.  Essential to our circulation, blood was transfused as bloody martinis, served from a hanging IV drip bag.  Our most important muscle, heart was rendered into skewered calves hearts sourced from a grass-fed beef producer in West Marin.  And liver was transformed into a foie gras brought in fresh from Sonoma and served on toast. A fine starting course.

Eat Your Veggies.  With this life-enhancing mandate, we weren't allowed to be choosy.  John served us a soup pureed from his own selection of organic vegetables from the farmers market.

Last Supper.  When confronted with one's mortality, only the best will do.  John obliged with a filet mignon, sous vide, accompanied by mashed cauliflower and bacon jam and smashed potatoes with caramelized shallots.

Brain Brownies.  What else but scratch brownies and vanilla ice cream topped with a bourbon and orange bitters drizzle?  Well, here's what else: for a touch of verisimilitude, mini brain lobes in the form of walnut halves atop each brownie.

Thank you, John, and we hope you enjoy your well-deserved trip to Iceland.  We also owe thanks to Paul (and his ever-patient and absent wife Jane) for allowing us, our guests, and a photographer to take over his beautiful home for a night. 

The Book
Atul Gawande's Being Mortal is one physician's attempt, in plain English, to expose our frequent resort to aggressive medical intervention as we approach the end of life.  Whether through experimental therapies, life-sustaining assistance, or institutional confinement, we too often seek to extend life without understanding the implications or the alternatives.

Gawande's presentation was disturbing and enlightening at the same time. I felt that his book was a barometer (measured by one's level of unease while reading it) for our readiness to make the hard decisions that lie ahead. Almost everyone shared his own story of family illness and death to illustrate our collective discomfort with what may be an unclear or even false choice as the end nears (i.e., quality over quantity).  While Armando, always the naturalist, read Being Mortal as a field guide to getting old, the scientist in Roy wasn't persuaded.  He found Gawande's prescriptions premature in a world of constant innovation and advancement.

Gawande's recurring question to end-stage patients is:  what do you most want and what are you willing to give up in order to get it? Illustrated by the stories of his patients, Gawande claims that quality of life is desired most and that, surprisingly, less intervention can prolong rather than shorten life.  We discussed his premise and the anecdotes sprinkled through the book (guest Mark declared the book a sales pitch for hospice care; guest Keith noted his personal connection to Sara Monopoli, one of Gawande's featured patients).  In the end, Paul pronounced Being Mortal the "most relevant" book we've read given its insistence that we set clear expectations for the end of our lives.  Tom then exhorted us to have our affairs in order by year end (with a current estate plan and advance healthcare directive).  Amen, Tom!

More disturbing than the book's focus on mortality (and Glenn's recent brush with same) was the tragic coincidence that longtime MBC friend and guest, Charlie, was killed and his wife Dorothy injured in an auto accident that same afternoon in New Jersey.  Present at our progressive holiday party in December, Charlie was a thoughtful, artistic man whose presence will be sorely missed.  Recover quickly, Dorothy.  Charlie remains in our thoughts.

RIP Charlie Kleiman

Next Up
For April, Larry made us choose between several outstanding writers: Adam Johnson (new to MBC), Annie Proulx (gasp! a woman!), E.L. Doctorow (the title--Andrew's Brain--gave it zero chance), and David Lipsky (recounting his five days with David Foster Wallace).  We went with Johnson's 2013 Pulitzer winner, The Orphan Master's Son. Here's to an evening of political and social repression, Pyongyang-style.  I trust Larry, our Dear Leader for the evening, will not visit famine upon us.

8 comments:

The Terminator said...

The food was, as always is the case with John, an adventure. The book stimulated what I think was probably the best conversation we've had at a book club meeting. This is one book that is relevant to every one of us and I think we all processed by telling our stories. Props too to John for diversity of choices of books over the years -- post-apocalyptic angst in The Road, Oyster farming in Power of the Dog, crazed academic in Self Comes to Mind, nostalgia in Thunderbolt Kid, and now harsh reality in Being Mortal. Perhaps the common theme among these books is survival in its many guises. And…wait for it…John's choices over the years seem to have the lowest misogyny quotient. Not sure what to make of that.

Jack said...

This book opened a depressing peephole into what lies ahead for me in ever approaching old age, so I was thrilled John's meal had us feasting on multiple red meat dishes, hard liquor and sugary sweets for dessert. Being Mortal reinforced for me my desire that, when it's my "time", I want to go quick. So, in that regard, I'm bringing on all the steaks and whiskey I can eat and drink as I plan to life for the now. What's the point of nibbling on salads that will only serve to send me into the sunset years of slowly declining bodily functions? ...Clearly, and more seriousy, the book struck a chord with us as I agree the discussion, as measured by the late hour, was thoughtful and heartfelt (no pun intended). And now for next month, we're on to something even more depressing than old age: North Korea! Spring Time with the ManBookClub, who's says us old geezers don't know how to have fun! -Jack

LAndow said...

