Wednesday, September 28, 2016

Haley Reading Group: Atul Gawande’s “No Risky Chances”



[Best American Science and Nature Writing]

By Cynthia A. Campbell

Atul Gawande’s article “No Risky Chances” focuses on the complexities that both physicians and patients face in making decisions about medical treatment that can prolong life and/or cause further complications. Gawande illuminates the implications of one cancer patient’s ordeal with her end-of-life treatment. Ultimately, the article speaks to the importance of understanding/processing issues of mortality.

Gawande’s discussion of courage was enlightening. At one point, Gawande notes that “The first is the courage to confront the reality of mortality—the courage to seek out the truth of what is feared and what is to be hoped when one is seriously ill…the second kind... the courage to act on the truth we find” (66). This point indicates that the certainty of death (our awareness that it is natural and inevitable) can allow us to face it with humility.

After reading Gawande’s article, what was one point concerning the patient’s decisions that caught your attention? Why was that point or scene notable to you? Please provide a page number citation.

76 comments:

Anonymous said...

I was not surprised when she said she would like to choose the least invasive path and does not want surgery. I was surprised however, about her reasoning for not choosing the surgery, which would provide the most beneficial results in the end. It was because she did not want to miss out on a wedding. It seemed to dismiss the seriousness of her illness. (67)

Alexis R.

Shervonti N. said...

On page 67, the decision to not sacrifice "a lot" because of an upcoming wedding was the the decision that caught my attention. My mind always wants to think that people are going to think of themselves in a serious moment like this but instead she is thinking about not messing up the wedding she was supposed to be a part of.

It made me think about illnesses in a different way and how different people will handle them in their own way.

gabriel said...

The biggest concern was how bad of a condition Jewel Douglas was in. Cancer is not a disease to take lightly. Mrs. Douglas wanted to finish her story the way she wanted. Her decision was understandable, because the option she had were few and had the conclusion remain the same. The after math of surgery and chemo was painful. Having the doctor insert the tubes helped stop the pain, and allowed her to live happily with the few days she had left. It was a notable scene, because she had accepted her mortality. I like how Gawande went over to meet with the patient, it showed how he cared/understood why she made the decision that she made (page 70).
Gabriel Msengi

Lucas Reincke said...

I think the most notable decision that Jewel made was that she wanted to not go on with more chemotherapy and that she wanted to live out her days. She wanted to be at the wedding between her brother-in-law and best friend. What that tells me is that she understands that time can be bought, but more time is not worth the pain. Jewel seems to care about living the rest of her life to the fullest extent, even if it will be short lived. Now, hindsight shows that she might have made the wrong decision, seeing as she was in the hospital less than a day later. (66-67)

Mikaela S said...

After reading Gawande’s article, one point concerning the patient’s decisions that caught my attention is found on page 69. Jewel was willing to have surgery after the surgeon agreed to take "no risky chances" (Gawande 69). This point was notable to me because studying nursing and being at clinical, I see a lot of cases where people are all for treatment or very against it. While some, like Jewel are willing to take palliative measures, often times the patient isn't stable enough to go through surgery, or is completely over their health condition. It was nice to see Jewel, her family, and the surgeon work together to make all parties happy. I liked how the surgeon was very flexible, and did not overstep his boundaries when he was performing the actual surgery.

jasmine williams said...

On page 67, it was notable that Jewel chose to stop chemotherapy. I think a lot of people overlook that fact that treatment of a disease is a conscious decision that a patient makes and is not the only option he or she has. Sometimes the side effects of treatment cause the patient to lose control of their life. Jewel was chose to try to live her life normally by attending a wedding, and I think that is commendable.

Jasmine W.

Maya Searcy said...

On page 67 Jewel says she doesnt want a big surgery or treatment because of her best friends wedding. I felt this made Jewel seem like she didnt understand the seriousness of her choices. She had said before that she was afraid of suffering and all she wanted was her friends and family at the end of the day. I also think this statement shows how determined she was just to get her life back on track.

Crystal Rice said...

The most notable decision Jewel Douglass made was that she didn't want to take any "risky chances" that could change the ending of her story or her life. She was afraid to go into surgery because of the "pain, the tubes, and the horrors of possible complications," (68). This scene was notable to be because no one wants to go through a lot of pain or have to endure things that could possible end their life early and that was her fear. Even though she was very eager to be home with her family and attend her best friend's wedding and do the things she used to be able to do freely before all of these problems aroused, she had to realize that her health was more important and comes first before anything else.

