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

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Gently dismantling the myth of medical infallibility, Dr. Atul Gawande's Complications: A Surgeon's Notes on an Imperfect Science is essential reading for anyone involved in medicine--on either end of the stethoscope. Medical professionals make mistakes, learn on the job, and improvise much of their technique and self-confidence. Gawande's tales are humane and passionate reminders that doctors are people, too. His prose is thoughtful and deeply engaging, shifting from sometimes painful stories of suffering patients (including his own child) to intriguing suggestions for improving medicine with the same care he expresses in the surgical theater. Some of his ideas will make health care providers nervous or even angry, but his disarming style, confessional tone, and thoughtful arguments should win over most readers. Complications is a book with heart and an excellent bedside manner, celebrating rather than berating doctors for being merely human. --Rob Lightner

In gripping accounts of true cases, surgeon Atul Gawande explores the power and the limits of medicine, offering an unflinching view from the scalpel’s edge. Complications lays bare a science not in its idealized form but as it actually is—uncertain, perplexing, and profoundly human.

Customer Reviews:

  • Thoughtful, provocative
    This book is no longer new. Dr. Gawande is no longer an unsure resident. The themes, however, transcend his own experience and certainly may be considered memos from many a young doctor's story, regardless of medical specialty. I recently read this book, while currently finishing my training at Dr. Gawande's hospital, and it seems a shared experience, separated only by time and specific patient interactions. It is a fast read for anyone interested in the evolution of a physician-in-training and a psychologic elixir for those physicians-in-training who pick it up....more info
  • take it with a grain of salt
    This book has gotten rave reviews but I was not so impressed. Dr. Gawande describes his training in a large academic medical center where every test, scan and specialist is available at the snap of ones fingers. Mobs of specialists descend on complicated patients like swarms of locust. Dr. Gawande describes one anxiety filled period time when he has to wait a full 20 minutes for one such specialist to appear. This is not how most medicine is practiced. I think Dr. Gawande should do a shift in a rural emergency room to learn what real uncertainty is all about. ...more info
  • Great writing and some good old-fashioned follow-up reporting
    MacArthur Fellow. General Surgeon. Staff writer for The New Yorker. Assistant Professor at Harvard Medical School and Harvard School of Public Health. Husband. Father of three.

    That's nothing short of amazing. What's more amazing still is the quality of the writing - it's insightful, fast-paced, educational, and chock full of applicable research and the results of some good old-fashioned follow-up reporting by Dr. Gawande. Gawande is quick and gracious to spread praise to his editor, Henry Finder. Indeed, the pieces seem supremely edited. I'm struck by how focused and well-crafted they are. Results like this aren't from happenstance. Gawande talks of Finder's "patience and persistence and optimism to pull me through seven complete rewrites of the first article I submitted to The New Yorker." That effort is borne in spades on these pages.

    I enjoyed every piece. What stands out is how much more there is to doctoring than just the practicing of medicine and how well Gawande gets to the essence of those 'other' aspects. ...more info
  • Realistic and Entertaining
    I bought this book a year back but started reading just a month ago and finished it in no time. The theme of the book is to underscore medicine being an imperfect science. I hope all people read this book and understand that medicine is an imperfect science and the result of any surgical or medical intervention may not be what they expect. Unfortunate result doesn't always mean doctors were negligent.
    The first chapter highlights the dilemma of allowing novice trainees to practice the procedures to become experts. While no patient wants to be treated by a trainee resident how shall we get doctors for the future?
    I particularly liked the chapters on impaired physicians, 'When Good Doctors Go Bad.'. He depicts the life of an orthopedic surgeon who suffers from depression and is forced to leave the practice. And there is very little support for the impaired physician from the hospital they work for, the state they work in. A real tragedy.
    The chapters on Annual Surgeons' conference - Nine Thousand Surgeons, The computer and the Hernia Factory, The pain Perplex are readable and very informative but not as dramatic as 'Full Moon Friday the Thirteenth.'
    The 'Dead Baby Mystery' depicts how criminals can take advantage of mysterious facts of medicine where in a woman killed several of her babies and claimed her babies died from 'Sudden Infant Death Syndrome.'
    The last chapter 'The Case of the Red Leg' is written like a suspense story.
    I couldn't put this book down. The writing flows nicely, the human drama is depicted like a TV series based in the hospital setting and it is backed by scientific data just enough to make us believe, nay, live through the incidents.
    My only grievance is while Dr. Gawande works every time in the OR with anesthesiologists why did he write so little about the imperfect science of anesthesiology?
    I hope may be he will in the future....more info
  • A Surgeon Reflects on his Profession
    This book is comprised of very thoughtful and well-written medical essays, much in the spirit of Jerome Groopman's writing. Because there are close to 200 reviews already, I'll keep this brief.