I summarized the book with the words, "Carpe Diem" and certainly the evening bore that out. Thanks to John and the crew, we ate, drank and discussed like there was no tomorrow. If the fact that the discussion went on for longer than any meeting I can remember (thank you Paul and family for allowing us hang out) wasn't telling enough about the impact of the book, Being Mortal, Charlie's death brought the issue of dealing with our own demise and those we are responsible for into sharp relief. Aging will especially be an issue here in Marin. According to the 2015 Marin Grand Jury report on Aging in Marin, one in four Marin residents is over 60. In 14 years that will be one in three giving Marin another first -- the highest percentage of older adults of any county in California (see the link to the report below). We are riding the wave of our own aging tsunami.

Looking forward, next meeting is at my house April 19th. The book -- The Orphan Master's Son -- reads quickly but is just over 400 pages, so you are forewarned. The book is also about death, but this time fictionalized in the context of life in North Korea. Kimchi anyone? - Larry

http://www.marincounty.org/~/media/files/maringov/board-actions/2014/aug/201408197caoagingreport.pdf

Dan DeFrank said...

If only this book was available during the time prior to my dad's passing. Our 30-45min conversation prior to his heart surgery would have been much different. Instead of talking about the book that accompanied me, I would have asked the 3 main questions: 1 What are your biggest fears and concerns? 2. What goals are most important to you? 3. What trade-offs are you willing to make and what ones are you not? Hindsight is 20/20 and to be honest I could answer those for him. All I saw in those eyes was one scared soul, so I did what any son/daughter would do; tell him everything will be alright and think positive thoughts and we talked about Butch Cassidy. Yep, the book I was ready was "Butch Cassidy, A Biography" My dad never was the same after that surgery and fortunately somehow he was able to communicate that enough was enough. After disconnecting all the bullshit that was keeping him alive, he passed away within 10 minutes. I wish I could say I enjoyed this book, it's hard to enjoy a book that brings back memories of: could have, should have, would have, thoughts. Instead, this book was my wake up call. Thank you John and sorry I missed a very emotional meeting.

On another note, so Andrew, WTF, NY Times shows fucking interest and you can pump out a blog review in less than a week. Dude, cut the bullshit and post on the blog about my damn book, 2nd highest rating, unless you include my 9 to Thomason's book!

Finally, my dad was an MFCC and his hobby was work. So my dad's answers to the 3 main questions. He would have said: " If I can't work and help my patients then there is not a purpose for me being here." He received his wish. Yay, I said it.

Final Final: Rest in Peace-Charlie


LAndow said...

A reminder that the next MBC meeting (at my house) is a little over 2 weeks away -- April 19th. The book -- The Orphan Master's Son -- moves along, but at 441 pages in hardback not an overnight assignment. I have a library copy for anyone who wants to come by. Let me know.

For those of you who have started reading the book and find (no spoiler alert) the level of foreign kidnapping over the top fictionalization, below are URLs to actual brazen North Korean actions. The This American Life podcast segment (with the author of "A Kim Jung-Il Production") in particular seems a likely inspiration for parts of The Orphan Master's Son.

http://www.thisamericanlife.org/radio-archives/episode/556/same-bed-different-dreams

https://www.washingtonpost.com/world/for-south-korean-rescues-of-people-abducted-by-north-korea-come-with-controversy/2013/10/29/c98e0d26-38a2-11e3-89db-8002ba99b894_story.html


andrew said...

Thanks Larry. I wondered how much poetic license was being taken by Johnson, but like so much else in this book the kidnappings appear grounded in fact.

George said...

Gents, What an amazing evening. As I mentioned, I thought the book covered the subject well, but left out some of the emotional back and forth that both sides of the equation feel. That is why I recommended "Refuge" to John, as it is a more in depth look at the feelings people experience. The amazing part of the evening was the heartfelt discussion of the book and all of our related personal experiences. What a great group. I am asking my sisters to read "Being Mortal", so we may have clearer discussions with our aging parents.

Dan DeFrank said...

OK gents, I would like to retract my statement regarding my comment directed to our fearless leader. Apparently I need to pay more attention to the blog before spouting off and looking like the Village Idiot. Cheers and looking forward to seeing at the next MBC meeting.