Mar 17, 2016

John's Immortal Evening

men's book club group discussion review Being Mortal Atul Gawande
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.