Complications: A Surgeon's Notes on an Imperfect Science
Picador - Picador
Release date: 2003-04-01
Paperback
Author: Atul Gawande
Medical, Medical / Nursing, Essays, Health & Fitness / Health Care Issues, Surgery - General, Anecdotes, Biography, Surgeons, Surgery, United States
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Complications: A Surgeon's Notes on an Imperfect Science
Date undefinedIt's not that doctors skip most of their classes or that they're getting a second-rate education. It's that we walk in as enigmas--we don't fit the textbook case. Just extracting this idea from "Complications" is worth your time and money. Instead of becoming frustrated and/or scared from an "I don't know" response, we can attempt to appreciate the complexity of our bodies and the influential contexts in which we live.
Gawande writes with an excellent style. There's humor, irony and mystery throughout. The topics are fascinating and the information can even prove to be useful (it hit on an area of concern of mine).
Don't come here to research any given disease. Come here to be intrigued, entertained and exposed to a few big ideas, particularly, that medicine remains "an Imperfect Science." Highly recommended.
-Jack H. Bender, author of Disregarded: Transforming the School and Workplace through Deep Respect and Courage
Complications: A Surgeon's Notes on an Imperfect Science
Date undefinedThe author wrote many of these for The New Yorker and other publications; what is even more remarkable, however, is that he wrote these essays when he was beginning his career as a surgeon.
Surgery is among the most controversial, and difficult fields in medicine. The risks are so high, the complications so abounding.
I began reading this book with a jaded and jaundiced eye, hoping to find validation for my subjective impression of a field gone awry.
Intead, I had greater respect for the field of surgery, in the author's well-written and incisive book.
Complications: A Surgeon's Notes on an Imperfect Science
Date undefinedSimilar to his other book titled Better, Dr. Gawande divided his book into three sections: Fallibility, Mystery and Uncertainties. As much as I enjoyed reading the five fascinating stories about medical mysteries (Mysteries about Friday the Thirteenth, pain, blushing nausea and food obsession), I found the two other sections more stimulating and inspiring. Speaking from his own experience (many of them gruesome and daunting), he successfully convinced his audience that medicine is full of uncertainties and doctors, just like any other human beings, are not infallible (even though we may hope that we are not).
In Education of a Knife, he candidly and modestly described the enthralling, and at times disappointing and frustrating, learning process he went through to administer a central line on live patients during his surgical training. The discomfort he caused during his first few unsuccessful trials led him into asking the question, "Is it possible to train the novices without harming patients or putting them at risk when only relentless practices can lead to perfection?"
Another story that caught my attention is When Doctors Make Mistakes. I was mesmerized by his honesty and morality in telling the mishap he encountered during his first emergency tracheotomy. We, human beings, have the natural tendency to hide our failure. When we make mistakes, we often shift the blame to others as a damage control. It is incredible that instead of hiding this episode of embarrassment, he laid it all out in complete details and full disclosure (just like a journalist would for the most controversial and intriguing story) to make the point that doctors are infallible no matter how much they strive for perfection because there are always other contributing factors such as "the lack of standardized protocols, the surgeon's inexperience, the hospital's inexperience, inadequately designed technology and techniques, think staffing, poor teamwork, time of day, the effects of managed care and corporate medicine, and so on and so on." If Six Sigma is not achievable in medicine (as possible in other industries) at our current time, the least we should do perhaps is to aim closer to this target?!
Whose Body Is It, Anyway? is another thought-provoking story included in this book. It examined the various questions about patient involvement in decision-making during the treatment process. The key question is not whether patient and their families should be involved in the decision making process, but how best can physicians guide them through the process and work collaboratively with them when they are clearly incapable of making the decision during such vulnerable moments in their lives when emotion overrules logic (as demonstrated by Dr. Gawande's own "childlike regression" during his daughter's hospitalization).
