Sherwin B. Nuland.  1993.  Vintage Books.  296p.

Nuland, a Clinical Professor of Surgery, wrote this book to “to demythologize the process of dying”.  He provides unabashed details of how various conditions and diseases lead to death, from “old age because we have been worn and torn and programmed to cave in” to the devastating impacts of cancer and AIDS.

The role of the doctor as detective to find the cause of disease is well examined, but Nuland also speaks to how the conviction, even mission, of doctors to do more rather than less has increasingly pushed the “boundaries of medical futility” which may serve more “the doctor’s needs rather than the patient’s”.  Put otherwise, “We live today in the era not of the art of dying, but of the art of saving life, and the dilemmas in that art are multitudinous”.

In the 2010 coda of the book, Nuland reflects further that there should be less of a focus on payments and more on people, where doctors are increasingly labelled as ‘providers’ rather than ‘physicians’.