- Paperback: 288 pages
- Publisher: Picador USA; Reprint edition (1 April 2003)
- Language: English
- ISBN-10: 0312421702
- ISBN-13: 978-0312421700
- Product Dimensions: 13.9 x 2.1 x 20.8 cm
- Boxed-product Weight: 249 g
- Customer Reviews: 835 customer ratings
- Amazon Bestsellers Rank: 139,407 in Books (See Top 100 in Books)
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COMPLICATIONS: A Surgeon's Notes on an Imperfect Science Paperback – 1 April 2003
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"None surpass Gawande in the ability to create a sense of immediacy, in his power to conjure the reality of the ward, the thrill of the moment-by-moment medical or surgical drama. Complications impresses for its truth and authenticity, virtues that it owes to its author being as much forceful writer as uncompromising chronicler." --The New York Times Book Review"No one writes about medicine as a human subject as well as Atul Gawande. His stories about becoming a surgeon are scary, funny, absorbing....Complications is a uniquely soulful book about the science of mending bodies." --Adam Gopnik, author of Paris to the Moon "Gawande is arguably the best nonfiction doctor-writer around....He's prescient and thoughtful...the heir to Lewis Thomas' humble, insightful and brilliantly crafted oeuvre." --Salon.com "Complications is a book about medicine that reads like a thriller. Every subject Atul Gawande touches is probed and dissected and turned inside out with such deftness and feeling and counterintuitive insight that the reader is left breathless." --Malcolm Gladwell, author of The Tipping Point "Gawande is a writer with a scalpel pen and an X-ray eye.... He turns every case--from gunshot wounds to morbid obesity to flesh-eating bacteria--into a thriller in miniature. Diagnosis: riveting." --Time "Gawande's prose, much like the scalpel he wields, is precise, daring, but never reckless....Much like reading George Orwell, the reader emerges entertained, enlightened, transformed and immensely satisfied." --Abraham Verghese, author of My Own Country "Wrenching human tales...Gawande has pushed the medical yarn in a new direction." --The Boston Globe "Atul Gawande is a rare and wonderful storyteller who portrays his profession with bravery and humanity." --Ellen Goodman, Pulitzer Prize-winning columnist "The stories in Complications are gripping medical mysteries that always have something extra. Gawande draws you in with the story but leaves you wiser about science, about health care issues, and even about the human condition." --Michael Kinsley
About the Author
Atul Gawande is author of three bestselling books: Complications, a finalist for the National Book Award; Better, selected by Amazon.com as one of the ten best books of 2007; and The Checklist Manifesto. His latest book is Being Mortal: Medicine and What Matters in the End. He is also a surgeon at Brigham and Women's Hospital in Boston, a staff writer for The New Yorker, and a professor at Harvard Medical School and the Harvard School of Public Health. He has won the Lewis Thomas Prize for Writing about Science, a MacArthur Fellowship, and two National Magazine Awards. In his work in public health, he is Executive Director of Ariadne Labs, a joint center for health systems innovation, and chairman of Lifebox, a nonprofit organization making surgery safer globally. He and his wife have three children and live in Newton, Massachusetts.
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Gawande writes, as he speaks (I discovered him giving the BBC Reith lectures in 2014) in such an open, easy, and eloquent way: I just enjoyed every story, and his humanity shining through. His compassion is life affirming. And his respect for his parents' experiences in India, and in the US just shine through the pages. He puts all health professionals in their appropriate places: as card carrying ordinary human beings, and I'm recommending reading him to all the health professionals I've had to deal with lately!
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A perfect example of this, although extreme, is the final case he discusses of an otherwise healthy young woman who presents with an inflamed red leg. Is this a severe case of cellulitis (probability approaching 100%) or is the leg infected with the bacteria necrotizing fasciitis (probability vanishingly small, but with potentially devastating consequences)? The author honestly admits that hunches, gut feelings and other unscientific considerations inevitably play a role in decisions about what actions to take, however much he wishes that they didn't. He is just as frank about other aspects of medical practice, such as the need for surgeons to hone their technique on real patients, with the inevitable consequences that the less advantaged in society become the `guinea pigs' and some operations will not be done well. But when his own child becomes dangerously ill he honestly confesses that he does not want an operation to be done by an inexperienced junior surgeon, as would any parent wanting the best for their child. How do we resolve this dilemma?
There are many other dilemmas of medical practice discussed in the book, such as: how should poorly performing surgeons be disciplined in a way that does not make the profession in general too conservative and hence hinder surgical progress; to what extent is a surgeon entitled to `steer' a patient into a course of action that they, the doctor, thinks is the right choice, even though the risks may be high; and should a doctor attempt to prolong life, even when the treatment will not prevent the inevitable outcome and may even produce more suffering?
This well-written book brings home to the reader not just the technical difficulties of being a surgeon, but also the ethical responsibilities it entails and the stark problems that surgeons have to face daily. It can usefully be read by both medical students and professionals, as well as by anyone who is liable to be a patient at some time, and that means all of us.
I think the one thing which comes over to me from all the medical books I read is that however much medical science advances there is just so much about the human body which remains undiscovered. Doctors are never going to get it right all the time however well trained they are and however much experience they have. I was interested to see how much of an inexact science diagnosis is and the autopsy figures quoted by the author show that the cause of death may turn out to be incorrect as many as a third of cases. The figures haven't changed in the US since the 1930s in spite of the huge increase in modern technology and ways of seeing inside the human body.
It is all too easy to assume that modern medicine has all the answers and this book will swiftly disabuse the reader of this idea. I found the chapter about patients being given all the risks and options fascinating. Do we want doctors to make decisions for us or do we want to be given enough information to make our own decisions? What should a doctor do if he/she believes a patient is making the wrong decision? This author's books are a must read for anyone who has had any dealing with modern medicine if only because it helps to remind us all that doctors are people too
Thought provoking and highly recommended.
At times I found the narrative too detailed when providing an argument to his point. I would not fuss about it though.
Reading it made me realise that a practicing clinician needs both medical knowledge and loads of common sense. This book tries to help us improve on the second aspect.
Very interesting all the same.
Very well written.