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Writer's pictureJaya Julienne Ashmore

"Just simply asking people: What are your priorities?"


Atul Gawande raises questions that help us be as perfectly imperfect as we are--mortal and holding very specific things precious. He suggests that doctors ask us, "What are you priorities? What are you willing to sacrifice?" I would broaden those very questions, to help us not only die, but also live gracefully.

These very questions could help us uncover an unconditional willingness to center our lives around what we hold most precious. Not only to say, Okay, life will not be worth living if I can't act a certain way...but also to unlock ourselves from the trance of conventions, and to live now as if each moment were the first or last.

While his questions and conversations are ground-breaking and tender, let's also allow


life accommodate death in a way that brings out our willingness to be present, whether we can have our way or not.

Here are some lines from a talk he gave at the Harvard Divinity School.

"'Psychologists have shown that if you can reasonably expect to live another 20 years, you behave as if you’re immortal,' Gawande said. One consequence is that most of us don’t give enough thought to what’s most precious to us.

"He told the story of one patient who said he should be kept alive as long as he was able to enjoy chocolate ice cream and watch football on television."

"Ideas about aging and death have changed dramatically in the past century, he noted. Life expectancy in the early 1900s was just 47, a reflection of the fact that health threats loomed at every stage of life. Old age was not seen as something that increased your risk of dying, as it is today, but rather as a measure of good fortune."

"People are willing to sacrifice their health, their finances, even their lives for what’s important to them, he said, citing family, country, religion, beauty, and justice. Patients want to be at peace, often with a higher power, to have a sense of an arc to their lives, and to not be a burden to others.

"...patients and doctors are not communicating about these priorities. Such conversations are difficult and physicians aren’t well-trained in how to lead them."

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