    Atul Gawande, M.D. and surgeon, writes about his experiences as a doctor and in the operating room. He reflects on what it is to be a doctor and a surgeon. I especially liked the essays about the impaired sugeon and the flesh-eating bacteria in a young girl's leg. Both essays were well-written and riveting.

    I recommend this book....more info
  • doctor diagnoses doctors
    Gawande's essays provide a long-overdue look at what it's really like to be a surgeon and the uncertainties and quirky personalities behind doctors' professional masks. It would appear that more recent books that take readers behind the scenes of modern medicine and explore the persons behind the mask owe a great deal to Gawande's pioneering work. He had the courage to explore and expose these issues when he was at a relatively early and therefore very vulnerable stage of his career. Would a female surgeon who tackled these subjects - and perhaps addressed the sexism in her medical speciality -- have been as well-received as Gawande says he was? Interesting question. Most of the topics are interesting - why good surgeons go bad, nausea, flesh eating bacteria. Although the essays at the beginning and end of the book are quite fascinating, the ones in the middle are uneven - both in terms of the quality of the subject matter and the quality of his writing. He's also somewhat formulaic in how he puts each essay together. But his candor, his evident commitment to his patients, his endless curiosity, and the way he follows up with patients about whom he clearly cares very deeply make this a wonderful read - and give laypersons reason to hope that if the need arises, we may have the good fortune to encounter such a caring and honest surgeon in real life. Well done and well worth reading. ...more info
  • Captivating Read!
    I am considering a career change to medicine and have recently undergone several surgeries myself. This was an eye-opening book that says what you know deep down, but that doctors usually will not admit: They may try their best, but they do not have all the answers and they do make mistakes. It's thoughtfully written, and full of compassion for his patients. It made me wish Dr. Gawande was my doctor. Every doctor should read to not lose sight of the patient perspective, and every patient should read to understand why they cannot expect perfection from medicine....more info
  • Vignettes On The Scalpel's Edge
    Being in the medical field, I found myself pretty engrossed in Atul Gawande's COMPLICATIONS. But even if you're not in medicine, there's no reason you shouldn't pick up the book. Focusing on both sides of the scalpel (those that get cut as well as those that do the cutting), the vignettes sketched out here are hit upon with compassion, thoughtfulness, and razor-sharp telling ("We have taken [medicine] to be both more perfect than it is and less extraordinary than it can be.")

    Gawande holds back nothing in his narrative. One chapter will discuss the evolution of a surgeon and how perilous and dangerous it can be ("Everyone wants a surgeon with experience, but how does a new surgeon become the veteran?"), while the next will look at how effective specialized medicine is (a hospital that does ONLY hernia operations and how incredibly successful those surgeons are).

    The most frightening portion of the book -- for me -- was the discussion on dangerous doctors (chapter 5: When Good Doctors Go Bad). When MD's get older and can't function as well, or get burned out, or simply can't keep up with new medical technology, there's no system in place to remove them. The AMA, local affiliate groups, none have the sole power to remove a doctor until it is often too late for the patients (Gawande's examples are horrifying, showing us an orthopedist who had more law suits pending against him than patients in his practice, and still he practiced and operated).

    The big flaw with this "novel" is that it isn't novel at all. It is a compilation of short stories without a core. Whipping back and forth between medical superstitions in one chapter to the study of subjective pain the next, there's no rhyme or reason to the placement of chapters within the book. This isn't all bad, though, just something the reader should be aware of before digging in.

