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The Art of Dying Well: A Practical Guide,  by Katy Butler.

April 30, 2019

The Art of Dying Well
The Art of Dying Well: A Practical Guide,  by Katy Butler.  Scribner’s, February 2019.

5 stars—Favorite

Simple philosophy and practical suggestions for retaining a measure of choice and self through our final decades.

“People who are willing to contemplate their aging, vulnerability, and mortality often live better lives in old age and illness, and experience better deaths, than those who don’t.”

Katy Butler is an American journalist, writer and speaker, best known for her innovative ideas about death and dying.  She was born in 1949 in South Africa and grew up in Boston and England before earning a B.A. from Wesleyan University.  Her journalism began in the San Francisco area and has expanded to include a wide variety of writings.  Her memoir, Knocking at Heaven’s Door, described how her father’s death became particularly difficult when his pacemaker remained active after his brain stopped functioning.  This book lifted her into the forefront of medical reformers where she has written and spoken widely and at prestigious institutions.

In The Art of Dying Well, Katy Butler has written an important and unusual book about death and dying.  She does not denounce the medical profession.   She simply suggests ways to avoid “reducing dying to a medical procedure and stripping it of ceremony and humanity.”  Analyzing the ways in which the American medicine prioritizes technological fixes over the needs of the whole person, she lays out what we need to do to protect our dignity and desires. As she argues, doctors should be our consultants not our bosses.

Butler takes readers, decade by decade as we age and our needs change and increase.  She points out that more hospital-level care introduces its own dangers to those who are fragile and vulnerable.  She warns us about the real dangers that elders face during hospital stays, surgery, or other medical procedures.  Her research reveals that the stories we hear are real. As we age, our bodies and their minds can no longer be assumed to withstand stresses and chaos that younger people tolerate easily.  Choosing less medical attention rather than more may prolong functionality and even life itself.

As we begin to notice that we are aging in our fifties and sixties, Butler advises us to think about where and what we will need as we age.  We ought to think about being in a supportive network of family and friends with whom we can exchange care. Medical coordination and flexibility is key.  If we are not able to find an old-fashioned family doctor, we can try to find someone, professional or not, who can help us balance the often contradictory dictates of multiple specialists.

Throughout the book, Butler maintains that there is no one way to “die well.”  Many of us will have to cobble together ways to get what we need.   We will need to plan ahead as much as possible.  Even more, we will need to face the reality of what is happening.  Spirituality is important.  Her own religious commitment is Buddhism, and she offers workshops and meditation groups in that tradition.  In The Art of Dying Well, however, she is supportive of religion without pushing her own choices.   Instead she envisions her readers as people who can create and find something more.

They make peace with the coming of death, and seize the time to forgive, to apologize, and to thank those they love. They rethink the meaning of “hope.”

The Art of Dying Well is an important book and one that needs to be read widely as we personally face our own deaths and the deaths of those we love.  It is also important as we consider what we need as a society and nation to provide for the good of us all.

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