Complications: A Surgeon's Notes on an Imperfect Science
by Atul Gawande
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Book Summary Information
Author: Atul GawandeEdition: Paperback
Format: Bargain Price
Published: 2003-04-01
ISBN: N/A
Number of pages: 288
Book Reviews of Complications: A Surgeon's Notes on an Imperfect Science
Book Review: Medicine - Mysterious and Uncertain Science
Summary: 5 Stars
Similar 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).
Summary of Complications: A Surgeon's Notes on an Imperfect Science
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.
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
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