When Jewel Douglass returns to the hospital, Gawande realizes that being Dr. Informative is not adequate. Instead of just offering options, he also needs to talk with her about her biggest fears and concerns. He needs to hear her goals and know what trade-offs she will make or avoid. In the end, Jewel Douglass is willing to undergo some surgery but no risky chances. She is able to return home again and dies in her sleep. The author’s father passes in the same way, after deciding that he wants to be medicated enough to not be wakeful when he goes.

After his father’s passing, the author and his family travel to India to scatter his father’s ashes. As Gawande says his final goodbyes, he reflects on his deep admiration for his father. His father knew the limits of being human and lived with courage and acceptance within those limits. The author feels he is a better person and physician for all he’s taken from his father’s life and death.