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.

The Dishwasher’s Anxiety: The Return of the Lesser Tasks

Doing the dishes brings me (back) to the desert of the real and gives me anxiety. When I’m disconnected from the virtual world, and there are no distractions (like music or TV), and there’s no one else (like my wife) with me in the kitchen, certain thoughts, like dead fish (forgotten to be fed), rise to the surface to float among the oceanic debris of my mind. My thoughts go to where the trash is, to the center of an unremembered psychological gyre, where mental litter has been accumulating for a long time. And as I rinse the first batch of plates and arrange them on the dish rack, anxiety builds. My heart simmers in a saucepan on the gas stove.

Cutting the Umbilical Wire

Unplugging myself from the virtual world has become a little like cutting my own umbilical cord (again and again), separating myself from the pseudo-singularity that intends to keep me in its womb. But this separation never lasts long. Either the umbilical cord — wire — (like a slithering cable, a hissing electrical wire) will come after me to reconnect me to the virtual world, or, after agonizing withdrawal symptoms, I will seek the teat of the (omnipresent, omniscient) machine and start sucking on it.

The artificial universe keeps me busy. It keeps me entertained. It keeps me away from myself, whom it would be hell to spend time with.

[We’ve become like whales. The artificial universe is our sea. We still come up for air, but we are sea animals now.] [We are like foie gras ducks. We allow the ramming of virtual pipes down our eye sockets and ears to enable the pumping of massive amounts of content into our brains.]

But it’s important to note here that disconnecting from the internet is not enough to exit the hyperreal, to reenter raw reality. If the TV is on, or if there’s music playing in the background, I am still in the hyperreal. I must exclude everything from the setting that can interfere with my mind’s idleness — or, to put it differently, for this to work, to experience the anxiety of a man washing the dishes, my mind must be “unassigned,” idle. Only then can the mind drift and, often without the slightest intention, find itself at the center of the psychological gyre, the Atlantis that can only be found when we are lost in the sea of Kierkegaard’s doppelganger’s infinite resignation. Land ahoy! Here it is, then, finally, the island made of everything we’ve thrown (tried to throw) away.

Here, I expect that some of you will say, “But we know you. You spend much less time staring at screens than many of us.” You are right, and this changes nothing. I still (unconsciously and sometimes consciously) keep myself from rediscovering Atlantis. I do this by getting wasted, by constantly intoxicating myself with booze, books, and other boredom-repelling activities. No one wants to stay in the desert of the real, which is exile, or a penal colony of sorts that is paradoxically (the nauseating) freedom (we all cower from). So, like almost everyone in this technologically advanced, becoming world, I am almost always in the hyperreal. It is only when I do things like washing the dishes (without distractions) that I enter the process of exiting the hyperreal: this process is the anxiety I’m talking about.

The Dishwasher’s Anxiety

This anxiety (of a man doing the dishes without distraction) is too intense for me — it’s unbearable. (Is this why dirty dishes pile up in the sink when it’s my turn to do them?) One can only wash so many mugs, spoons, forks, knives, pots, and plates without coming face to face with the [unnamable] that human progress strove to leave behind.

In addition to the above, the anxiety I’m talking about seems to be powered by postponement. It isn’t procrastination because the mind is never idle, and we are always “working.” There’s always something “more important” (which is, in fact, less important) to do, and that’s what we’re continuously preoccupied with. The mind never finds time for defragmentation. (Sleep is not enough since it happens automatically in the subconscious. Conscious, deliberate defragmentation is also needed.) Unfortunately, we constantly postpone things we ought to deal with. We let these things die (like fish) and, as they (remain uneaten and) slowly decompose, join the accumulated trash at the center of our polluted psychological gyres.

“I do not have time for this,” our busy mindset keeps repeating. “I will deal with this later,” we keep saying. We focus on the “important” or more “urgent” things while we postpone going to the dentist or the doctor, postpone spending quality time with the wife, postpone the confrontation with the person who’s been bothering us, postpone the planned dinner with the parents, postpone the call with the mother, postpone the happy hour with friends, postpone calling the plumber or the electrician, postpone dealing with this little issue and that little issue, et cetera, ad infinitum. And when the more “important” and more “urgent” tasks are completed, we find ourselves too exhausted to take care of what we postponed.

In other words, we postpone certain things to prioritize certain other things, and later, the time comes for us to deal with the corpse (or the ghost) of what we postponed more than we should have, which gives us the dishwasher’s anxiety when we, well, do the dishes.

But that’s not all. There are more things to consider. There’s also [The repression of the awareness of death: we do not think about our death; we only acknowledge our eventual death in passing. After all, who has time to look at the hourglass, to count the slipping sands of time? Who is willing to waste their finite time to contemplate mortality?] And also [The repression of the absurd: we do not think about the meaninglessness; we merely acknowledge it in passing as if it’s an acquaintance we’ve never had (or will never have) a conversation with.]

