Discussion Guide

Book Club Discussion Guide

1. As a reader, have you experienced the kind of day that makes you question everything you’ve done and causes you to worry about all that the future holds? Do you believe these types of experiences are healthy in the long run?

2. In Chapter 3, Dr. Dosa discusses his fears about “ending up like Ida.” Do you think his fears are rational or irrational? Is it beneficial for a doctor to have a sense of his/her own mortality?

3. In Chapter 3, Kathy reminds Dr. Dosa that the little victories and experiences are all that matter. What do you think of Kathy’s coping mechanism?

4. In Chapter 6, Dr. Dosa talks about the difficulties of talking with patients about end-of-life care—particularly in slowly progressive diseases like dementia. Was Dr. Dosa wrong to suggest that Frank consider pulling the plug on his wife, Ruth? What are your feelings about end-of-life decisions?

5. In Chapter 9, Ms. Straham belittles one of the aids about a pair of shoes. Discuss why you think she had such a reaction and whether or not you think she finally saw the error in her ways. Do you think Dr. Dosa was right in chastising her?

6. In Chapter 11, we learn about how Lino Ferretti’s wife often played music in his room. Why do you think music can comfort patients even after communication skills have been lost? Do you think Oscar and other animals could provide similar comfort?

7. At the beginning of Chapter 19, Cyndy Viveiros refers to death as the “dirty D word.” Why do you think our culture is so afraid of death? Do you think our fear of death affects our medical decisions and prevents us from achieving what we want in our health care system?

8. In Chapter 20, Frank requests privacy with his wife, presumably for some intimacy. What are your thoughts about allowing sexual relations on a dementia floor? Ethically, where do you draw the line between mutual consent and taking advantage of someone with a medical illness?

9. In the book, Frank Rubenstein remains fervently attached to his wife Ruth, serving as her staunch advocate. Yet, at the end of the book, he says goodbye to his wife for the last time, after she forgets who he is. Do you think Frank’s action is an act of abandonment or love? What would you do if you were faced with a similar situation?

10. Steere House believes that all patients should leave the hospital as they entered it—through the front door. In our culture that shies away from death, are such rituals an important part of closure, or are they exploitative? Should other hospitals and health care facilities adopt similar end-of-life rituals?

11. By the book’s end, did you come away with an appreciation for what Oscar provides to end-of-life patients and their families? Do you think he is unique, or is it possible that other animals are equally intuitive?

12. Throughout the book, there are many examples of family members and their coping mechanisms. Diversion, misdirection, and guilt are among them. Discuss some of the healthier ways of coping with the illnesses of loved ones.