Book Review and Quotes from Atul Gawande's Being Mortal

Notes and Quotes from Atul Gawande’s Being Mortal

This morning, I spent some time reorganizing my bookshelves before the start of my workday. Reorganizing my books relaxes me. It’s like a mindfulness session, if you know what I mean. So, sometimes, I do it for that reason alone.

When I picked up Atul Gawande’s Being Mortal: Medicine and What Matters in the End, I began to flip through its pages and went on reading the sentences I had underlined years ago. I remember loving the book. I remember reading it back when I was “studying” death: What is the meaning of death? How does the awareness and the fear of death affect us? What is the death instinct? How does one prepare to die? Etc. Besides the classics like Ernest Becker’s The Denial of Death and Sigmund Freud’s Beyond the Pleasure Principle, Gawande’s Being Mortal was one of the books I ended up reading.

Being Mortal talks about aging and the inevitable conclusion of life. More precisely, it talks about what medicine can do about these inescapable realities.

Here I am now, sharing, for no particular reason and after so many years, some of the sentences I had underlined, and they are not necessarily about death…

First Quote

Nothing that takes off becomes quite what the creator wants it to be. Like a child, it grows, not always in the expected direction.

– Atul Gawande, Being Mortal

I like this quote because it can live outside the book it was created for. Even when used out of context, it still delivers a philosophical insight. In a way, it does not need its surrounding words; on the contrary, its surrounding words become more meaningful when it is added to them… So, let us take this quote and walk out of the book for a moment. Doesn’t it make us want to ask the following: Can the creation transcend what it was created for? And is not the answer a resounding yes? Think about it.

Second Quote

The only way death is not meaningless is to see yourself as part of something greater: a family, a community, a society. If you don’t, mortality is only a horror. But if you do, it is not.

– Atul Gawande, Being Mortal

Aloneness will, sooner or later, swallow us whole if we don’t chain ourselves to an idea that is larger than life. One cannot live a fulfilling life without believing in something. As they say, a good reason to live for is simultaneously a good reason to die for.

Third Quote

All we ask it to be allowed to remain the writers of our own story. That story is ever changing. Over the course of our lives, we may encounter unimaginable difficulties. Our concerns and desires may shift. But whatever happens, we want to retain the freedom to shape our lives in ways consistent with our character and loyalties.
This is why the betrayals of body and mind that threaten to erase our character and memory remain among our most awful tortures.

– Atul Gawande, Being Mortal

Gawande repeats this idea in different parts of the book. I’d even say that he repeats it more poetically elsewhere. Don’t worry, however; the quote I chose delivers the message clearly. What Gawande keeps communicating throughout the book is that life becomes meaningful when it feels like a story. When you lose chapters of your story or when you’re no longer able to connect the dots of your self, life loses its meaning. Life doesn’t only end when one’s story ends. Life also (figuratively) ends when it ceases being a story.

Fourth Quote

Patients tend to be optimists, even if that makes them prefer doctors who are more likely to be wrong.

– Atul Gawande, Being Mortal

This is already observable with the naked eye: A person has the tendency to prefer the flatterer over the critic. But those who plan on becoming better, must eventually leave behind the former and listen to the latter.

Driving in a Sea of Clouds

A sea of clouds beneath us.
Mountain chains
like frozen shadows
of surging waves.
The setting sun sinking into the fog
reminds me of the
yolk of a hard boiled egg.
And then, there’s the silhouette of
a mountain, like an island in the middle of
the sea of
clouds, and its peak reminds me of
the tip of
an iceberg.

The steering wheel of the car I’m driving
suddenly feels like the helm of a massive ship,
and I am the captain of that ship.

And now, the car dives like a submarine
into the fog.
I turn the headlights and the fog lights on.
I turn the hazard lights on,
and
its
clicking
sound
becomes our metronome.

I drive slowly,
very slowly.

My wife is in the back seat
next to my seven-month-old son,
who’s sleeping peacefully
in his car seat.

I keep on driving,
and
I drive slowly, very slowly.
And the fog
never
ends.
We can’t see anything.
“I can’t see anything,” my wife says.
“Please, be careful.”
Will the fog ever
end?
And the fog never ends
until it suddenly
finally
ends,
and
we can see
the road ahead of us
again.



