"Rethinking Medicine: Treating the Whole Person, Not Just the Disease"

“Medical professionals concentrate on repair of health, not sustenance of soul:” a few simple words reframed my entire view of the medical field. I just finished reading Atul Gawande’s Being Mortal - Medicine and What Matters in the End, a thought-provoking reflection discussing our experience with medicine as we age. The idea of “treating a person as a whole,” not just their disease, wasn’t new to me, but after reading Being Mortal, I started understanding what this means in context: the wholesome decisions doctors work with their patients to make while keeping in mind patients’ hopes for the rest of their lives. 

Through this blog, I hope to share a story from the book that truly resonated with me, as well as take a deeper dive into the world of hospice care, a practice Dr. Gawande presents as a solution for centering holistic patient care. 

In the book, Dr. Atul Gawande tells the story of Alice Hobson, a grandmother enjoying her independent life in Virginia. Over time, she began to lose control over her body and experienced increasingly frequent falls. As her health deteriorated, her family decided it was best for her to have the full-time care a nursing home could provide. While she had the medical support she needed, Alice mourned her independence, leading to a depression lasting the rest of her life. 

Dr. Gawande guides his reader through wondering what Alice’s experience might have been if her doctors, nurses, and caretakers had allowed her to be independent instead of always trying to keep her on the optimal schedule for her medical health. What would her last few months have looked like if she woke up when she liked, ate when she felt hungry, and went for walks when she felt like it, rather than living by a routine prescribed by her providers? Perhaps her life would have ended sooner, but maybe she would have been a little happier. 

What if Alice had lived in a hospice care center, focused on a peaceful transition to end of life? Hospice and palliative care centers are all about providing patients with comfort during their final days through care methods such as management. Unlike Alice’s situation, where her doctors and nurses were working to treat her in the best way possible, even for the sake of her happiness, this isn’t really the case in hospice and palliative centers, where comfort is most important. 

During a conversation with my mom, I learned hospice centers aren’t just for the patients themselves but also for the families and their loved ones of these patients. Hospice centers offer families and loved ones a chance to come to terms with the fact that their loved ones is nearing the end of life. Based on this, the idea is that the most important aspect of medicine at the end of a patient’s life is that their happiness encompasses much more, including the well-being and comfort of the patient family. This thought was also one that Dr. Gawande presented through the story of a woman fighting cancer in her early thirties. After years of pushing through treatment after treatment with her family by her side, the time came that the disease just couldn’t be treated any longer. After her transfer to the hospice center, her family spent every day with her, spending time and making their final memories together while understanding her situation and that she was going to go. 

What does prioritizing happiness and comfort at the end of life look like? In a hospital setting, this involves a doctor presenting options and ideas to a patient and family and discussing them with them to make the best decision to proceed, keeping the patient’s wants and needs in mind. This allows the patient and family to feel comfortable with the doctor and make an informed decision, keeping the person “as a whole” in mind. 

Overall, I’ve learned from Being Mortal - Medicine and What Matters in the End, by Dr. Atul Gawande, that it’s important for doctors to understand a patient's background, wants, and desires as they take them through their healing journey. “In medicine, it’s not just about treating the disease; it’s about treating the person.”