Book Review: That Good Night
Life and Medicine in the Eleventh Hour
Honest and brutal, Sunita Puri’s book is also beautiful and deeply reassuring. Dr. Puri is an assistant professor of clinical medicine at the University of Southern California and the medical director of palliative medicine at the Keck Hospital of USC and USC Norris Cancer Hospital. She’s the daughter of immigrant parents and her mother is an anesthesiologist. I mention this because her relationship with her parents is essential within the book, grounding her as a young doctor as she discovers her life’s calling: palliative care.
In That Good Night, Dr. Puri shares the story of how she came to embrace the field, which is a new subspecialty of medicine. In the West, doctors have been taught to reflexively do everything they can to preserve human life, and technology has also advanced. The result is that the end-of-life stage can become prolonged and cruel. “I wondered why I offered patients treatments that I wished they’d decline,” Puri writes, wryly. Vetoing life-prolonging treatments, even when they are futile and may cause suffering, is often taboo in medicine. Palliative care, offered by specialists such as Puri, relieves suffering physically with medication and other recommendations, but, as I discovered reading this book, also relieves by helping family members, and their fellow doctors, recognize and acknowledge when the end of life is imminent.
“They need your honesty,” she says, steeling herself prior to a difficult conversation with the family of a dying patient. Her work, which she says is “in the borderland between life and death,” will change how you see mortality and end-of-life decisions, and how you discuss these subjects with loved ones. —KDW