Gawande begins by noting that as comprehensive as his medical education was, the issue of mortality was never truly addressed. The only time he remembers discussing mortality was during a Patient-Doctor seminar geared towards making physicians more humane and responsive. In that course, he and classmates read and discussed Tolstoy’s novella, “Death of Ivan Ilyich.” Gawande reflects on the suffering of the titular character, which was made so intense because no relative, friend or neighbor was willing to openly admit that Ilyich was dying. Instead, he was told he was simply ill. More and more expensive doctors were sent for, and Ilyich was forced to undergo pointless and supposedly curative measures. As a doctor, Gawande notes that what Ilyich clearly wanted, and needed, was someone to help him in his fear of death and to offer him companionship at the end. Gawande connects his thought on this book with his own experiences with a patient, Mr. Lazaroff. Mr. Lazaroff’s prostate cancer had spread throughout his body yet he underwent a surgery to have a tumor removed from his spine. Though the surgery was technically a success, Mr. Lazaroff never recovered from the procedure and spent his last days on a ventilator.