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A Surgeon's Notes on Performance
by Atul Gawande
Book Reviewed by:The New York Times bestselling author of Complications examines, in riveting accounts of medical failure and triumph, how success is achieved in a complex and risk-filled profession
The struggle to perform well is universal: each one of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable.
Gawande’s gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors’ participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable.
At once unflinching and compassionate, Better is an exhilarating journey narrated by “arguably the best nonfiction doctor-writer around” (Salon). Gawande’s investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.
Introduction
Several years ago, in my final year of medical school, I took care of a patient who has stuck in my mind. I was on an internal medicine rotation, my last rotation before graduating. The senior resident had assigned me primary responsibility for three or four patients. One was a wrinkled, seventy-something-year-old Portuguese woman who had been admitted because—I’ll use the technical term here—she didn’t feel too good. Her body ached. She had become tired all the time. She had a cough. She had no fever. Her pulse and blood pressure were fine. But some laboratory tests revealed her white blood cell count was abnormally high. A chest X-ray showed a possible pneumonia—maybe it was, maybe it wasn’t. So her internist admitted her to the hospital, and now she was under my care. I took sputum and blood cultures and, following the internist’s instructions, started her on an antibiotic for this possible pneumonia. I went to see her twice ...
Better offers inspiration to any of us who are tempted to settle for average...continued
Full Review
(485 words)
(Reviewed by BookBrowse Review Team).
Atul Gawande, a 2006 MacArthur
fellow, is a general surgeon at the
Brigham and Women's Hospital in Boston,
a staff writer for The New Yorker,
an assistant professor at Harvard
Medical School, and a frequent
contributor to The New England
Journal of Medicine. He lives with
his wife and three children in Newton,
Massachusetts.
Both his parents were physicians — his
father a urologist and his mother a
pediatrician — and initially he resisted
following in their footsteps and instead
wanted to be a musician: "I wanted to be
a rock star. I played ...
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