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Better: A Surgeon's Notes on Performance | [Atul Gawande]

Better: A Surgeon's Notes on Performance

Atul Gawande explores how doctors strive for best performance in the face of seemingly insurmountable obstacles. His stories of diligence and ingenuity 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 medicine, and recounts the astoundingly contentious history of hand washing.
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Publisher's Summary

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 audiobook, 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. 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.

©2007 Atul Gawande; (P)2007 Audio Renaissance, a division of Holtzbrinck Publishers, LLC

What the Critics Say

"Surgeon and MacArthur fellow Gawande applies his gift for dulcet prose to medical and ethical dilemmas in this collection." (Publishers Weekly)
"Better is a masterpiece, a series of stories set inside the four walls of a hospital that end up telling us something unforgettable about the world outside." (Malcolm Gladwell, author of Blink and The Tipping Point)

What Members Say

Average Customer Rating

4.4 (396 )
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  •  
    Bonneville Thunder Bay, Ontario, Canada 02-20-09
    Bonneville Thunder Bay, Ontario, Canada 02-20-09 Member Since 2007
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    "Unfocused & Rambling"

    This book is meant to address the science of human performance in medicine. It is, instead, an unfocused collection of anecdotes seasoned with facts drawn from the history of medicine (Semelweiss & Lister). I think the intent was to use each case to illustrate larger principles or themes, but this simply didn't happen. The stories seem randomly selected; they neither standout singlely for the wisdom they contain, nor do they build one upon the other. It would be like a research paper that's all methodology, but no results, no discussion, no conclusion.

    The sections on efforts to eradicate polio and good CF programs vs great CF programs are especially long on exposition, and short on synthesis. Battlefield medicine is tough & expensive; we've had to work harder, spend more and try new things to get better survival results.
    General surgeons in India don't have all the same resources as in North America, but they're willing to improvise.

    The book ends(it doesn't conclude)with the authors tips on how to get better - "become a positive deviant." These don't appear to be based on the previous 7.5hours. More like, 'everything I need to know about improving my health care organization I learned in kindergarten.'
    -talk to people
    -listen to them
    -write things down
    -don't whine
    -do things differently

    5 of 5 people found this review helpful
  •  
    Kathy Davis, CA, United States 08-11-14
    Kathy Davis, CA, United States 08-11-14 Member Since 2008

    Newly retired, I am a reading fiend! I like many types of books, both fiction and non-fiction, with the exception of romance and fantasy

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    "A MUST read . . ."

    for anyone interested in the current state of health care and the medical field, for professionals, and those like me who aspire to be a doctor in my next life.

    Seriously, this is an excellent book that covers very interesting and surprising issues related to improving medical care and outcomes. A few of the things Dr. Gawande touches on are cleanliness, battle injuries, eradicating polio, doctors' salaries, hospital excellence (or lack of), and practice of medicine in impoverished areas of India. Each topic had surprising information and was compellingly interesting to me. The author's intelligence, clear-thinking, and caring came through as the book progressed. He has a great deal to offer medical professionals and also the non-medical, average person, too.

    John Bedford Lloyd did a fabulous narration. I never felt that he was reading someone elses book. He read it like it was his own. His voice is simply wonderful, too.

    Highly recommended if the topic is of interest to you.

    2 of 2 people found this review helpful
  •  
    Charles Winchester, KY, United States 03-07-13
    Charles Winchester, KY, United States 03-07-13 Member Since 2009
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    "From an outlying negative view..."

    I am baffled how people are rating this so high. It is a rambling, discontinuous stream of conscious kind of work. I have purchased approximately 40 books on Audible and this is the first one that simply did not warrant finishing. At 2/3rds of the way, I surrendered---no more. I, too, am in a medical field and so was particularly attracted to this about getting better in practice and teaching. Nothing in this collection of anecdotes provides a basis for self-study insights toward improvement. The narrator is fine. In fact, he has my admiration for doing his job on this one.

    2 of 2 people found this review helpful
  •  
    Lillian 05-23-10
    Lillian 05-23-10
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    "Fascinating and Well Read"

    Though the narrative is slightly disjointed (the separate sections were not related to each other), I found each section fascinating on its own. The actor reading the book clearly didn't know a few of the words but in general did a good job with pronunciation of medical and science terms.

    2 of 2 people found this review helpful
  •  
    Irene Vancouver, British Columbia, Canada 07-11-09
    Irene Vancouver, British Columbia, Canada 07-11-09
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    "Excellent but..."

    This book was excellent and the reader did a very fine job. I enjoyed it all; writer Atul Gawande provides an incredible store of data, and that, coupled with his wide knowledge and experience as a surgeon, made this book a wonderful experience. However, I may buy the hard copy now--just to to be able to go over all the information at leisure. I am a relative newcomer to audiobooks, but even so, I felt a bit overwhelmed. I can't praise Gawande enough. I read the paperback edition of his book Complications and would recommend that highly to readers too.

    2 of 2 people found this review helpful
  •  
    Soraya Queenstown, MD, United States 02-20-12
    Soraya Queenstown, MD, United States 02-20-12
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    "I need a script for my addiction to Dr. Gawande"
    What made the experience of listening to Better the most enjoyable?

    I enjoyed the wide birth of topics pertinent to physicians discussed. From the business side of medicine no one ever discusses in medical school, to moral dilemas only doctors face; he gives variety in topics too little discussed and the information is more than useful.


    Any additional comments?

    I'd recommend this book to both aspiring doctors, as well as established physicians. Those considering the field can get a view of what comes along with that MD besides hefty loans and patients, and practicing Doctors should ever be on the quest to be

    1 of 1 people found this review helpful
  •  
    Vivek Auburn, MA, United States 04-08-07
    Vivek Auburn, MA, United States 04-08-07
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    "Well written , Keeps you engaged througout"

    A very well written book, as good if not better than the first book. Great narration as well. I think this book would interest anyone in health care profession obviously. But, I am sure it would interest non health care professional reades as much.

    A liked how he ended the book with some great but simple suggestions for his readers to be become what he call a positive deviant : Ask, Do not complain, Count, Write and Change.

    3 of 4 people found this review helpful
  •  
    DK Mirozena 04-29-07
    DK Mirozena 04-29-07 Member Since 2006
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    "A Must Read for Anyone Interested in Excellence"

    This is the best Organizational Change book I've ever come across - I plan to share it with several colleagues. I am not in the medical profession but I found his lessons to be ones that made you think. I look at everything through a different lense now.

    2 of 3 people found this review helpful
  •  
    Tara Kunkel GREENFIELD, IN, US 12-11-12
    Tara Kunkel GREENFIELD, IN, US 12-11-12 Member Since 2012
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    "Listening and Thinking"

    This was a wonderful book that touched controversial as well as mundane problems in healthcare. All beautifully narrated into a great story. I found myself driving more so that I could keep listening.

    0 of 0 people found this review helpful
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    Joseph NEW YORK, NY, United States 07-16-12
    Joseph NEW YORK, NY, United States 07-16-12 Member Since 2011
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    "Will likely help change the face of medicine"
    Would you consider the audio edition of Better to be better than the print version?

    No


    What other book might you compare Better to and why?

    Checklist Manifesto


    What does John Bedford Lloyd bring to the story that you wouldn’t experience if you just read the book?

    I think if I heard him speak again, I would think he's Atul Gawande


    If you were to make a film of this book, what would be the tag line be?

    Atul Gawande rocks the medical world.


    Any additional comments?

    I love the way he thinks, and challenges those in health care.

    0 of 0 people found this review helpful
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