Crystal R.

Jordan R. said...

What was significant to me about Jewel's decision is how natural it was; she went with her first most natural instinct, to be fearful of dying before she felt she was ready. It was remarkable how Dr. Gawande explained the situation of death; "We have room to act and shape our stories--although as we get older, we do within narrower and narrower confines" (71). Jewel knew she was not ready to die, but her circumstances were out of her control.

The most remarkable thing she did was to "shape her story" into her own; make her own choices about what medical procedure made her completely comfortable.

Anonymous said...

For me, the most notable decision Jewel made was deciding to use medicine to help her pain instead of going through chemotherapy and surgery so she can go to a wedding. This caught my attention because she was placing others first instead of her health, showing how she cares more about leaving her friends and family a happy memory of her instead of taking a chance to get better.

Kyla T.

Alexandra Johnson said...

What stood out most to me was her selflessness throughout this situation. On page 67, it was remarkable that through everything she was going through, the first thing she thought of was her friends wedding and her families sanity. She only touched briefly on sacrifices that pertained to her. To me this emphasizes bravery and positivity, even in a situation where you know the ending is not the best and may be nearing soon.

Unknown said...

On page 67 Jewel made the decision to not go through with surgery all for the simple fact that she wasn't sure of the outcome and she wanted to make sure that she was able to make it to her friends wedding. I honestly don't think this decision was totally horrible, yes she should of thought of herself more but at the same time she has a good heart and she felt obligated to be there for her friend and you can't down her for that.

Unknown said...

On page 67 Jewel made the decision to not go through with surgery all for the simple fact that she wasn't sure of the outcome and she wanted to make sure that she was able to make it to her friends wedding. I honestly don't think this decision was totally horrible, yes she should of thought of herself more but at the same time she has a good heart and she felt obligated to be there for her friend and you can't down her for that.

Erica K. said...

On page 67 Jewel made the decision to not go through with surgery all for the simple fact that she wasn't sure of the outcome and she wanted to make sure that she was able to make it to her friends wedding. I honestly don't think this decision was totally horrible, yes she should of thought of herself more but at the same time she has a good heart and she felt obligated to be there for her friend and you can't down her for that.

Erica K.

Ashia Kent said...

The one point regarding the patient's decision that stood out the most to me was how strong of a love that she had for her family and how that bond played such a strong role in her health decisions. She hesitantly excepted to the surgery, but made it very clear that if it involved having to take too much of a risk, resulting in her death, that she was not accepting to that because she wanted to be with her family. And towards the end of the story it made sense. She spent those last moments she knew she had with her family. And all of this was notable to me because it just showed me that she was an incredibly unselfish person and even in the moment where it should've been about her and what she wanted, she still put others first.

Ashia K.

Jazsmine Towner said...

In my opinion one of the most notable decisions that Mrs.Douglas makes was to live her last days comfortable and doing the things she loved. On page 67 she was very concerned about making it to her friend's wedding, and she didn't want to risk missing it. This was important to me because I think it shows a lot about Jewel's character, she not thinking of herself and her health but about being there for her friends and family. It shows that she is family-oriented, kind, and that she puts her family first even when she should put herself and her health first. I think the decision of not risking her life in a surgery shows how humble and brave Mrs.Douglas was.


Jazsmine Towner

JaLeah M . said...

The most notable part to me was when it read, "Her difficulty wasn't lack of courage to act in the face of risks; it was sorting out how to think about them. Her greatest fear was of suffering" (68). I think this is what a lot of elderly whom become seriously ill, fear when being put in a position to make the choice of going under a knife and possibly getting better or coming out worse. I couldn't imagine how hard that decision would have to be to make for yourself. I also think there is a point where one becomes content and exceptive of their situation and if religious, faith play a huge role and they simply desire to enjoy the days they do have left and this was how Jewel felt.

Sydney Oats said...

"Life is meaningful becasue it is a story, and a story's arc is determined by the moments when something happens" (Gawande 69). That is a very powerful sentence to me becasue we do not remember every single detail of our life. Only the most memorable, and meaningful, as mentioned, is what helps mold and shape our life's story. Douglas knew her story was coming to an end, but she wanted it to be as postive and uplifiting as possible with the condiotion she was in. This was a very interesting read, and I enjoyed it.

