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Dr. Atul Gawande’s Ingersoll Lecture on Being Mortal

by | Sep 21, 2018

I recently had the opportunity to see Dr. Atul Gawande speak at Harvard Divinity School’s Ingersoll Lecture, and I want to share some of the experience with First Parish.

What is the Ingersoll Lecture? 
The Ingersoll Lecture is an annual event in which a prominent theologian, activist, or author is invited to Harvard to speak on the topic of human immortality. Over the last 99 years, contributors have included Paul Tillich, Howard Thurman, Elisabeth Kübler-Ross, John Haynes Holmes (a 20th century Unitarian pacifist), Karen Armstrong, James Cone, and Toni Morrison, among many other impressive thinkers.

Who is Dr. Atul Gawande? 
This year, the lecture was delivered by Dr. Atul Gawande, a surgeon at Brigham & Women’s Hospital, and the author of four bestselling books on medical ethics, human fallibility, and end-of-life decision making.

Why did I attend? 
I have long been a fan of Dr. Gawande’s work. When my own grandfather was nearing the end of his life in 2016, my mother insisted that I pick up Being Mortal, Dr. Gawande’s 2014 book about medicine’s failure to prepare us for the inevitable decisions we must make about how we and our loved ones die. Eventually, my whole family read it, and drew a great deal of strength and insight from it during those final months with my Grandpa. 

Why do we keep talking about immortality? 
or “Let her have the damn cookies!”
Thanks to my appreciation for his writing, I showed up to Dr. Gawande’s Ingersoll Lecture expecting wisdom, humor, and meaningful introspection, and I was not disappointed. Though his 90 minute talk ranged over many topics, one story was particularly memorable. Dr. Gawande reminisced about a woman he knew who transitioned into hospice care at an assisted living facility. She had dementia, started having difficulty swallowing, and was put on a strict liquids-only diet. Eating solid foods put her at risk of choking, which, even if she survived it, would be scary and painful. 
Despite this, the woman kept stealing cookies from the kitchen and stashing them to eat secretly in her room. Each time the medical staff discovered her with cookies, they would take them away, scold her, and remind her why she must only have liquids from now on. She kept stealing the cookies, the doctors kept taking them away, and she quickly became known as a problem patient. Here Dr. Gawande paused in his telling, shook his head, and laughingly exclaimed, “Let her have the damn cookies!” We in the audience all chuckled, then quieted to hear what came next. “Let her have the cookies,” he repeated, “because she is telling you what her joy is.” 
His words prompted reflection on how difficult it can be to communicate with loved ones who are nearing the end of their life. This woman’s constant disobedience to medical direction wasn’t a problem, but a gift! She was communicating, in the most basic language, what she wanted from her life, what made her happy. In this case, what she wanted was the joy of eating those cookies. 
Why do we humans keep talking about immortality? Dr. Gawande’s point, I think, is that our longing for immortality isn’t fueled by a desire to preserve biological life-signs, but a desire to keep living life, to keep eating cookies. We, as human beings, have priorities other than living longer; we have reasons to be alive. This can be an uncomfortably spiritual thought for medical doctors, and modern medicine understandably prioritizes heartbeat and brainwaves above the much more difficult-to-quantify measures of joy or despair. But Dr. Gawande and others have long advocated for modern medicine to include more of the messy and inexpressible parts of life and death.
We, as spiritual and emotional beings living in community with each other, want to live longer lives because we want to keep doing the things that bring joy and meaning to us and others. We want to spend time with loved ones, make positive change in our communities, and yes, we want to eat cookies. My hope is that each part of the lives we live—at home, at work, and here at First Parish—will help us to see and honor those reasons we all might long for immortality. May we all find that which we won’t want to give up. The joy that makes us want to keep living a little bit longer, to keep taking risks, and to keep stealing those cookies until the very end.

Sally Fritsche, Ministerial Intern, Sept 2018