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Understanding Modern Death

Death is confusing. Many people can’t understand it and don’t know how to approach the topic. What we all know is that death is inevitable. In his latest work, Modern Death: How Medicine Changed the End of LifeDr. Haider Warraich explores how people die today, from the cellular level up to the very definition of death itself. Death is a biological, cultural, religious and philosophical process, shrouded in controversy, from healthcare to social media. Modern Death explains, with compassion and understanding, what so many of us try to understand: Death and dying. 

 

Dr. Haider Warraich graduated from medical school in Pakistan in 2009. He did his residency in internal medicine at Harvard Medical School’s Beth Israel Deaconess Medical Center, one of the main teaching hospitals of Harvard Medical School.  He is currently a fellow in cardiology at Duke University Medical Center. His medical and Op Ed pieces have appeared in many media outlets including the New York Times, The Atlantic, the Wall Street Journal, Slate, and the LA Times among others.

Q: What inspired you to write this book? 

Too many times, I have found myself in situations where patients and their loved ones found themselves in critical situations yet had no idea about what the end of life entailed. I wanted this book to provide them a map so that they could navigate the complex landscape of modern death. 

Q: You say that families want more treatment and procedures while the medical team wants less; why do those in the medical field wants less? 

In some circumstances, when patients are terminally ill, families might desire more treatment, yet their medical teams, given previous experiences, might feel that more treatment might be futile, and even harmful. 

Q: What is the greatest impact of social media on people’s experience with death? Do you think social media has a positive, negative, or mixed impact on our experiences with death?

Social media has definitely had a positive impact – the end of life can be an isolated and lonely place. Patients are frequently in the hospital and social media helps them not only articulate their thoughts and experiences, but they can share them with countless others. 

Q: Modern Death is filled with scientific information. How did you navigate turning such complex information into a book that a large audience could relate to and understand?

Modern death is a complicated topic, which is what makes it even more important for it to be translated into a cohesive narrative readers can wrap their heads around. I do feel that the information provided, wrapped within history and my personal stories, will help people understand just exactly how medicine changed not only life, but death. 

Q: Do you think that, overall, advancement in technology that has the ability of extending a person’s life is a good thing for humanity? Why or why not? [Maybe touch on ‘dramatic extension’ of life and what this does to loved ones and patients]

I strongly believe that the extension of human life is a wonderful achievement. So many human lives and years that would have otherwise remained unlived, are now experienced. Yet, with this dramatic extension, many challenges that we did not anticipate, such as the isolation many elderly experience, have arisen. My hope is that this book will bring those challenges into focus and that would be the first step to help overcome them. 

Q: When did the concept of ‘dying’ become a thing? 

People used to die of things like heart attacks but modern medicine allowed most to live through such setbacks. Yet, because of that, we have seen an increasing number of people live with chronic diseases. Even diseases such as HIV/AIDS and cancer are now considered chronic diseases. By averting an untimely death, we introduced the concept of dying, in which patients though alive, live with multiple medical conditions, and are in and out of the hospital until the end. 

Q: Why do you think some, perhaps most, people fear death? Do you have any advice for how people who fear death can best confront it?

The fear of death is the most essential component of our survival mechanisms and has determined the success of our species. We will be able to overcome this fear, not with drugs or procedures, but by simply talking about death in a more open and honest way. I hope that this book becomes a part of that endeavor. 

Q: Have you faced backlash for your research, findings, and theories? 

Far from it, I have received great support both within and outside the medical community. There is consensus that we need to seriously and scientifically face the challenges represented by modern death. 

Q: What is a healthcare proxy, and why is it important?

A healthcare proxy is someone designated by a patient to help communicate their wishes to the medical staff when they are themselves unable to do so. IN principle, a healthcare proxy does not make decisions themselves, but informs the medical team of the sort of care the patient would have desired were they able to communicate that themselves. 

Q: As a doctor not originally from the U.S, what have you observed to be some of the biggest differences in the way the U.S., either culturally or scientifically, deals with death and dying compared with your home country [or other countries]?  

The US values patient autonomy perhaps more than any other country in the world. I have learnt the value of making decisions with patients rather than in an arbitrary way.