Цитаты из книги «Все мы смертны. Что для нас дорого в самом конце и чем тут может помочь медицина» Атул Гаванде

In the end, people don’t view their life as merely the average of all of its moments—which, after all, is mostly nothing much plus some sleep. 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 ones where something happens. Measurements of people’s minute-by-minute levels of pleasure and pain miss this fundamental aspect of human existence. A seemingly happy life may be empty. A seemingly difficult life may be devoted to a great cause. We have purposes larger than ourselves. Unlike your experiencing self—which is absorbed in the moment—your remembering self is attempting to recognize not only the peaks of joy and valleys of misery but also how the story works out as a whole. That is profoundly affected by how things ultimately turn out. Why would a football fan let a few flubbed minutes at the end of the game ruin three hours of bliss? Because a football game is a story. And in stories, endings matter.

Возьмем хотя бы то обстоятельство, что нас очень волнует, что будет с миром после нашей смерти. Если бы главным источником смысла жизни были наши личные интересы, нам было бы все равно – даже если бы через час после нашей смерти все, кого мы знаем, исчезли с лица земли. Однако большинство из нас уверено в том, что случись подобное – и наша жизнь лишится всякого смысла.Смерть осмысленна, только если считаешь себя частью чего-то большего – семьи, общины, общества. Иначе мысль о смерти не может внушать ничего, кроме ужаса.

Ройс полагал, что всем нам необходим некий внешний мотив (cause), нечто большее, чем мы сами. Он считал, что это неотъемлемая человеческая потребность. Мотив может быть масштабным (семья, страна, какой-то принцип) или скромным (строительство дома, забота о домашнем животном). Важно, что, когда мы наделяем этот мотив ценностью и считаем, что ради него стоит идти на жертвы, мы придаем смысл своей жизни.

Таким образом, сегодня, когда в большинстве стран средняя продолжительность жизни перевалила за 80 лет, мы представляем собой своего рода курьезы, живущие гораздо дольше предназначенного нам времени. Изучая старение, мы стремимся постичь вовсе не естественный процесс, а противоестественный.

Your chances of avoiding the nursing home are directly related to the number of children you have

Being mortal is about the struggle to cope with the constraints of our biology, with the limits set by genes and cells and flesh and bone. Medical science has given us remarkable power to push against these limits, and the potential value of this power was a central reason I became a doctor. But again and again, I have seen the damage we in medicine do when we fail to acknowledge that such power is finite and always will be. We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way. Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?

Courage is strength in the face of knowledge of what is to be feared or hoped. Wisdom is prudent strength.

Life is choices, and they are relentless. No sooner have you made one choice than another is upon you.

For all but our most recent history, death was a common, ever-present possibility. It didn’t matter whether you were five or fifty. Every day was a roll of the dice.

Our ultimate goal, after all, is not a good death but a good life to the very end.