Working in consumer health publishing, I’ve heard an awful lot about Atul Gawande. He’s a surgeon, a fantastic writer, and a humble, nice human being. Gawande is the author of three books, which have all been successful. And he works right next door to my office! I keep hoping I’ll run into him walking on the QUAD or in the cafeteria, but I think people like that are slightly super human. They have to save lives (!), no time for eating.
Complications is Gawande’s account of his surgical residency at Brigham and Women’s Hospital in Boston. The book is made up of 14 stories that cohesively demonstrate that medicine is complicated. Gawande is quick to admit his faults and failures, which make him a sympathetic narrator and simultaneously make you pray that you never have to go to a hospital ever.
Gawande proposes this conundrum: we want the best possible care for ourselves and our loved ones, so we should choose the experienced doctor. However, if we all choose the experienced doctor then the resident will never learn how to become the experienced doctor. So, in essence, if we choose the experienced doctor we are depriving future generations by not helping train the residents.
Gawande speaks intelligently and comprehensively about many other issues in health care. For example, when should you stop trying to save a 23-year-old’s leg and just amputate it? How much input should a patient have in the course of their care? Who is responsible when something goes wrong? In whose medical care would Gawande leave his own child? What would make a doctor purposefully misdiagnose a patient/ignore their suffering?
The great thing about Complications is that it doesn’t lay the blame entirely on any one party. Gawande doesn’t cast himself as the hero, nor does he cast anyone else as the villain. His democratic portrayal of what goes on behind closed doors in the medical community is comprehensive and strikingly ambivalent.