    Regardless, it is an eye-opener to those in the medical profession and those who are patients within it. Gawande is as sharp with his pen as he is with his scalpel. And he spares no one; from the physicians within his own cadre, to the misconceptions patients hold for their care givers.

    Complications should be required reading by all physicians, past, present and, especially, future simply because it is brutally honest and keeps its perspective tightly woven toward patient care....more info
  • Gawande is an asset to both the layman and the entrenched physician
    Atul Gawande has a keen eye for the fallibilities and eccentricities of medicine. While inherently clinical and precise, his prose is accessible and engrossing. This book should be on the must read lists of anyone who goes to a physician, and to physicians in practice. I laud Gawande for showing that medicine is far from a perfect science and is often more art than science. Medicine is often a guessing game based upon probabilities unclear studies. We treat our doctors with such a severe double standards. We expect doctors to be able to cure all of our health problems no matter the cost and yet we fail to take care of ourselves. We expect them to never make a mistake and yet often we are unable control our own diets, exercise every once in a while, or to follow medical orders properly. Gawande's ultimate purpose coupled with his gift of story telling, is to educate us all that doctors are not perfect, nor do they always have the right answer, in fact they often guess. Most of all doctors are just like you and me, do you ever make mistakes at your job? Do you think doctors are somehow exempt from this? Unfortunately the magnitude of their mistakes are often grave. Doctors cannot be perfect, but they must always try to be, what more can we ask. ...more info
  • Interesting insight into the world of being an intern and a doctor
    The first part of the book is the typical medical error conversation - the system needs changes, but, instead, the last doctor to touch a patient is always ultimately responsible. The last two sections of the book are full of interesting patient stories and antecdotes, leaving the reader with a sense of "why do I pay so much for services that are not consistent and not scientifically proven?" Gawande does an excellent job pointing out some of the uncertaintaties of medicine and some of the major health disparities and inequalities - the poor are usually the ones that are used as training tools for interns and residents, and receive subpar-care compared to the well-insured.

    A very easy and quick read. ...more info
  • Not that extreme
    Going into this book I envisioned many extreme surgical cases to overwhelm me. That wasn't the case though. This book only gives cases from one persons viewpoint as examples of the learning process for those in the medical profession. This book is really trying to gain a bigger audience than it deserves by playing up the complications of surgery when it is really more of a learning aid. I enjoyed it but was somewhat let down....more info
  • great book for medical and non-medical professionals!
    Excellent book on the imperfections of medicine. Keeps the reader interrested through the entire book - it's almost sad when finished......more info
  • Though provoking, and easy to read
    As a practicing psychologist and a professor who trains doctoral level psychologists, I really enjoyed reading about the need for trial-and-error in training / learning of an "imperfect science" and to hear a rational challenge to the notion that perfection is required in medical --or any other-- practice which involves human beings implementing and receiving an intervention. Gawande is a compassionate, perceptive, and thoughtful clinician; the kind of doctor I wish I had for myself and my children. ...more info
  • Great book
    This is an excellent book, especially if you are interested in medical ethics or in becoming a doctor. But for anyone, Gawande's stories are interesting and his writing style grabs your attention. ...more info
  • A peak inside
    I always appreciate a well written book that lets me into the inner circle of a group I will never know. "Reading Lolita in Tehran" served in much the same way....discussion between Muslim women in Iran behind closed doors. An American man will never hear those discussions. "Complications" is similar. I know physicians have their own argot...the secret language if you will, of their profession. They will never allow non-physicians to hear them speak/think be allowed into their clubhouse without the degree. Gawande let me a bit of a fly on the wall and I appreciate that. I rated this book four stars instead of five because he still hides out a bit behind his pride of profession. Wanting to show us without really letting us in. Hubris is too hard a word, but it's close.
    I've recommended this book....this one and Gawande's other, "Better" to physician friends. I haven't heard back, so I can't say how they will be received, but I suspect he'll get a five from a member of the fraternity."
    ...more info
  • Should be required reading!
    I really applaud Dr. Gawande for taking so much mystery out of health care. I've always felt that it was important to be a partner in my own health treatment, and I guess I would've considered myself an "educated consumer." But this book made me realize just how much I DIDN'T know about doctors, surgery, and so many other aspects of medical care. The way it's written, this book is an easy read... easy to pick up and read in bite-sized pieces. But, on a much deeper level, it gives you a much greater understanding of how doctors are trained, how they think, and how they're just as human (and fallible) as everyone else. On one hand, this book is a scary "wake-up call" for patients. On the other, it's an incredibly empowering and educational tool. Anyone who receives medical care should be required to read this book!...more info
  • Great Discussion Book
    I read "Complications" as part of a small discussion group at my med school. This book was wonderful!! It raised a lot of issues within medicine that aren't openly talked about. The book is a collection of short stories that have a central theme about how patients and physicians both want perfection, but that as human's we inevitably make mistakes. The hard part about mistakes in medicine is that they affect people's lives.

