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Book and Media Reviews
January 7, 2009

In Defiance of Death: Exposing the Real Costs of End-of-Life Care

JAMA. 2009;301(1):108-109. doi:10.1001/jama.2008.909

In his 2007 book, Better, Atul Gawande offered the following bit of advice to physicians who want to effect positive change in medicine: “Write something.” The product is not as important as the process of writing, through which both the author and audience are edified. And while an author might have any number of motives for writing, surely some of the best written works are born from an author's passion for his or her subject. Many physicians nowadays feel passionately about their profession, but few actually use writing to express their thoughts. Kenneth Fisher, a Michigan nephrologist, appears to have taken Gawande's advice to heart. Of In Defiance of Death: Exposing the Real Costs of End-of-Life Care, he writes that “After forty years of watching the profession I love go astray, I had to write this book.” The result is an impassioned plea for rationality and compassion in caring for the dying, through which Fisher's love of his profession becomes obvious and is inspiring.

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