Jesus talks in the Gospels about how to live your life. He doesn’t talk much about death or dying, but my guess is that He would want a good life lived well to end with grace and dignity, surrounded by loving friends and family. In light of that, Atul Gawande’s latest article for The New Yorker entitled “Letting Go” is something everyone should read.

My quick synopsis: despite all of our advances in medicine and development of new drugs, we are actually diminishing the quality of our endings. Two passages really hit me:

“Twenty-five per cent of all Medicare spending is for the five per cent of patients who are in their final year of life, and most of that money goes for care in their last couple of months which is of little apparent benefit.”

And, this note on hospice care:

“Like many people, I had believed that hospice care hastens death, because patients forgo hospital treatments and are allowed high-dose narcotics to combat pain. But studies suggest otherwise. In one, researchers followed 4,493 Medicare patients with either terminal cancer or congestive heart failure. They found no difference in survival time between hospice and non-hospice patients with breast cancer, prostate cancer, and colon cancer. Curiously, hospice care seemed to extend survival for some patients; those with pancreatic cancer gained an average of three weeks, those with lung cancer gained six weeks, and those with congestive heart failure gained three months. The lesson seems almost Zen: you live longer only when you stop trying to live longer.”