- Sydney Oats

Natalie Thompson said...

One point that caught my attention had to do with the patient not wanting to do the surgery even thought there was a "75% chance that the surgery would make her future better" (Pg. 68). This was notable to me because it seemed that the benefit of the surgery outweighed the risk. The risk of something going wrong was 25%. I'm sure she didn't know she would pass away 2 weeks later from the procedure she did have. I think sometimes when the benefits outweigh the risks that much, it is worth a shot.

- Natalie Thompson

cassidy oliver said...

What was most interesting was that she did not want to take any risky chances. Though there were procedures that had a 75% chance of making her feel better, at least for a while, she did not deem it worthy. Her priorities were not "merely being safe and living longer", but instead living a life filled with meaning and substance (Skloot 71). The quality of ones life is important. Death should not be feared if ones life was filled memories.

Jaleelah Muhammad said...

On page 70, Gawande discussed the last conversation that they had with the patient. "She said she didn't like all the contraptions sticking out of her. But the first time she found that just opening a tube could take away her nausea, she said, 'I looked at the tube and said, 'Thank you for being there.''" This really spoke to me because it's hard for someone to humble themselves in the face of death. When the most common reaction is to complain and question God in anger as to why this has to be, she instead chose to accept her fate. I admire her for that.

Living And Helping said...

A considerable amount of people like Jewel Douglass choose what's best for their soul and not their body. What I really admire about Jewel Douglass is her unwavering determination to attend her husband's brother's wedding. Instead of choosing countless treatments of chemotherapy, she wanted to be with her family even though she didn't have much time left. When the doctor asked what sacrifices Jewel would be willing to make, it says, "Uppermost in her mind was a wedding that weekend that she was desperate not to miss." (67). Judging from her actions, happiness and peace of mind was clearly Jewel's first priority.

Jeremiah T said...

On page 68, Jewel canceled the operation because she was afraid. The part that stuck out to me was that she had already came to terms with the fact that she was dying and just wanted to be as comfortable as possible in her last days.
-Jeremiah T.

Roland Wooters said...

The situittion that stood out the most to me was the case with Jewel Douglass. She was a woman who was suffering with ovarian cancer which led to her being terminally ill. What stood out was her unwavering sense of happiness and acceptance. When everyone around her was negative she remained positive. That is the beauty of morality - it is subjective. That is truly an admirable quality to have.

Asher said...

This was a very sad read, but also a very peaceful one. I guess, I expected a happy ending, in the case of Jewel's cancer. So, when she said, "But no risky chances" (pg 69), I knew something was quite off. I think the ideas of our "remembering" selves" and our "experiencing" selves, are two large aspects of how we make life changing decisions. I can't relate to Jewel's decision of such magnitude, but I can relate in a small way. I had a cyst on my wrist for most of last year, and it was a third recurring one. I knew that I would have to get it removed sooner or later, because it was causing me pain. But, before I made the decision to get it removed, I mulled over the fact that, if I did get the surgery, I wouldn't be able to get a summer job, and If I didn't get the surgery, I still wouldn't be able to get a summer job because, it was hard to carry things. So, our brain's are always thinking up scenarios and outcomes of our likely decisions, and a lot of the time it's hard for us to weight down which one to listen to. For Jewel, she chose her remembering self, or her anticipation self.

-Asher Denkyirah

Anonymous said...

It's obvious that her determination of making it to her brother-in-law's wedding was a shocker, but I'm familiar with people wanting quality over quantity. What disappointed me was that it sounded like she didn't make it to the wedding. I feel like good people deserve one last, authentic moment of normalcy. That wedding seemed to be that for her, but when she was forced to choose surgery by her nausea, I was curious to see how she would deal with it. I expected her to be frustrated by the fact that she was robbed of one last celebration. Instead, however, she seemed to accept it, immediately trying to figure out the next best course of action for herself. (66-67)
It's commendable that she didn't let emotions keep her from truly analyzing the situation and figuring out was most true to her story. Cancer is one of the big illnesses that is known for breaking down and completely changing people, but it sounds like Jewel Douglass managed to hold onto her authenticity, and that is what sticks out to me the most.

Que'rra M.

Sierra E said...

