I had the absolute privilege of listening to Atul Gawande talk in 2012. This is before he had finished his book “Being Mortal”.

He is such a master story teller that I was completely absorbed in his tale of his own father’s mortality and how we fail miserably at listening to patients’ wishes at the end and create a less than ideal medical plan of care that does not offer us a good ending.

I remember him saying that, “If every human life is a book, then the last chapter matters”. It struck a cord with me. It matters how we leave this world and it matters that if our time is short, we should be offered a soft landing and not a crash and burn situation.

More often than not, as physicians, we do not allow for a soft landing. We do all we can to keep the patients alive, until they are clearly no longer ‘alive’. While there is a pulse and a detectable oxygen saturation, the body that lays in the ICU bed is far from the human being that embodied it. We don’t know when enough is enough, and we ask the family what we should do?

My hope is to start a conversation. To start a place where patients can turn to and ask pointed questions. Where physicians can turn to so that they can learn skill sets to be able to communicate the reality of patient’s prognosis. Such that patients and family can make decisions that are aligned with their wishes.

I wish there was another way out of this world. But, there isn’t. We need to support each other so that we can all be the author of our own last chapter of the book of our lives.

My hope is that I can empower us all to get there somehow.