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Author: Sherwin B. Nuland
Quotes of Author: Sherwin B. Nuland

Sherwin B. Nuland _ How We Die: Reflections on
The virus has robbed them of their youth, and it is about to rob them of the rest of their"
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Sherwin B. Nuland _ How We Die: Reflections of
All along the way, family members have been experiencing feelings of ambivalence, helplessness, and crisis. They fear what they are seeing, as well as what they have yet to see. No matter how often they are reminded, many people persist in believing they are permitting conscious suffering. And yet, it is always so hard to let go. Such legal instruments as living wills and durable power of attorney may function as so-called advance directives, but all too often they do not exist; a grieving wife or husband, or children already struggling with family problems of their own, are adrift in a sea of conflicting emotions. The difficulty of deciding is compounded by the difficulty of living with what has been decided.
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Sherwin B. Nuland _ How We Die: Reflections of
This is the period when hard decisions are faced by families, having to do with the insertion of feeding tubes and the vigor with which medical measures should be taken to fend off those natural processes that descend like jackals-or perhaps like friends-on debilitated people.
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Sherwin B. Nuland _ How We Die: Reflections on
It is also the recognition that the real event taking place at the end of our life is our death, not the attempts to prevent it.
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Sherwin B. Nuland _ How We Die: Reflections on
bioengineers but by those who know who we are.
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Sherwin B. Nuland _ How We Die: Reflections on
Although it is not always admitted, the hospital has offered families a place where they can hide the unseemly invalid whom neither the world nor they can endure. … The hospital has become the place of solitary death.
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Sherwin B. Nuland _ How We Die: Reflections on
the last hours. In fact, they are abandoned, to the good intentions of highly skilled professional personnel who barely know them.
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Sherwin B. Nuland _ How We Die: Reflections of
The originator of the literary form we call the essay, the sixteenth-century Frenchman Michel de Montaigne, was a social philosopher who viewed mankind through the scrutinizing lens of unadorned and unforgiving reality and heard its self-deceits with the ear of the skeptic. In his fifty-nine years, he gave much thought to death, and wrote of the necessity to accept each of its various forms as being equally natural: "Your death is a part of the order of the universe, 'tis a part of the life of the world...'tis the condition of your creation." And in the same essay, entitled "To Study Philosophy Is to Learn to Die," he wrote, "Give place to others, as others have given place to you.
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Sherwin B. Nuland _ How We Die: Reflections on
if peace and dignity are what we delude ourselves to expect, most of us will die wondering what we, or our doctors, have done wrong.
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Sherwin B. Nuland _ How We Die: Reflections of
Far from being irreplaceable, we should be replaced. Fantasies of staying the hand of mortality are incompatible with the best interests of our species and the continuity of humankind's progress. More directly, they are incompatible with the best interests of our very own children. Tennyson says it clearly: "Old men must die; or the world would grow moldy, would only breed the past again.
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Sherwin B. Nuland _ How We Die: Reflections of
I recently discussed this with my school's professor of geriatric medicine, Dr. Leo Cooney, who later summarized his viewpoint in two pithy paragraphs of a letter: "Most geriatricians are at the forefront of those who believe in withholding vigorous interventions designed simply to prolong life. It is geriatricians who are constantly challenging nephrologists {kidney specialists} who dialyze very old people, pulmonologists {lung specialists} who intubate people with no quality of life, and even surgeons who seem unable to withhold their scalpels from patients for whom peritonitis would be a merciful mode of death. We wish to improve the quality of life for older individuals, not to prolong its duration. Thus, we would like to see that older people are independent and lead a dignified life for as long as possible.
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Sherwin B. Nuland _ How We Die: Reflections on
unattended and isolated. For it is the promise of spiritual companionship near the end that gives us hope, much more than does the mere offsetting of the fear of being physically without anyone.
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