    Dr. Gwande explores mistakes as students (the care students provide will be "lower quality" than a physician with years of practice, but how else can they learn?), residents, and physicians with years of experience (what do you do about a physician who is grossly negligent but still allowed to practice?)

    The stories are well written, easy to understand, and a quick read. Well worth it!
    ...more info
  • A wonderful book: thoughtful, insightful, and clearly written
    I cannot recommend this book too highly for anyone interested in medical practice as a clinician, future clinician, present or future patient, or friend or loved one of a patient. In other words, just about everyone. I am using it in my Medical Ethics (philosophy) course because each of the essays raises important bioethical questions. We are also using it for an educational session in the Pediatric Ethics Committee of a major teaching hospital.

    My only regret in assigning Gawande's essays in a university course is that all of the other readings, even the best written, may seem a bit dull by comparison. Gawande is a master story-teller, and most of the essays tell compelling stories. More than anything I've read, they give the reader a feel for the drama of medical decision-making. But they do more than that because Gawande uses each narrative as a springboard for raising larger issues and, in many cases, offering insightful and compassionate suggestions for how to address them.

    Gawande's essays are, in spite of the ultra-serious subject, a joy to read. They are models of clarity and among the best-written essays I've ever read (and I've been teaching over 30 years).

    Gawande presents the medical profession realistically without sugar-coating. Medical errors and plain negligence are not ignored. But in the end one gains a realistic appreciation of the medical profession, of the frequent need to make life-and-death choices without the comfort of definite evidence, and of the extent and limits of patient autonomy. ...more info
  • Humble Human makes a Great Doctor!
    An amazing thriller...

    Dr.Atul's superb portrayal of finest qualities of a doctor, yet the limitations of an individual, their weekness,strengths, system flaws etc with vivid examples of real life cases makes "Complications" the best medical book I'v ever read.It's not the content of the book alone that deserves appreciation, it's also the flow of words that blend with the topic.

    Certainly the pinnacle of the book is the story of Joseph Lazaroff, Atul's Anguish depicting the finest of human character and also the professionalism of a doctor, also his questions behind the ethics of "absolute insane rights of patient's expression". I felt a pain in the heart for that "unknown soul" ( a gist of that chapter is below)

    Chapter : Whose body is it Anyway :
    ...I turned the ventilator off, and the suddenly the room was quiet .His breathing slowed ...Joseph Lazaroff had died.But Knowing how much Lazaroff had dreaded dying the way he died....

    Chapter : Education of a Knife:
    I said to the patient that there were "slight risks" involved.And the disasters weighed on my mind: the woman who had died from massive bleeding, the man who had to have a chest opened, the man who had a cardiac arrests.I said nothing of such things when I asked my patient's permission to do this

    Chapter : When Doctors Make Mistakes:
    At 2 A.M on a crisp friday in winter a few years agao, I was in sterile gown , pulling a teenage knifing victim's abdomen open, when my pager sounded "code trauma, three minutes"

    Chapter : When Good doctor's Go bad:
    Before the license of Dr.Goodman was taken away, he was a highly respected and sought after surgeon...he could do some of the best, most brilliant work around....In one case , he put the wrong-size screw into a patient's ankle,another case when he refused to do hip replacement. For the last several years, he was the defendent of a stream of malpractice suits.

