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Article
June 22, 1994

How We Die: Reflections on Life's Final Chapter

Author Affiliations

Bozeman, Mont

 

by Sherwin B. Nuland, 278 pp, $24, ISBN 0-679-41461-4, New York, NY, Alfred A Knopf, 1993.

JAMA. 1994;271(24):1966. doi:10.1001/jama.1994.03510480092046

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Abstract

The literature on death and dying and the psychological and emotional components of that process has by now become somewhat overwhelming in its quantity. This reviewer has read enough on this subject to last a lifetime. With no disrespect to its pioneers and enthusiasts, I think the whole business is wearying and—I hope—what became a fad is starting to fade.

On the other hand, there has been comparatively little writing on the physical details of life's final events. Such details can be informative to an increasingly sophisticated lay audience and, when presented by a knowledgeable physician with a long view and a gentle touch, satisfy a need. The book at hand qualifies.

The author is at Yale, where he teaches both surgery and the history of medicine. His expertise in the latter is most helpful as he explains the pathophysiology of disease and of life's terminal events. When myocardial ischemia

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