Sherwin B. Nuland wasn’t the first writer, or the first physician, to recoil at the aggressive efforts doctors sometimes make to keep patients alive long after it’s clear that they can’t be saved. But Nuland’s 1994 book “How We Die” came along amid a broad public debate about end-of-life care. For readers accustomed to seeing death as an abstraction that occurs mainly in hospitals, Nuland painted a vivid picture of how death actually occurs. He made a humane case for letting patients decide whether to accept death or fight it to the very end.
“How We Die” was a bestseller and went on to win a National Book Award — evidence of the urgency of the topic for many Americans. Yet Nuland’s work also reflects a deeper need within the medical profession to communicate better with the public about the moral and emotional issues embedded in so many health care decisions. Beyond his books, he spoke movingly about undergoing electroshock therapy to treat his own crippling depression. When Nuland died Monday at 83, he left behind a model for other doctors who seek to demystify the healing professions. He also left behind a franker public discussion of death, the one experience that all patients will eventually confront.