    Chapter : The Man Who Cannot stop Eating :
    ...He had to let his legs apart to let his abdomen sag between them. He cannot lie down and breath properly because of excess fat in the tongue and upper airway. He had to sleep in the recliner and every thirty minutes or so , he would wake up asphyxating, He could no longer stand up to urinate, he had to shower after moving his bowels to get clean

    A Must Read book...Afterall, someday you might be an example in his future books!

    ...more info
  • Easy to read
    Needless to say, this is a very interesting book. What surprised me is that it is so easy to read. It doesn't have many big words or difficult medical terms. I really enjoyed the book. I especially recommend this to anyone interested in doctor's life or practice of medicine (from a non-technical and more general view)....more info
  • A Great Read !!!
    This book has such great detail thta you feel that you are right there and involved. The author is really good at defining medical terminology and, what others might not understand. Very good, if you interested in the medical field....more info
  • excellent product
    i am very satisfied with the quality of the product. it was a very smooth transaction and very quick shipping....more info
  • Boringgggggggggggggggggggggg!
    This book is too much statistics, and no story behind all their statistics. It is boring to the reader that likes medical stories....more info
  • eye opener to the world of surgery
    my husband is starting his general surgery residency this summer. i read this book a few years ago at his recommendation. it's opened my eyes to his world. i'm able to understand what he does so much better. the book is superbly written! my husband met Atul Gawande at one of his interviews and is in awe of him and his accomplishments. a must read for all of us who live this life of the surgeon....more info
  • I've been slashed
    I find this book which has gotten such rave reviews disappointing. Dr. Gawande addresses a number of issues which are pertinent to surgical practice. However,I found the book to be superficial and lacking of "heart".

    I will elicudate. Dr. Gawande states frequently that surgeons slash their way into a patient.I suspect that this is for dramatic effect.There are other examples of this such as the description of an autopsy.He tones it down later.He treads lightly on the fact that doctors don't want to own their mistakes which is why there is no improvement in medical care over 20 years ago despite huge advances in both technology and costs.

    The only Surgeon I have ever known who "slashed" his way into a patient ended up losing his privileges...thank God but it took many years and a yeoman's effort and those who spoke up were alienated and shunned. It was not as simple as is portrayed in this book.I do laud him for bringing up the "good doctors going bad" issue. It is a huge problem and bad doctors are often covered for years and years while patients are repetitively injured. It is also very harmful to the doctor who is creating the problem. The cost of this problem to patients, hospitals and society is staggering.

    I looked up the reference that computers were better than doctors at diagnosis. It is not about medical diagnosis, it was about psychologists' diagnosis. The second article was from 1954...A bit dated. before the computer era.

    I laud him for the courage in mentioning his screwed up tracheostomy attempt. There are numerous methods for both intubation and percutanous guided tracheostomy techniques that have been available for 20 years. I have to wonder why he was unaware of these. The technique that he describes for subclavian vein cathethers is also not as safe as other methods which use a small guage finding needle. I have to wonder why 20-30 years after these problems were identified that this young doctor was not being instructed in these techniques.

    His chapter on bariatric surgery is notable for his mentioning of the commercialization of medicine an increasingly dangerous trend is appropriate. At this point bariatric surgery has been shown to be helpful for a large number of patients, but without question medicine has been commercialized.

    His section on uncertainty is the best part of this book. He saved the best for last.

    Nonetheless, I find his "laissez-faire" attitude to these problems even more worrisome.I find little actual feeling that he cared about his patients in this book. This is not surprising as it pervades medicine today.

    I haven't found this book to be a thriller.It lacks depth of character. If he had connected with us and his patients emotionally I believe that it would have been a much more powerful work.

