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

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Compelling reflections on the dignity of human life, and the emotional inevitability of its end. Professor Stephen Westaby Dr. Jarrett has a humane outlook and advocates against subjecting people to prolonged deaths that involve only extended treatments and extended suffering. Interestingly, it's the one chapter about someone who didn't die, which recounts his own experience being successfully treated by the NHS (Britain's National Health Service) that helpfully reminds us that, while he has focussed on people at the ends of their lives, sometimes medical treatments work and people do recover. 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. A remarkably likeable guide to a grisly subject ... daunting, yet ultimately life-affirming Independent

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. In a year when Covid-19 has had a devastating effect on families, with loved ones dying sometimes alone in hospital or without the usual funeral rites, Tom Sutcliffe and guests discuss mortality and what it means to have ‘a good death’. 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. A thoughtful and thought provoking series of short chapters that explore different aspects of what can - or does - happen at the end of life, often illuminated by the author's own experience as a doctor, but also as a human with relatives, friends, and foibles of his own.

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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. 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. A remarkably likeable guide to a grisly subject ... daunting, yet ultimately life-affirming" - Independent

Brilliant - a grimly humorous yet humane account of the realities of growing old in the modern age. Everybody over the age of 60 should read it and ponder their probable future. Henry Marsh Brilliant - a grimly humorous yet humane account of the realities of growing old in the modern age." - Henry Marsh 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. 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. 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 BrownIn a nutshell, he is asking us, why are we obsessed with prolonging human lifespans and dying with indignity, more often these days with progressive and irreversible cognitive impairment? Shouldn’t we expect, and even demand, a better end of life for ourselves and our loved ones? And it is a call to arms for us to make radical changes to our perspective on 'the seventh age of man'. Jarrett is an NHS consultant in geriatric and stroke medicine. I’ve read a lot of books about death at this point, so it takes a really special one to entice me to read the whole thing rather than just skimming for interesting nuggets. This contains the usual mixture of personal material, patients he’s treated, thoughts on the general standard of care in this country, and recommendations for how to have a healthier societal attitude towards death. All set out more entertainingly than in Seamus O’Mahony’s The Way We Die Now. 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.

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. Profound, provocative, strangely funny and astonishingly compelling, it is an impassioned plea that we start talking frankly and openly about death. He writes about all the conversations that we, our parents, our children, the medical community, our government and society as a whole should be having. 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. It is striking how the candour of our public discourse fails when we get on to the subject of death, a significant and puzzling failure for it is the fate we all share. David Jarrett's 33 Meditations, the fruit of forty years of professional experience with people at the end of their lives, is not only timely and important, but hugely enjoyable. One of the most memorable books I've read recently. The Revd Richard Coles