Temple of Bacchus in Baalbek, Lebanon

Unstructured Reflections on Love: Libido Transfer

Libido transfer. — To a certain extent, when someone is totally in love, (the essence of) the loved one replaces the self of the lover. We come across this in Sigmund Freud’s An Outline of Psychoanalysis, where the libido of the lover is transferred onto the object, which is the beloved. For the sake of simplification, here, let us assume that the lover in our story is (as is so traditionally) a he, and the loved one is a she. When a man falls madly in love with a woman, something in him changes. His friends notice this first and say things like, “He’s become a different man,” or in sadder scenarios, “He’s not one of the boys anymore.” They don’t understand the transformation their friend is going through because they haven’t been struck by love yet themselves. According to the lover’s psyche, the beloved is no longer a separate individual; reversely, he no longer represents himself alone. The representations (or the qualities) of her self are merged with his, and his actions now represent the synthesis of his self and hers. Love makes him an extension of the person he loves. Then it goes further than that. It is not enough that their souls are entangled and have formed a Gordian Knot, but instead of prioritizing his needs and desires, he now starts prioritizing hers. (Symmetrically, if the relationship is a mutualistic symbiosis, she also becomes an extension of him — after becoming more like her, he sees her in the mirror, and vice versa.) At this point, when the man has become possessed by love, his self’s independence begins to diminish. The invisible love leash chokes him when the distance (as well as the time) between him and his beloved expands. He feels incomplete, even guilty, when separated from her. He gives up his freedom, changes his habits to match his partner’s, and sacrifices whatever he must to preserve the fetters of love. And it’s not only his behavior that changes; he starts to see things from his beloved’s lens. He interprets and experiences life differently by identifying with her needs, desires, wants, ideologies, beliefs, culture, traditions, and emotions. He says, “If she’s happy, I’m happy,” or (in jest), “Happy wife, happy life.” [A test: How do you know if you are the lover or the beloved in a certain set of circumstances? If the actions of the other aim to please you, then you are the beloved. If it’s the other way around, you are the lover.] [I must add a note here: Although the lover-beloved balance between two individuals in a relationship isn’t always in equilibrium, we must remember that love isn’t a one-way relationship. In a healthy romantic relationship, there ought to be scenarios in which you are the lover and scenarios in which you are the beloved, (unconsciously) switching roles with your partner as you go. You’ll need to take turns because you cannot be both the lover and the beloved simultaneously. You can play one role at a time.] The lover must be brave, ready to take big risks. He needs that Kierkegaardian leap of faith. He needs to close his eyes and jump. To love is a courageous act. One must be ready to do crazy things for love. He must surrender to it. Unlike popular belief, a healthy romantic relationship has nothing to do with the preservation of physical or mental health. A healthy romantic relationship is a spiritual relationship that may sometimes include sacrifices such as the surrender of mental or physical health. Nonetheless, the altruistic lover who lets go of his ego altogether is not a real lover; he is a symbiote with an ego mimicking the beloved’s ego. The altruistic lover is the beloved’s machine that generates recognition and satisfaction. The opposite of the altruistic lover, the narcissistic lover, is also not a real lover; he is a parasitic symbiote. He only loves lovers, not beloveds. Those who resist libido transfer suppress (and prevent the development of) true love. They are not ready for true love simply because they are not ready to sacrifice themselves on its altar. They will not be remembered as great lovers… It is no surprise that many individuals resist transferring libido to a loved one. (Their number, in fact, far exceeds those who truly love.) They fear potential heartbreak, they lack trust in people, and they don’t want to lose themselves and their freedom. (Withholding libido transfer is the safer option for those who want to keep the self unblemished.) But when these individuals simulate acts of love by repeating what they read in books and what they see in movies, they’re not loving, they’re only playing the role of the lover. They’re playing it safe and are not really invested in the relationship. They are only showing love but not genuinely loving. Unknowingly, they are pretending to love. They don’t know that those who want to remain who they are cannot love absolutely. When the time of sacrifice comes, they’ll ask, “Why would I live for someone else when I can live for myself?” They’ll ask, “Why would anyone want to lose their self, their Ich, their ego?” While some sacrifice themselves for love, they sacrifice love for themselves. What they don’t get is this: when you love, you don’t lose yourself; you become more than yourself.