    Sharply contrasting the content of this book is Dr. Gawande's newest book BETTER. Better: A Surgeon's Notes on Performance .
    For readers of this book, reading BETTER is mandatory. It supplies much needed perspective and demonstrates the immense growth Dr. Gawande has gone through both in his professional development and literary ability....more info
  • The Best Doctors Are Fallible
    This is the sobering message of Atul Gawande's excellent book. A writer for the "New Yorker" as well as a practicing surgeon (how does he do it?), Gawande reflects on his profession as it really is--human beings trying to help other human beings.

    Gawande makes a persuasive case, on the one hand, for the routinization of medicine. He cites the amazing record of a hospital in Toronto which does only hernia operations. The goal is not a high success rate, but perfection, and the doctors there do hundreds of hernia repairs in a year--more than a general surgeon does in a lifetime. But Gawande also points out that fallibility is the price humans pay for being instinctive, for having that sixth sense that all of us often ignore at our peril. It was this sense that saved the life of a young patient who appeared to have a simple bacterial infection--having seen a far more deadly form of it recently, Gawande urged a biopsy, and against all odds he was right. An over-conscientious resident? Was he overdiagnosing? Performing an unnecessary, costly test? That's what we'd say if he had been wrong.

    Gawande writes with a humility and sensitivity that the stereotype of the typical surgeon doesn't have. We owe it to ourselves to be well-informed as consumers of medical services--but that needn't be burdensome or boring. I highly recommend "Complications."...more info
  • best med essays
    Dr. Gawande's book is one of my recent favarites. If you watch ER, Grey's Anatomy, this is a must have!...more info
    This book is plain EXCELLENT!

    A friend of mine suggested it, and wow, I found I had to force myself to stop reading and go back to work!

    Dr AG somehow has been able to combine extremely interesting and compelling medical cases with deep considerations about the field, about being a doctor, about the limitations of medicine and how we cope with them.

    Even more amazing is the humility and simplicity of the author's writing. No bragging, no self-praise, just an extremely intimate conversation on the experiences he had as a doctor, the lessons he learned and the meaning he saw through them.

    The feel of the book is that of an incredibly fascinating conversation with a close friend in a warm caf¨¦.

    thank you Dr.!...more info
  • Intelligently written.
    If you have ever wondered about this body of yours and about what goes on in the minds of Doctors who treat the many ailments of this body of yours,this is certainly the book for you. Never has a book of Non-fiction managed to be such a riveting read.

    Atul Gawande has written with intelligence, honesty, and with extreme respect and tenderness towards the many people that he introduces the reader to. Many of the complicated procedures of surgery are described in the most understandable language,that a person with no medical training such as I , feel very smart now!!
    I thank Gawande for this wonderful book, and hope to read his " Better" soon....more info
  • Lucid, Thoughtful, Entertaining
    "Complications" was written by Dr. Atul Gawande, a seventh year surgery resident at Brigham and Women's Hospital in Boston. In it, Gawande uses individual cases from his repertoire of experience to illustrate some of modern health care's most complex concepts.

    Gawande addresses topics like how surgeons are trained, how doctors make complex decisions, and how doctors are held accountable for thier mistakes. Throughout the book, Gawande portrays medical professionals not as omniscient restorative demigods but as fallible human beings: imperfect, error-prone, and often besieged by doubt.

    Though this book is not an expos¨¦ (Gawand has no particular axe to grind), its essential honesty - which is obvious and profound - provides an almost voyeristic glimpse into medicine's convoluted innards.

    Gawande's prose is lucid and uncomplicated. What's more, he manages to integrate his thoughtful philosophical discourse with gripping medical drama: the result is a intricately layered concoction that's both healthy AND delicious.

    "Complications" is as entertaining as it is thought-provoking. In short, it's exactly the type of book that's needed to inspire discussion about modern medicine: what it is, what it should be, and how to get from here to there. ...more info
  • Great book on surgery
    Atul Gawande gratefully takes the reader to the back of the OR, a place open for a few, yet intriguing for many. Dr. Gawande is extremely frank and poignant, as he describes actual cases from his own surgical practice. He admits that cutting someone open for the first time is hell, praises surgery which gives chance to obese people, wonders about doctor's intuition, and remains human in every case.