I think we all can resonate with her choice not to take risky chances. Sometimes when faced with too many options we are overwhelmed by the amount of routes there are to take. But each one of us have to realize that some chances are worth taking and some are not. We have to decide what risks can benefit us and others and which one could lead to greater discontent and possible destruction. For her, she knew what mattered most to her and she knew what deal breakers there were for her in this life or death situation. Even when faced with the great possibility of survival, she was in a way crippled by the fear of suffering. She ultimately got what she wants and was filled up by the fact that she didn't have to suffer. In her acceptance of death, she also got a chance to appreciate her life. Her refusal to take the risky route gave her the time she needed to control how she would leave her earthly body. Impressive and insightful story.

page 68-69

J'kolbe Kelly said...

The part that stuck out to me the most occurs on page 67. This is where the doctor inquires about Mrs. Douglass's concerns, goals, and trade off's. Gawande stated that not everyone is capable of answering these questions but she does. She in a nut shell tells him that she would love to recover but not at the cost of not being around her family. I believe this is a show of great character as well as self understanding in the face of mortality

J'kolbe Kelly said...

The part that stuck out to me the most occurs on page 67. This is where the doctor inquires about Mrs. Douglass's concerns, goals, and trade off's. Gawande stated that not everyone is capable of answering these questions but she does. She in a nut shell tells him that she would love to recover but not at the cost of not being around her family. I believe this is a show of great character as well as self understanding in the face of mortality

Chris Ukachukwu said...

What stood out to me the most was the fact she just wanted to be healthy enough to attend her friend's wedding. This shows that she was a great friend that put her friends and family before herself. She died trying to make it to another person's event. So she will be remembered as a unselfish and compassionate person.

Aliyah Johnson said...

The point that stood out to me the most was Jewel Douglass' priority to suffer as little as possible. I can understand why this is her priority, and agree that "our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer"(p.71). Often times people fail to see the sick as having other priorities such as spending time with their families, spending time with god, or giving. We often times think that their main purpose considering their circumstances should be to live longer. This is not okay.
--Aliyah J.

kenneth Tolliver said...

Kenneth Tolliver

When dealing with pain, most people will do whatever it takes to ease it, as discomfort is the least enjoyable thing in life. With this in mind, when Jewel Douglass made the decision to take Tylenol over prescription narcotics in order for her to enjoy her friends and family spoke to me (pg 70). She was willing to go through her already agonizing pain just so she can see the people she loved. That speaks volumes about her mindset. Her goal wasn't just to keep going as pain free as she can, but to go enjoying the people she loved and cherished.

Kenneth Tolliver said...

When considering

Mike Dade said...

It was unexpected that Jewel turned down the more extensive surgery, as you'd think she'd want it for the simple fact that it had a chance to make her feel better than the minor treatments she was receiving to just get by. What was even more eye-opening was realizing the rationale behind it; she understood the inevitability of mortality in this sense, and decided to instead focus on embracing those last few moments of what she had left.

Mike Dade said...

It was unexpected that Jewel turned down the more extensive surgery, as you'd think she'd want it for the simple fact that it had a chance to make her feel better than the minor treatments she was receiving to just get by. What was even more eye-opening was realizing the rationale behind it. She understood the inevitability of mortality in this sense, and decided to instead focus on embracing those last few moments of what she had left, being in control of her final decisions. "Douglass's story was not ending the way she ever envisioned, but it was nonetheless ending with her being able to make the choices that meant the most to her." (70)

-Michael D.

Nia PIggott said...

After reading "No Risky Chances"the part that stood out to me was how she made it clear with her doctor on how she wanted to handle her surgery and how she didn't want to do anything too dangerous. On page 68 she states "I'm afraid.. I don't want to take risky chances." This catches my attention because although she seems fearful she also shown in the artice to be brave, strong and filled with happiness. She comes to terms with her disease and makes the best out of her last days with her family.

Brianna R. said...

The part of the article that was most memorable to me was on page 67 when Mrs. Douglass was asked what sacrifices she was willing to endure in the current moment in order to prolong her life. I was surprised by the fact that she said "Not a lot". Mrs. Douglass was only concerned about the immediate future. She had a few things she felt she still needed to do that were important, like attending her brother in-law's wedding to her best friend, and having a day of shared memories, visits, and possible goodbyes with her loved ones. That was what was important to her, not living for many more years or beating her cancer.It made me realize that most of the time when facing death people only really want one or two simple things,relief of suffering, and enough time to remissness on good times with loved ones and share those last moments with the people most important to them. That is the way I feel everyone should get the opportunity to pass, in comfort and at peace.

