This is a book for someone who wants a clear eyed, honest assessment of western medical practices around terminal illness. Dr. O’Mahony believes we are mostly starry eyed when we talk of a good death. In his practice, he seldoms sees this. He sees the multiple interventions that medicine makes as the patient comes closer to death. He is not a fan – not even of CPR. He contrasts this with his observation of how doctors who are given terminal diagnoses act. Mostly, they get their affairs in order, enjoy the time left to them and do not have medical interventions. He points out that what death can teach us about living our life needs to be understood before we come to the end – so we can change what isn’t working about our lives, so we can do more of what is.
He is championing what is called Slow Medicine. Citing the fact that most people can now be diagnosed with something wrong, and that medicine exists to correct that, even if it isn’t really needed for a full life, we are all somehow the walking ill….. A growing resistance movement is emerging t counteract this. An Italian doctor listed the characteristics of current western health systems: “complexity, uncertainty, opacity, poor measurement, variability in decision-making, asymmetry of information, conflict of interest, and corruption.” There is a similar movement in the US called “Choosing Wisely” Their website – choosingwisely.org – will give you information on what many doctors feel are truly necessary procedures and medicines, as opposed to those over prescribed, not based on evidence and not a duplicate of things you’ve already tested, tried or taken.