….Here are some links.

Atul Gawande knows how to stop the spread of coronavirus when we reopen.

A VP at Amazon resigned in disgust due to the treatment of whistleblowers about the treatment of warehouse employees. Word.

God, Anne Carson rules.

Why we miss our weak ties so much in the age of COVID.

COVID has added a new clause to America’s racial contract.

Jaya Saxena signs up for oodles of online experiences, and reports back.

G….osh, I have learned some things about author Emily Giffin this month.

Antarctican isolation offers the perfect opportunity to observe a new accent as it forms. Antarctica also offers insight into why people are starting to go extra crazy in these exact days that we are now in.

SL Huang considers the vagaries of genre labels (as a writer whose books straddle the line between SF and thriller).

The hero our quarantine needs: The filmed staged version of Hamilton (with the original cast!) is coming to Disney+ on July 3rd.

The translation of women by women is a feminist project.

If you’re like me and have been mopity-moping around since 2013 about the lack of new Sarah McCarry books, your struggles are at an end!!

What are you up to these days, my lovely friends? Has anything from the internet particularly tickled your fancy? Drop me a line and tell me all about it!

The post Atul Gawande Saves the Day with Common Sense: A Links Round-Up appeared first on Reading the End.

This has been the persistent pattern of how modern society has dealt with old age. The systems we’ve devised were almost always designed to solve some other problem. As one scholar put it, describing the history of nursing homes from the perspective of the elderly “is like describing the opening of the American West from the perspective of the mules; they were certainly there, and epochal events were certainly critical to the mules, but hardly anyone was paying very much attention to them at the time.”

The excerpt I read from Being Mortal in the New Yorker dealt with the astonishing rarity and efficacy of conversations about end-of-life care, about which more in a minute. But the book ranges far more widely than just the choices you make when there are no choices left. Gawande explores the history of elder care in America, from home care to nursing homes to assisted living. As the quotation above indicates, much of this history is about adapting to impossible circumstances in ways that were never intended to become permanent, but then they did anyway.

As is typical from what I’ve read of Gawande, he doesn’t place blame anywhere in particular. He himself has been on several sides of this issue: As the son of an aging father, he experienced for himself the difficulty of initiating a conversation about the circumstances under which his father wanted to be kept alive or not kept alive. And as a doctor, he has found himself confronted with patients and families who sacrifice realism for hope, always chasing after the next treatment, no matter how dangerous, because of the slim chance of a cure.

One solution to this is for families to have serious conversations with their aging loved ones about what they want. Gawande tells the story of Susan Block, whose father says that he is willing to stay alive as long as he’s able to sit in his chair and watch football on TV. Gawande’s own father wants more, including some level of self-sufficiency over his bodily functions and the strength to see and visit with his friends and relations.

More broadly, Gawande recommends that aging (or fatally ill) patients receive access to specialists in elder care, who can discuss their wishes with them in a specific and caring way. Though it’s a higher upfront cost, access to such specialists cuts way back on emergency room visits and medical expenses, and patients who receive it live 25% longer than the control group.

The main argument here is that the American separation from death and severe illness has left us in a place where we’re unwilling to have the hard conversations about mortality. And according to Gawande, the emotional and financial costs of our reluctance are substantial.

Recommended! But, extremely sad. Gawande is perfectly right that I do not want to think about these matters in relation to my own very beloved family members.

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