Anonymous said...

What caught my attention about Jewel's decisions regarding her treatment was her insistence on not taking risks. On page 68 she says "I don't want to take risky chances", then again on page 69 she makes known she will undergo the surgery as long as no "risky chances" are taken. This stood out to me in particular because I feel that it shows how much she didn't want her ailments to interfere with enjoying as much of her life as she could. Also, being family oriented myself, I admire her persistence in choosing the route that takes the least risks so she can feel as best she can and enjoy her friends and family for what would end up being her last days.

Sydnee T.

Jasmin Smoot said...

When I first began reading "Risky Chances" I assumed it was about a person with a gambling issue (i.e. blackjack, poker, craps, etc). In a way, I do see life as a gamble. The woman who was discussed in these few pages had to make a life changing decision: choose to get a surgery with the chance of saving her life, or making things worse, or continue to stay in the same state she was in. According to Dictionary.com, a gamble is "any matter or thing involving risk or hazardous uncertainty." Mrs. Douglass was so unsure about what decision to make. I know if I were to have been in the same situation, I would be terrified. It is almost as if the bad outweighed the good. How could someone just expect me to make a choice so hastily? But one thing I admired about her was her serenity and optimism. All through the confusion and fear, she saw the bright side to it all. She fully accepted herself and came to terms with the fact that death was approaching. This was an amazing read and I hope to be as positive as she.

Naomi Olsson said...

Through reading the chapter I found page 67 to be the most surprising and memorable part of the patience decision. This part caught my attention because it really got me thinking about what I would do were I Mrs. Douglass' position. What would my priorities be. Mrs Douglass wanted more than anything to go to her best friends wedding. "She was willing to do anything to make it, she said." (67). I understood that she wanted to go to the wedding and it was her top priority. That is when I realized that I would have done the same thing if I were in her shoes. I would have wanted to be with my family and friend and not take the chance on the operation. I also realized that we as human beings never think about these things until we are faced with such a difficult situation. It really got me thinking about what choices I would make if I knew that I would be dying.


Naomi Olsson

Naomi Olsson said...

Through reading the chapter I found page 67 to be the most surprising and memorable part of the patience decision. This part caught my attention because it really got me thinking about what I would do were I Mrs. Douglass' position. What would my priorities be. Mrs Douglass wanted more than anything to go to her best friends wedding. "She was willing to do anything to make it, she said." (67). I understood that she wanted to go to the wedding and it was her top priority. That is when I realized that I would have done the same thing if I were in her shoes. I would have wanted to be with my family and friend and not take the chance on the operation. I also realized that we as human beings never think about these things until we are faced with such a difficult situation. It really got me thinking about what choices I would make if I knew that I would be dying.

Kytela Medearis said...

The situation with Jewel (page 67) dredging resonated with me. Cancer is such an awful disease it is hard for me to fathom someone not wanting to continue the treatment for it. For Jewel to stop chemotherapy in order to live out her last days the way she wants is extremely humbling. She wanted to have a great end of her life that isnt hindered by the effects of chemo.

Xavier J. said...

This piece of writing illustrated the concept of priorities very vividly. As I read the essay, my idea of what the writer wanted to convey changed drastically from keeping Ms. Douglass alive at all cost to striving for the story that you want told . Ms. Douglass put more value on her social connections with people in her life than her natural life and I found that very admirable.

Bman L said...

What caught my attention was when Jewel said she didn't like the contraptions sticking out of her. Considering that one of the main themes of this story is death, these contraptions signify that Jewel is prolonging the inevitable. Two weeks after the doctor visited Jewel, Jewel's daughter sent a note saying she passed away, which further proves my point. (70-71)

Brandon N.

Jade Huerta said...

On page 68, Jewel Douglass canceled her surgery because she didn't want to take any risky chances. This caught my attention because she thought of everything that could go wrong, and thought of nothing that could go right. I feel as though everyone has that point in their life when something life changing is about to happen, and instead of seeing the good, people only see the bad because there is always still that chance that something could go wrong.

