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Book Review: How We Die: Reflections on Life’s Final Chapter

No matter the subject or genre, an author with a command of the language and a gift of storytelling can make a book sing. One such writer is Sherwin B. Nuland, a surgeon and National Book Award winner. My introduction to his writings came years ago when a friend gave me a copy of How We Die: Reflections on Life’s Final Chapter.

With the constant media coverage of the Terry Schiavo case and the non-stop dialogue regarding right-to-die issues, it was only a matter of time before my experience reading Sherwin B. Nuland’s 1994 National Book Award winner How We Die surfaced. I imagine, given the current national debate, I am not alone. Make no mistake, this is a powerful book. Nuland provides a frank discussion of how we, meaning our bodies, die.

In 1994, I spent Christmas weekend on a death watch. My best friend, having been diagnosed with multiple cancers, had, on that Friday, begun the descent into renal failure and the final stages of his life. A close friend, also a nurse with ER and hospice training, stopped by the hospital, pulled his chart and explained what was happening and what I could expect. She then gave me a copy of How We Die and explained that my friend was on "comfort care" and was listed as a DNR (do not resuscitate). She thought the book would help me through the coming hours.

All I can say is that it was a god-send. Although Nuland, a Yale physician with a great gift of language, didn’t pull any punches, I found the book a comfort because it did, indeed, help prepare me for what was to come. When my friend’s breathing changed, I understood where he was in the process. When those final moments arrived, I was able to meet his gaze at the moment of death and not flinch.

Did reading the book spare me any grief? No. But it did help me understand what had happened to my friend and to his body. Nuland talks of a cancer cell as being in an arrested teen hormonal development stage; it’s ravenous and single-minded. For the first time I truly grasped exactly what was happening to my friend’s body. How We Die is not written in a dry, clinical style but, instead, is written compassionately with personal stories and examples. Nuland does not hold back. He tackles heart attacks, cancer, Aids, Alzheimer’s, assisted suicide and euthanasia. He relates stories that deal with the illnesses and deaths of those closest to him and of those who were his patients.

Nuland’s command of the language and his gift as a great storyteller, provide him with the necessary skills needed to write a book that is intended to bring the reader face to face with death. It’s been eleven years since I’ve read How We Die. With parents who are approaching ninety and as an only child, I am once more moving into a phase of life where these issues become very personal. If you are curious about these issues or you are coming face to face with friends and family members who are struggling with these issues and the various illnesses that wreak havoc on the body, Nuland’s bestseller How We Die could prove to be a good and necessary read.

(Note: this review has been posted to Blogcritics.org.)


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  • Deborah Whitaker

    Even though the topic of your book review is a sad one, Vikk, this is a beautiful reminiscence. It’s when you speak these kinds of truths that I am most forcibly reminded of what an exquisite writer you are.
    I’ll be keeping good thoughts for you and your parents.
    Deb

  • Deborah Whitaker

    Even though the topic of your book review is a sad one, Vikk, this is a beautiful reminiscence. It’s when you speak these kinds of truths that I am most forcibly reminded of what an exquisite writer you are.
    I’ll be keeping good thoughts for you and your parents.
    Deb

  • http://clear-lake-reflections.com Mark

    I’m helping care for an 89 year-old grandfather with cancer. Maybe I should read this book. Thanks.

  • http://clear-lake-reflections.com Mark

    I’m helping care for an 89 year-old grandfather with cancer. Maybe I should read this book. Thanks.