For human beings, life is meaningful because it is a story. A story has a sense of a whole, and its arc is determined by the significant moments, the… - Atul Gawande

The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that they have had an incorrect view of what makes life significant. The problem is that they have had almost no view at all. Medicine’s focus is narrow. Medical professionals concentrate on repair of health, not sustenance of the soul. Yet — and this is the painful paradox — we have decided that they should be the ones who largely define how we live in our waning days. For more than half a century now, we have treated the trials of sickness, aging, and mortality as medical concerns. It’s been an experiment in social engineering, putting our fates in the hands of people valued more for their technical prowess than for their understanding of human needs. That experiment has failed. If safety and protection were all we sought in life, perhaps we could conclude differently. But because we seek a life of worth and purpose, and yet are routinely denied the conditions that might make it possible, there is no other way to see what modern society has done.

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

Their attitude seemed to result from incomprehension rather than cruelty, but as Tolstoy would have said, what's the difference in the end?