Although she did not want to go through with it, she did, and no risky chances were involved thanks to her doctor. In the end she was grateful for the decision she made because she was able to be surrounded by her loved ones before her time came, and that's all that matters.

Jade H.

Sandra Yokley said...

In reading "No Risky Chances" by Atul Gawande, Jewel Douglas made several decisions in regards to her health and future. One particularly notable one to me was found page 67 in her responses to question about what sacrifices she was willing to endure. She was clear - "not a lot" - she said. She was passionate and persistent about being a part of her friends' wedding. I'm afraid this excitement may have potentially blocked her judgement on what was best from an outside point of view, but for her, it was worth it. And that's why this scene was most notable to me. What seemed foolish to me was what she knew would bring her the most joy in that moment. With her being so clear and straightforward about the goals she wanted to accomplish, I would have rest assured in her decision to pursue going to the wedding.

-Sandra Yokley

YaQkeha Witherspoon said...

The most concerning point that was made was when Gawande talked about people having two selves on page 68 after Jewel said that she was afraid and did not want to take risky chances. I think that remembering what pain feels like and the risk of having to feel that again scared Jewel. Sometimes the remembering self can be stronger than the experiencing self, and knowing which one to listen to is hard. Ultimately, I think Jewel made the decision that she thought that was best for her.

Deborrah Blackburn said...

One point that caught my attention was when Douglass agreed to the surgery but only if there was minimal risk involved.(69) She made this decision because she didn't want to lose the chance to see her family before she died. This caught my attention because most people don't know that a patient is allowed to make decisions like this for themselves. Often times they listen only to the doctor or other medical professional who wouldn't know what is important to you. This is very important for patients who are terminally ill to know that they have the right to choose their own treatment.
Deborrah B.

Nia Oke-Famakinde said...

One point concerning the patient’s decisions that caught my attention was how clear Jewel Douglass was on what she wanted. On page 67, the author wrote "Not all can answer such questions, but she did". This stuck out to me because even though Jewel was in a severe situation, her goals of going to a wedding and being with her loved ones remained clear. In situations where a person is terminally ill, the person may feel confused to how to go about deciding on what risks they'd take to potentially become better. Or the person may make discisons off of bad judgement due to their emotions. This is why I believe Jewel's ability to know what she wants and what risks she would take is remarkable.

Nia O.

Cody Osborne said...

By far the biggest surprise for me was when she elected to no longer continue her chemotherapy treatment (67). However, I can also understand why because of what my grandmother went through and while she elected to halt the treatment, just as Jewel did, she knew that it was because it was keeping her from enjoying her last few days here. That was 20 years ago and somehow she's still at it...

Cody Osborne

Tiera Williams said...

There were a lot of notable points that caught my attention in this chapter. The one I'm choosing to comment on, however is on page 67 when the doctor asks the patient "what sacrifices she was willing to endure now for the possibility of more time later." Her response was "Not a lot." The reason this response stood out a lot for me is because I feel it is an important question I along with other college students should be asking ourselves when it comes to our education. What sacrifices are we willing to make now to contribute to our futures? When you're young it's hard to think past the now and you have a different perspective on sacrifice and what's important. It opened my eyes to a bigger picture of the term sacrifice. And ask myself the question what am I willing to sacrifice now for the possibility of a greater outcome later on. In this case to obtain my degree.

- Tiera Williams

JAme said...

I found Jewel's resistance to surgery the most striking(pg.69). In stories and real life we never hear about the person who would not rather take the risks to get better, but to just struggle through with what they were already dealing with. It was a bit of a shock to read about someone who decided not to take every chance they could to make it through their sickness.

Tameah F said...

Jewel's decision to not try anything risky was very intriguing to me. Most people expect the only solution sick and elderly people want is to live longer, but Jewel only looked forward to spending her last days with her family, rather than lying in a hospital bed recovering from a surgery that had a 25 percent chance of going wrong. The fact that she died peacefully while she was asleep, made the entire chapter very enlightening.

Andrea R. said...

The most notable part for me about Jewel's decision was how she didn't want to take any "risky chances" when it came to surgery (pg.67). While her decision may seem like a shock, I also believe she was more worried about how things could go wrong because she was already in such bad shape and older.This part was also notable for me because I had a similar experience when my grandma had to go to the hospital for a health related issue. Although she was not worried that the surgery would go wrong, we were all afraid for her because of how old she was and how serious the issue was.

