Modernization did not demote the elderly. It demoted the family. It gave people — the young and the old — a way of life with more liberty and control… - Atul Gawande

Modernization did not demote the elderly. It demoted the family.

The seemingly easiest and most sensible rule for a doctor to follow is: Always Fight. Always look for what more you could do.

we need practice to get good at what we do. There is one difference in medicine, though: it is people we practice upon.

During the Second World War, for example, Lieutenant Colonel Henry K. Beecher conducted a classic study of men with serious battlefield injuries. In the Cartesian view, the degree of injury ought to determine the degree of pain, rather like a dial controlling volume. Yet 58 percent of the men — men with compound fractures, gunshot wounds, torn limbs — reported only slight pain or no pain at all. Just 27 percent of the men felt enough pain to request pain medication, although such wounds routinely require narcotics in civilians. Clearly, something that was going on in their minds — Beecher thought they were overjoyed to have escaped alive from the battlefield — counteracted the signals sent by their injuries. Pain was becoming recognized as far more complex than a one-way transmission from injury to “ouch.