33 Meditations on Death: Notes from the Wrong End of Medicine

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It’s a view shared by the consultant geriatrician David Jarrett. In 33 Meditations on Death – Notes from the Wrong End of Medicine he draws on family stories and case histories from his three decades treating those who become old and frail. Jarret’s book is an impassioned plea for everyone – old and young – to engage and make plans for the end. Despite the author’s use of humour in places, and some praise (NHS care) and positivity, this book is probably one of the most sobering collection of essays I’ve yet come across. I suppose I allowed myself to be misled by the word “meditations” in the title. This isn’t a benign philosophical work, rather a critical look at the developed worlds attitude to death, quality of life near its end, healthcare (particularly in the UK). It’s grim reading for the most part; practically ranting in one or two places. This unusual and important book is a series of reflections on death in all its forms: the science of it, the medicine, the tragedy and the comedy. Dr David Jarrett draws on family stories and case histories from his thirty years of treating the old, demented and frail to try to find his own understanding of the end. An extraordinary, unflinching rumination that brings us into a more companionable relationship with death, and in doing so helps us to live. There is a deceptive lightness to David's writing which keeps us in easy company, undoes much of its mystery, and helps us in that most vital adult project: to face our mortality. This book will stay with you. Derren Brown

The second line appeared on my lateral flow test. I grabbed a few essentials from the kitchen and retired to bed. As symptoms circulated around my bronchial passages, I reached for ‘33 Meditations on Death: Notes From the Wrong End of Medicine’ by David Jarrett. Covid 19 does not appear until the final chapter, but contemplating age and vulnerability proactively are themes of the book.David Jarrett MD is a long serving physician providing medical care to older people. If you are, or have been involved with the care of someone frail or elderly, you may already be aware of the medical ‘twilight zone’, the spectrum between life and death that older people can often fall into. In her latest book, Should We Stay Or Should We Go, the writer Lionel Shriver explores a number of alternative endings. The couple at the centre of her novel make a pact to end their lives when they hit 80, to avoid a slow decline either physically or mentally. As Shriver looks at how that decision might play out in reality, she’s arguing for a more open discussion about the end of life.

Over a career that spans decades, we are given an inside perspective on the changes in medical practice, both for good or ill. We are treated both to the stories of patients, and doctors, who are dealing with mortality. It is a wise and engaging read, that brings insight to the perfect storm, “of longevity, prolonged infirmity and sheer numbers.” We are dying longer, as a consequence of living longer. There is a great deal of sound thinking, alongside compassion and humour in the stories that come from Jarrett’s long service in geriatric and stroke care. “We are obsessed by mortality in modern health services, when we should be paying greater attention to quality of life. One is very easy to measure and the other virtually impossible,” he suggests. A remarkably likeable guide to a grisly subject ... daunting, yet ultimately life-affirming IndependentThis unusual and important book is a series of reflections on death in all its forms- the science of it, the medicine, the tragedy and the comedy. Dr David Jarrett draws on family stories and case histories from his thirty years of treating the old, demented and frail to try to find his own understanding of the end. By an eminent geriatric consultant, 33 Meditations on Death is a call to arms for us to discuss and plan how we improve our end of life. Compelling reflections on the dignity of human life, and the emotional inevitability of its end. Professor Stephen Westaby