She did make it thankfully.

Anitra B. said...

As others have mentioned above, the point that caught my attention was when Jewel decided she did not to take any risky chance. With every surgery there are risks that involved, and even if the risks are low the outcome is still unknown. I think that what she did was courageous. Jewel wanted to make sure that she was still there for her loved ones and had a good quality of life. I respect her decision.

Persephone C. said...

After reading "No Risky Chances" the most notable part about Jewel's decision was in page 69, when she chose to get surgery done but did not want the surgeon to make any risky decisions. She wanted surgery, but only if it was surely going to make her better.
That part really stood out to me, because it shows how strong Jewel was. She was not worried about the longevity of her life if she would be living in misery. She was able to accept the fact that if it was her time, then it was her time.

Victoria Wright said...

After reading Gawande's article, the thing that caught my attention about the patient's decisions the most was that she kept her head up even though everything concerning her health was going downhill. She seemed so calm about everything going on and she kept a positive mindset and a smile on her face no matter what. She loved being able to see her family for the last time, she was thankful for the tubes inside of her that were hanging out of her, and she kept talking about good memories(Gawande 70). Mrs. Douglass's gracefulness and gratefulness as her world was ending inspired me to be just like her while mine is still spinning.

Miya Evans said...

on page 67, the patient put her own needs aside for the happiness of others. This is a side of humanity that can sometimes get lost with all the hustle and bustle that goes on. Out of all the options, she chose the least evasive route even though it wasnt her best option. This stood as a surprise to me. Most people like to consider their own lives, but in a way she did. She spent her remaining days surrounded by family and love. She went out on her terms and i think that speaks volumes.

Rodrick Robins said...

On page 67, when the patient chose to attend a wedding instead of mind her own health, I thought it surprising and interesting. Upon further thought on the patient's decision, I realize that perhaps she valued sentimental and family time more than time alone, being sick, and going through procedure. The patient valued time of the spirit more than time of the physical.

Victoria Wright said...

The most notable part of Gawande's article to me was how Jewel stayed positive and kept her head up no matter what. He always walked in to her smiling and greeting him as if she wasn't hurting. Jewel's decision not to have the risky surgery was made with the mindset of "no risky chances" (Gawande 69)... she didn't want to suffer. I agree with her decision because she knew what was happening and she wanted to pass away in her own way, not because of a risky chance she took. Jewel influenced me to stay positive even through the terrible times, because we can make decisions on our own concerning our lives.

Anitra B. said...

As others have mentioned above, the point that caught my attention was when Jewel decided she did not to take any risky chance. With every surgery there are risks that involved, and even if the risks are low the outcome is still unknown. I think that what she did was courageous. Jewel wanted to make sure that she was still there for her loved ones and had a good quality of life. I respect her decision.

Joey N. said...

While reading the selected reading a point that stood out to me was when the doctor asked the Jewel what sacrifices she was willing to to endure now for the possibility of more time later on page 67. This moral dilemma is both intriguing and prevalent in the world today. Whether its school or jobs, men and women make sacrifices every day in the hope of a better tomorrow.

Tashawna N. said...

One thing that caught my attention through out this was when she was able to say what she wanted and answer the questions her doctor had (pg. 67). This stuck out to me because most of the time people don't ever really know what they want. She was not afraid to say what she wanted and just lay back and go with whatever was suggested but she told them what she did and did not want to go through and from that she got more options and was able to spend her last few days somewhat at peace.

~Tashawna N.

Anonymous said...

The most notable decision that Jewel made was when she allowed him to do the surgery while stressing 'no risky chances.'She wanted to do something to alleviate her pain and discomfort without being faced with the possibility of relatively sudden death. She wanted to be able to die on her own terms. She knew she'd been battling cancer and her fight was coming to an end, but she wanted to be able to die at home with her loved ones there o comfort her and say their goodbyes before her dying breath. I completely understand her mode of reasoning, but I cant say I wouldve done the same. I would have wanted them to try everything and at least i go down fighting. (pg.68)

Shelby Washington

Trion T. said...

One thing that was most notable about Jewel's decisions is how calmly she was able to make the decisions. At no point did she get hysterical about her situation. She knew exactly what she wanted in the end and she got it. Not many people can say or do that about regular things in life, let along end of life decisions.

