An intriguing life

Sherwin B. Nuland, Author of ‘How We Die,’ Is Dead at 83

Dr. Nuland wrote that his intention was to demythologize death, making it more familiar and therefore less frightening, so that the dying might approach decisions regarding their care with greater knowledge and more reasonable expectations. The issue has only grown since the book was published, prompting discussion and debate in the medical world, on campuses, in the news media and among politicians and government officials engaged in health care policy.

“The final disease that nature inflicts on us will determine the atmosphere in which we take our leave of life,” Dr. Nuland wrote, “but our own choices should be allowed, insofar as possible, to be the decisive factor in the manner of our going.”

Beyond its descriptions of ruptured embolisms, spreading metastases and bodily functions run amok, “How We Die” was a criticism of a medical profession that saw death as an enemy to be engaged, frequently beyond the point of futility.

In chiding physicians, Dr. Nuland, a surgeon at Yale-New Haven Hospital for three decades, pointed the finger at himself, confessing that on more than one occasion he had persuaded dying patients to accept aggressive treatments that intensified their suffering and robbed them of an easier death. One of those patients was his brother, Harvey, an accountant who died of colon cancer in 1990 after receiving an experimental treatment with no reasonable chance of success.

Dr. Nuland wrote that he had mistakenly tried to give his brother hope, failing to acknowledge that disease, not death, was the true nemesis.

I was not familiar with his work, but was intrigued. His books are available in paperback at very reasonable prices; I ordered three today that should be here Friday. They are How We Die, How We Live, and The Art of Aging. I'll let you know what I think of them. I hope his own passing was a decent as it could have been.