Hope for a Cool Pillow


Hope For a Cool Pillow – 

Outpost 19, 2016 (Amazon, 2017)

“From the end of the bed, I marveled at her quiet aplomb. This is the way to go, I realized.”

Hope for A Cool Pillow is Overton’s passionate argument for planning end-of-life care. As physician, daughter and student of American health care, Overton deftly shows us the emotional, financial and physical costs of not being prepared. Her daily rounds reveal harrowing consequences, her studies at Harvard highlight the industry’s limits, and her own aging parents make her case universal. Deeply felt and frankly told, this book will challenge and guide to make your own choices about end-of-life care.




Within the arena of questionable and expensive medical procedures, Overton (Good in a Crisis) weighs in with a fresh perspective on end-of-life patient care. Drawing from her background as an anesthesiologist and as a caregiver for her aging parents, the author strongly advocates the necessity of palliative treatment and interrogates the practice of prolonging life among the terminally ill. She contends that in addition to valuable resources being taken from patients who might have a high chance of recovery, the quality of life is affected adversely. Generally, the culprits are a lack of communication and preparation. When physicians are reluctant to explain fully their patient’s options, and patients don’t take responsibility for their own health, the end-of-life experience will be especially challenging. A wealth of credible information in Overton’s writing is evidenced by the well-documented bibliography. VERDICT: This book should be required reading for general readers who have not yet considered terminal illness, either for themselves or for their loved ones.”Library Journal, March 15, 2016


[Has] abundant humor that makes a tough subject accessible”

With longer life expectancies has come heightened concern among children of aging parents about quality of life, or, to be more   precise, quality of death. It is, for some, a terrifying conversation that many families put off for another day. Not Margaret Overton’s family. Overton, an Elmhurst native, recalls that her family had the conversation “all the time.” Her father was obsessive about it.

“He would send my sisters and I mimeographed letters with updates on his end-of-life plan,” she says. “I thought this was normal.”

After Overton became a physician, she realized her family was an exception. She began to see families at the hospital where she worked who had not had not discussed end-of-life care, so the patients’ wishes were unknown.

To encourage more conversations along these lines, Overton has written, “Hope for a Cool Pillow,” a memoir chronicling her experience…(read more)” — The Chicago Tribune


Death is, for most of us, an uncomfortable topic. In Hope for a Cool Pillow, Overton has shared an intimate insider’s view of different sides of the healthcare equation. As such, it is a thought-provoking read.”   – Chicago Book Review

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wry, out-of-the-ordinary new memoir…I loved every bit of this short, powerful book.” 

“If pressed to say which books Margaret Overton’s wry, out-of-the-ordinary new memoir most reminded me of, I’d describe it as a cross between Atul Gawande’s Being Mortal and Roz Chast’s Can’t We Talk about Something More Pleasant? The Chicago-area anesthesiologist is the author of a previous memoir, Good in a Crisis (2012), about the aftermath of a divorce and a brain aneurysm. Her latest book, which released on March 1st, started off as a manifesto on the need for an overhaul of American end-of-life care, with a strong drive towards creating an advanced directive and otherwise being meticulously prepared for one’s own death.

From there, I gather, the book took on a life of its own. It’s delightfully digressive, incorporating cases Overton observed in the hospital where she worked and lessons gleaned from a Harvard Business School course on healthcare delivery but also her personal experience of guiding her parents through their last days – her father died of lung cancer in 1998 and her mother, who suffered from dementia, finally followed in 2010.

Years surrounded by infirmity and the possibility of death have convinced her of the benefits of hospice and physician-assisted suicide, still only legal in a few states. We need to know (as we already do for our pets) when suffering is too much and stop extending life at any cost, Overton insists – rather than allowing hospitals to profit from death, as currently happens, with many elderly patients undergoing expensive and ultimately ineffectual procedures in their final weeks. “The last six months of life accounted for roughly twenty-five percent of our Medicare spending.”

For as universal as suffering and death are, we sure are wont to refuse them space in our lives. Again and again Overton uses the striking metaphor of “lemon juice,” drawn from a news story about a hapless would-be bank robber who thought spraying himself with lemon juice would make him invisible to onlookers and police. In our daily lives, she opines, we keep wearing that lemon juice, denying that there is a problem with our healthcare system and our thinking about death.”

        Read Full Blog Post   –Bookish Beck


Dying isn’t funny, but Overton finds humor in it…” —  My Statesman (Austin American-Statesmen) (read more)


A moving argument for the reform of end-of-life care. In 2010, as her mother declined from dementia, anesthesiologist Overton (Good in a Crisis, 2012) enrolled in a nine-month Executive Education course at the Harvard Business School called Managing Healthcare Delivery. She was searching for answers about the failures of the health care system, particularly about ways in which practitioners treat dying patients. In a patient’s last year of life, she discovered, “nearly one in three had surgery”; in the last month, “nearly one out of five”; and in the last week, “nearly one out of ten….Those are astounding numbers,” she admits, and believes the profit motive—on the parts of drug companies and hospitals—is driving unnecessary and expensive interventions. Patients who undergo such treatment do not live longer than those in hospice, where the cost is about one-third of that in hospitals. Interwoven with her reflections on the Harvard course and her own medical work, the author sensitively recounts her parents’ last years. Her father endured bouts of chemotherapy, radiation, and surgery for metastasized cancer, each time told by physicians that he would not suffer. But he did: “is lying easier than telling people the truth?” Overton asks. “We routinely make people suffer for no clear benefit except to ourselves,” she writes, and communicate in “euphemisms and circumlocutions.” Eventually, her father experienced excellent hospice care, but her mother had a less positive experience. With hospice now “big business,” Overton strongly recommends comparison shopping. She also advocates setting up medical directives, making wishes known to loved ones, and being aware of such organizations as Compassion & Choices and the Final Exit Network. Based on her personal and professional experiences, the author is convinced that neither legislation alone nor the health care industry can solve its complex problems. Capitalism, she concludes has ‘ruined healthcare.’ A timely, informed contribution to the ongoing debate over our nation’s health care policies.”  – Kirkus


Hilarious and compassionateHope for A Cool Pillow should also be read by anyone over 39 for its hard-won gerontological wisdom. Even those terrified by its subject should find it both useful and grimly entertaining.” – James McManus, author of The Education of a Poker Player


One of the ways many of us must repay our parents for bringing us into life is to hold them as they leave it. In Hope for A Cool Pillow, Margaret Overton confronts the deaths of her own parents with profound, aware love, serious thinking about our current way of death in America, and always her clean, beautiful writing. Anyone who loved Roz Chast’s Can’t We Talk About Something More Pleasant will want to read Hope for A Cool Pillow.” – Thomas Dyja, author of The Third Coast


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