    As always, Atul Gawande is not just writing about medicine; this book reaches far beyond the realm of the operating room. He touches on the most complicated ethical questions of medicine and society as a whole. Gawande speaks of mistakes and our imperfect judgment; tackling the questions of good doctors gone bad along with malpractice claims and punishments. He makes the case for autopsy as a means of learning. He admits that medical students must practice on cadavers or animals in order to cut people open; all ethical questions are answered by means of vivid examples.

    For instance, in the 1980s the death rate from a particular surgery would be about 10%. When the new surgical treatment of heart pathology arose, surgeons started trying the novice. At that training period, the rate of children death from this particular intervention increased to 25% of cases. Sounds horrible? Yes, but after surgeons learned, the rate fell down to just a couple percent. Was it worth it? Sure, granted the number of lives saved in the long run. Never, granted now many kids died just due to surgeons' learning. Would any doctor let anyone practice on his own kid? Never. At the same time, learning is a necessary part of medical progress.

    Those questions dominate the book; Gawande ponders at the patient's right to choose, reminds us that doctors are human and prone to mistakes, reveals mysteries of complications, which are usually open only during the M&M - Mortality and Morbidity Conference behind the closed door. Gawande is not afraid to open the doors. Moreover, he is confident that openness is the only way to reduce the complications.

    I almost wanted to say the book is too idealistic, except it's written by a person whose profession is to think realistically. Great book!...more info
  • About More Than Surgery
    This book is only ostensibly about surgery, and it achieves brilliance on many levels. Often it is the engineers, the lawyers, the doctors, who are the best writers. These types of people tend to care for the important details, and, when they choose to be writers, get these details down on the page. Atul Gawande, a surgeon from Boston, is the archetype for this rule. His prose is crisp, clean, and efficient. Needless to say, from a technical point of view, he also knows his stuff.

    Gawande structures his essays so that they create suspense. For example, in many essays he does not go right out and say what happens to a patient. He first frames a dire situation, then takes the reader on a tour of the problems, fallacies, and circumstances, and finally, only after the reader knows all the isses, Gawande constructs a climax. In other essays we read about his honesty in describing how difficult it is to master certain medical procedures. In the final part of the book (the last four essays) we learn about human decision making fallacies, and how they apply to human doctors making split-second decisions. These insights are typically wrapped around a heart-stopping narrative involving patients on the verge of death -- or, in the final essay, on the verge of losing a leg.

    COMPLICATIONS asks a lot from its reader. We think about philosophical issues facing Gawande's patients; we learn about decision making and psychology; we learn about the human drama of life -- what it means to live and die; we learn about the pressures 20th century professionals are under to perform well in an ever less empathetic world (see the essay "When Good Doctors Go Bad"). Gawande really brings it. ...more info
  • great read
    this book was fascinating. interesting cases, a good amount of medical information but not enough to leave you reeling, written with compassion and frankness. it made me really think about my own interactions with doctors. ...more info
  • Excellent writing and will challenge your assumptions about medicine
    Gawande is a wonderful, vivid writer and this book was well chosen as a National book Award finalist. He is not afraid to admit some errors he made along the way, including some regretable hubris that harmed some patients but he also writes about the way doctors learn - and the limits and challenges they still face in the imperfect world of medicine, where so much depends on following one's instincts, in spite of so many advances.
    Whether learning about how autopsies first came to be used (for religious reasons) or how a newscaster dealt with a disabling case of blushing or about how and why "Good Doctors go Bad" (and how they are treated), I found this book a rich compendium of useful facts and information.
    It will also help you ask the right questions next time you have to face a medical decision, large or small, guiding you to ask the right questions of your doctor. ...more info
  • Tells us What it is Really Like in the OR
    This puts the human touch on the Medical Profession. Gawande is an uncommonly good writer for a physician. He provides excelent real life examples of the uncertainty and progress in the medical profession. Good discussions on how the improvement on the processes are what separate the good facilities from the poor ones. ...more info


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