Belainesh Nigeda said...

Most interesting to me in this article was how Jewel decided not to take any "risky chances" (69). It was interesting that although she has a terminal illness that she could still even call anything risky. If I were her, everything would be risky to me. Her calm and courageous reactions caused me to further evaluate her mentality. My interpretation of her definition of what "risky" meant is anything that would make her situation worse...whether it be her enduring more pain than before, having to stay in the hospital for an extended amount of time, or her dying in the hospital. I admire her for being optimistic about ending her story. She knew that her situation was in no way pretty, but she did know that she did not want to be in any pain and that she would prefer to end her story at home with her family and friends.

-Belainesh Nigeda

Isaiah Blackburn said...

Jewel Douglass's initial decision to avoid getting surgery really illustrated what was really important to her. When she mentioned her plans to attend a wedding in two days, Atul Gawande highlights that, "She was willing to do anything to make it." (p 67) This determination to continue making memories with the people she loves instead of prioritizing on extending her life really stood out. This style of thinking doesn't usually resonate with younger individuals because we are just beginning to be independent, giving us this illusion that we are immortal with all the time in the work. But, it is important to remember that death could happen at any time and to create good memories with people you care about while we can.

Xavier Morrison-Wallace said...

After all of the fear that she was experiencing, when Douglass accepted the offer of surgery the second time stood out. she was more calm this time in making her decision because she was more comfortable and had some determination. Jewel's daughter was there(69) to give her determination and knowing that the doctor will at least try to manually remove the tumors in order to make her future better gave her more comfort.

Kelsey W said...

Douglass was scared but did not want to show it. She seemed to me still so full of life even though she knew it was quickly coming to an end. Her decision about not taking any risky chances during the surgery was notable to me. In most movies or books or in the media, the focus is people saying "Do whatever you can to save me" or whatever else along those lines. This article is real though. Douglass wanted to go with dignity and happiness. p.69

Dakarai P. said...

Jewel put on such a brave face and acted so causal even in so much pain. What stood out the most to me was the face that she put off surgery to go to her best friend's wedding. (p. 67) She was terminally ill but refused to stop enjoying her life. She was able to end her story the way she wanted to.

Andriana C. said...

What caught my attention most was Jewel's ability to lighten the mood in spite of all the negativity around her. The operation she was timid about went poorly, she knows her remaining time was limited. Even so, she said "I was never obsessed with food anyway" after finding out she would not be able to eat normally (Page 70). It's positivity and not denial coming from her. She knows her fate, but she still makes small jokes like this to better the situation for those around her. This stood out most to me.

Curtis Tallie said...

What caught my attention on page 67 Jewel was going to sacrifice getting the surgery she needs for her best friends wedding. This point stood out to me because it shows how much she really wanted to go to the wedding for her friend despite needing surgery because she was very ill.

Laree keys said...

With Mrs Douglass choice to avoid immediate surgery and attend a friends wedding I was somewhat surprised. This article explained that Douglass had quiet a few immediate family members and as a result of this I would have thought she would take the most immediate procedure to ensure more time with them. In the end however, it was very admirable of Douglass will to sacrifice her days for a very important event of friends.(67).

Alicia Sears said...

What struck me the most was Jewel's ability to stay so positive and calm throughout her situation. Jewel knew that she had lived a great life and did not show a fear of death which is how I think everyone should be. Jewel managed to keep a smile on her face and even managed to make decisions that would improve the quality of life and not just elongate it. (page 70)

Quincy S said...

After reading Gawande’s article, one point concerning the patient’s decisions that caught my attention was the great lengths the Doctor went to respect Ms. Douglas's wishes regarding her treatment. It is understandable why she she would not want to bring anymore trauma to her body. However, once she agreed to surgery I figured she would want all measures taken during the procedure to ensure the possibility of recovery. That is why the scene where the doctor decides against a risky chance, and shifts his focus stands out to me. Even if he thought the best route during surgery was to remove as many tumors from her abdomen, he had no choice to abide by Jewel's request.

Barry F. said...

After reading Gawande's article, it made me think more deeply into how patients view the last moments of their life after being diagnosed with a terminal illness. Jewel wanted to end her chemotherapy (67) and just to have a seemingly normal life for a few days. The side effects of chemo are terrible and I could fully understand why someone would want to make that decision.