2 •Things Fall Apart

Medicine and public health have transformed the

trajectoryofourlives.Forallbutourmostrecenthistory,
deathwasacommon,ever-present possibility.Itdidn’t
matterwhetheryouwerefiveorfifty.Everydaywasa
rollof thedice. Ifyou plotted thetypicalcourse of a
person’s health, it would look like this:

Lifeandhealthwouldputteralongnicely,notaproblem
intheworld.Thenillnesswouldhitandthebottomwould
drop out like a trap door—the way it did for my
grandmotherGopikabaiGawande,who’dbeenperfectly
well until the day she was struck by a fatal case of
malaria,noteventhirtyyears old,orforRichHobson,
whohadaheartattackonabusinesstripandthenwas
gone.