The first line from Dr. Atul Gawande’s bestselling book Being Mortal has stuck with me for a decade.
“I learned about a lot of things in medical school, but mortality wasn’t one of them.”
We are a people obsessed with health. Every other post on Instagram is about wellness, medicine, or nutrition. Every other book you see on the shelves at Target is about how to be healthy, happy, and productive. Get more sleep. Go to the gym. Rise and grind. Get after it.
We are Efficiency Monsters. Or, if we’re not, we want others to think we are when we post on Instagram. LOOK AT ME. I’VE DONE SIX IMPOSSIBLE THINGS BEFORE BREAKFAST. #Blessed
(Oh yeah? Well, I hit snooze three times and ate an old granola bar I found in my car for breakfast).
And yet, for all our talk about health, we don’t seem to want to talk about everyone’s very normal bodily reality—our mortality.
In the tragicomedy Rosencrantz and Guildenstern are Dead, Rosencrantz remarks how strange it is that he can’t remember when he first learned about death. As a child, he must have assumed that he’d go on forever, and surely the knowledge that this wasn’t the case must have shattered his young self. But he can’t remember it. Few seem to. I certainly don’t. So, his conclusion is that he must have been born with this knowledge. Everyone just…knows, before there are words to know it.
That might be true. But, if so, we’re trying REALLY HARD to unlearn it.
It’s not something we like to talk about in our shiny, positive thinking version of reality. And yet, there is enormous focus in self-help literature on health and healing. But what does that mean? Healing from what? What is the opposite of health? (Is there a cure for being human?)
In a short essay called “Healing as Killing,” the philosopher Byung-Chul Han, who is kind of having a moment right now, addresses this fad. Our focus on healing is not about fending off mortality or living well. It is, instead, a method of increasing those most neoliberal of values: efficiency and optimization. “In contemporary American self-help literature,” he writes, “the magic word is healing. The term refers to self-optimization that is supposed to therapeutically eliminate any and all functional weakness or mental obstacle in the name of efficiency and performance.”
You heal so you can be more productive. Better optimized. Feel better.
But this healing, argues Han, is really killing.
And this brings us back to mortality. To the recognition of our limitations. We work ourselves to exhaustion, we squeeze every drop of efficiency out of days, and no matter how hard we try and no matter how healthy we are, the end is always the same.
But “end” means something else too. In philosophy it is telos, or purpose. It is why something exists. So what is our purpose? And does death help us clarify it?
I recently had the chance to speak with Atul Gawande in partnership with the Aspen Ideas Festival. (You can watch our full conversation or listen on Apple or Spotify.) He gently reminds us that we all have limits. Everything has an end. As a surgeon, he fixed a lot of people. But he also had to learn “how much of my practice was going to be about working with people and problems that we weren’t going to be able to fix.” (Which reminds me of something theologian Jerry Sittser once told me: Miracles don’t keep.)
What makes us feel more human when faced with this? Gawande told me about “greenhousing,” the practice of giving sick people plants or, when they can, pets to take care of. Loving something “brings people alive,” he said, “and gives them a reason for living.”
There’s something deeply human about companionship and caring.
There’s also NOTHING OPTIMAL about it.
We allow pets to be inefficient. We don’t try to turn our dogs and cats into machines for hyper-effective dogness and catness. We let them be. Even though I am insanely allergic to cats and am being murdered by them as a result. Regardless, we even find animals more lovable the more ridiculous they are.
If we’re willing to let dogs and cats be dogs and cats and live lives that are not ruthlessly optimized for maximum productivity, why do we deny ourselves this same luxury? The simple relationship of human to pet helps remind us that life is about more than streamlining.
This doesn’t help with mortality though. It makes life more meaningful, but the end is still the end.
Although SOME PEOPLE think it isn’t. If you’ve seen Silicon Valley, you’ve seen the kinds of shenanigans that the tech bros can get up to in order to prolong their lives. Fancy injecting yourself with a younger person’s blood and eating roughly 100 pills every day?
(If you haven’t seen the darkly hilarious movie, Look Up!, you must so you can watch egomaniac venture capitalists manage to escape our burning planet only to be promptly eaten by aliens. Maybe I should put a billboard up in Palo Alto: YOU CAN’T STOP THE HEAT DEATH OF THE UNIVERSE.)
And yet, it’s easy to see the appeal. Who wants to die, anyway? As Gawande pointed out, if he could take a pill to live to 800 he probably would. It’d be a lie if I said I wasn’t tempted, too. Think of how many seasons of The Bachelorette you could hate-watch. “I’m sorry, Glorgon, I’m afraid you were not awarded the synth-rose.”
Sadly, for all our talk about health and living as long as possible, we don’t implement it fairly. We have the uber-rich trying to live forever, and the poor dying of preventable diseases, unclean water, and malnutrition. Much of this happens because of small decisions made here and there which end up having huge effects. And a good deal of it flows from our language about efficiency and productivity.
A terribly sad part of the story was Gawande’s work with USAID, and what’s happened there in the past year. In the name of cutting costs and eliminating waste (led by a government department devoted to “efficiency”), a small amount of money was saved. And that relatively small amount of money has already led to catastrophic disaster in Africa, where thousands are suffering and dying as a result. As Gawande pointed out, the estimates are around 300,000 deaths. “It’s brutal,” he said. In the end, this saves maybe a few tax dollars per person in the US.
It’s hard to think about this. I’d honestly prefer not to. Send me more funny pet memes. But the truth is we have to bear witness. To deny the reality of what’s happening enables it to keep happening.
And, as Atul encourages us, change begins around our kitchen tables. Conversations with friends and family is where we all can have an impact. Yes, it’s inefficient...but that’s what the slow work of change demands.
Wellness shouldn’t be some strategy to fine-tune our biological machine. Health is not just about maximizing your output. Maybe
is right, we’re more like trees than robots.Health needs to be seen in the context of life. It is about living and being; not producing, not the quarterly earnings report, not the siren song of maximum efficiency. Life is inefficient. Living well is inefficient. Mortality is inefficient. And that’s okay. Allow yourself to live more slowly. Observe the “scent of time,” as Han put it. Let it linger.
Which of you, by being more efficient, can add one cubit to your stature?1
You can listen to my full conversation with Atul Gawande on Spotify or Apple. Or watch it here.
And I’d love to know—What’s something in your life right now that’s gloriously, stubbornly inefficient? Tell me in the comments.
Matthew 6:27 (the Kate Bowler version) 😉
My grandaughter, age 4, is gloriously inefficient. Any moment can become a dance party!
Kate, bless you for this post, timely in my life today. I have been very inefficient for almost a week as I attended my dying dog and now mourn her passing. I put the rest of my life on hold and I’ll tell you it feels nice to be able to do that at 75. I spent these days in relationship with her, petting and cleaning up after her and taking her outside as she was able. Love is like that and true healing is not very efficient.