Best Complications: A Surgeon's Notes on an Imperfect Science By Atul Gawande

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Complications: A Surgeon's Notes on an Imperfect Science-Atul Gawande

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A brilliant and courageous doctor reveals, in gripping accounts of true cases, the power and limits of modern medicine.Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is -- complicated, perplexing, and profoundly human. Atul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur and why good surgeons go bad. He also shows us what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause; a young woman with nausea that won't go away; a television newscaster whose blushing is so severe that she cannot do her job. Gawande offers a richly detailed portrait of the people and the science, even as he tackles the paradoxes and imperfections inherent in caring for human lives.At once tough-minded and humane, Complications is a new kind of medical writing, nuanced and lucid, unafraid to confront the conflicts and uncertainties that lie at the heart of modern medicine, yet always alive to the possibilities of wisdom in this extraordinary endeavor.Complications is a 2002 National Book Award Finalist for Nonfiction.

Book Complications: A Surgeon's Notes on an Imperfect Science Review :



The author wrote 14 medical-related articles. He grouped these articles into 3 general categories. I’ve very briefly described the articles (and categories) below since your interest in this book may depend upon your interest in the topics the author has chosen to include in this book. Each article typically includes a specific patient’s case, which very nicely carries some of the general discussion over to real-world impact. Well written. Interesting. Easy for a layman to understand. But fairly general (i.e., no real surprises and not much new information).FALLIBILITY (I.e., doctors make mistakes) ----EDUCATION OF A KNIFE: New surgeons learning their craft by operating on real patients.COMPUTER & THE HERNIA FACTORY: Using computers and ultra-specialization to reduce medical errors.WHEN DOCTORS MAKE MISTAKES: Most doctors make mistakes. How can they be reduced?NINE THOUSAND SURGEONS: What it’s like at going to a surgeon’s convention.WHEN GOOD DOCTORS GO BAD: When an experienced doctor’s performance markedly declines.MYSTERY (I.e., not everything about medicine is known) ----FULL MOON FRIDAY THE 13th: Does the emergency room really get unusually busy on these superstitious evenings?THE PAIN PERPLEX: What causes pain? What drives the intensity of pain?A QUEASY FEELING: Nausea. Like pain, sometimes hard to determine its cause or alleviate its discomfort.CRIMSON TIDE: Nope, it’s not about periods – it’s about blushing.THE MAN WHO COULDN’T STOP EATING: Hunger and the gastric-bypass operation.UNCERTAINTY (I.e., what’s really the right thing for the doctor to do?) ----FINAL CUT: AutopsyTHE DEAD BABY MYSTERY: SIDS (Sudden Infant Death Syndrome)WHOSE BODY IS IT, ANYWAY?: Letting patient’s make their own informed decisions about their medical care.THE CASE OF THE RED LEG: Diagnostic uncertainty, doctor’s gut instinct and flesh-eating bacteria.
I was referred to this book by a friend of mine who knew I liked the books of Malcolm Gladwell. I first read it near about when it came out, around 2002, and just got around to re-reading it. I had only remembered two of the stories from the book, so it was very similar to reading it again for the first time.The theme of this book is reflected in its three parts: Fallibility, Mystery and Uncertainty. Each part talks about a particular aspect of Gawande’s career as a surgeon that deals with the less-certain side of being a doctor. Each concept is accompanied by one or more anecdotal references to his own real-life cases that illustrate his point brilliantly.And that point is that doctors know a lot - but they don’t know everything. Their education and practical experience can help prepare them with knowledge, but skill comes from years of learned real-world practice. I could really sympathize with him and the stressors he has to deal with. I’ve been guilty as well of feeling my doctor must and should know everything that is right for me to do. The truth is a lot more complicated than that.This book doesn’t even take into consideration the patient frustrations with healthcare - cost, attention, etc. It really does focus on pulling the screen back and giving you a glimpse into the vast uncertainty that accompanies this sometimes wondrous profession.This is NOT a book that says, “I’m a surgeon. Here’s all the supercool things I’ve done and this is why I’m awesome and don’t you wish you could get me as your doctor?” This book shows the doctor, warts and all, and makes them much more human.

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