The Fear of Missing Out

While I’d like to exit the hyperreal, I do not want to live exclusively in the desert of the real, where the anxiety is. Of course, in the universe of raw reality, the anxiety ultimately dies away if you stay there long enough. However, in this universe of raw reality, there will come a time when you’ll have to dump your humanness and return to being an animal or worse, a god. And that is not the path I want to take, for I wish to remain human.

And, no, I don’t think that if I stay where the anxiety is and keep searching, I will find Easter eggs that so many gamers love to find. I know I won’t unlock new levels. And I won’t uncover the “hidden” truth, will I? Will I uncover the “hidden” truth? Or is it because I already know the yet-uncovered “hidden” truth that I don’t want to dwell there too long? Or is it the “fear of missing out” that brings me back to the artificial universe? After all, whatever is interesting — or is talked about — is already uploaded or simulated in it.

The fear of missing out (FOMO) is a trending disorder, for sure. And one of the components of this anxiety that visits me when I’m washing the dishes is FOMO. But FOMO isn’t just the fear of missing out. I would like to redefine it, adjust its definition a little. FOMO is also the fear of having missed out on something. It is also the fear of not knowing that you’ve missed something. And because everything I don’t want to miss out on is in the virtual world (or is communicated to me via the virtual world), we can say that FOMO is triggered when I go offline. Moreover, FOMO is not always about the fear of missing out on something amazing. It can be something terrible, too. For instance, when I’m doing the dishes, I may think of the following things: “What if something happens to a family member, and I’m not there when they message me?” “What if I get an urgent email that I need to action on immediately?” “What if Israel has launched a large-scale attack and is now invading Southern Lebanon while I’m here soaping tea spoons and coffee mugs?” To be connected is to have access to (overwhelming) knowledge that you may or may not need. (And knowledge isn’t power, by the way.) On the other hand, to be disconnected is like swimming in the ocean at night, waiting for something from underwater to tickle your foot and make you shit your pants — or, in this case, your shorts.

The Return of the Lesser Tasks

This inner turmoil, this restlessness, this fear comes when I start soaping the second batch of dishware and silverware. It means that I’m now spending time with myself. And all the “secondary” tasks I previously postponed now occupy my thoughts. I feel guilty, and I worry about the consequences. Here they are, the ghosts of overdue tasks (and things that I wanted to do but didn’t), haunting me. It’s too late to do them now, and I have to decide whether I let them rot in my head (as buried potentialities) or do them anyway by saying, “It’s better too late than never.”

But I must now return to the artificial universe, which is the universe that man made. So, the house he built became his home. And he is home when he’s neither fully in the physical world nor fully in the virtual world. We’re only home when we’re in the hyperreal. But like the occasional hike in nature, it’s good to visit the desert of the real sometimes. It’s good to smell the flowers that bloom in fear. It’s good to hear the birds sing what we can never understand.


This piece was originally published on my Medium account on February 28, 2024.

Quotes from Ernest Hemingway's The Old Man and the Sea and Notes

One Lesson You Learn Reading Ernest Hemingway’s The Old Man and the Sea

I like to describe The Old Man and the Sea as Ernest Hemingway’s Moby Dick. After all, it’s about an old man going after a giant fish. Am I right?

The first time I read it, I was in my early twenties. I didn’t like it much. The second time I read it, I was in my early thirties. I liked it a little better that time even though reading it was a little like eating sauceless boiled spaghetti – as is.

But there’s this one killer paragraph that I keep coming back to. This paragraph makes the whole novel worth reading. It will sneak inside your soul and slowly, very slowly, change you.

Actually, I opened the book today looking for this paragraph that I’m telling you about. It was like I needed to read it.

The paragraph says:

You are killing me, fish, the old man thought. But you have a right to. Never have I seen a greater, or more beautiful, or a calmer or more noble thing than you, brother. Come on and kill me. I do not care who kills who.

– Ernest Hemingway, The Old Man and the Sea

What do we learn from this?
Well, let me put it this way and motivate you as I simultaneously motivate myself:

Go after what you want.
Go after something big, something beautiful, something noble.
Go after it with all you have – mind, body, and spirit.
Do everything in your power.
And then, do everything in your power again.
Risk everything.
Do it.
When you inhale, it’s this dream that fills your lungs.
Do it.
It doesn’t matter if you come out of it a winner.
If you give it all you got, if you really give it all you got,
it’s all that matters.

As you chase your dreams, it’s okay to say, “You are killing me, fish.”
Because, like Charles Bukowski once put it, “Find what you love, and let it kill you.”
And as Samuel Beckett once put it, “Ever tried. Ever failed. No matter. Try again. Fail again. Fail better.”