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Complications: A Surgeon's Notes on an Imperfect Science | [Atul Gawande]

Complications: A Surgeon's Notes on an Imperfect Science

Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is - complicated, perplexing, and profoundly human.
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Publisher's Summary

Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is - complicated, perplexing, and profoundly human.

Atul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur, why good surgeons go bad. He shows what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause; a young woman with nausea that won't go away; a television newscaster whose blushing is so severe that she cannot do her job. Gawande also ponders the human factor that makes saving lives possible.

At once tough-minded and humane, Complications is a new kind of medical writing, nuanced and lucid, unafraid to confront the conflicts and uncertainties that lie at the heart of modern medicine, yet always alive to the possibilities of wisdom in this extraordinary endeavor.

©2002 Atul Gawande (P)2003 Audio Renaissance, a division of Holtzbrinck Publishers, LLC

What the Critics Say

"Gawande's sharp eye, crisp prose, and insightful understanding make his book as enjoyable as it is edifying." (Los Angeles Times )
"Diagnosis: riveting." (Time)
"These exquisitely crafted essays, in which medical subjects segue into explorations of much larger themes, place Gawande among the best in the field." (Publishers Weekly)

What Members Say

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  •  
    K. Aydin Washington, DC 11-07-05
    K. Aydin Washington, DC 11-07-05 Listener Since 2004

    K Aydin

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    "Must read for believers of informed consent!"

    WOW! What a great book and really informative! I am a firm believer in informed consent when planning on surgery. This is a must read/listen for any patient or health provider. Let's be honest, it can't all fall on the service provder's shoulders, we also need to take some responsibility for our own health. By working together with our service provider, we can be much more likely to reach our goals. This book allows us to be informed of what could happen so that we can learn how to avoid unnecessary complications.

    1 of 1 people found this review helpful
  •  
    Stephen Moroni, UT, United States 03-15-05
    Stephen Moroni, UT, United States 03-15-05 Member Since 2002
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    "Wonderful Book!"

    Interested in medicine? Do you wonder what doctors are really like? Then you should enjoy this book. It covers medical ethics, medical mistakes, abuse, and more. Highly recommended. I enjoyed it from begining to end. You will enjoy it.

    1 of 1 people found this review helpful
  •  
    Gregory Turlock, CA, USA 11-16-04
    Gregory Turlock, CA, USA 11-16-04
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    "absolutely essential for any future doctor"

    This was the best book I have listened to in my last year as an Audible Member. I am a pre-medical student, and listening to Dr. Gawande's excellent storytelling absolutely captivated me. I have listened to this book about three times total now. I highly recommend this book to anyone interested in the often mysterious world of medicine and surgery.

    1 of 1 people found this review helpful
  •  
    Lori Fort Myers, FL, USA 05-10-04
    Lori Fort Myers, FL, USA 05-10-04
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    "Full of insight"

    Wonderful! If you are familiar with science and the uncertainties of real life research (and practice) as opposed to the text book models of "scientific process", this book won't come as a shock. It is a brilliant exploration of the uncertainties in the science of medicine and the impact that human beings, with their frailties and their brilliant insights, have on a medicine. While I must admit it leaves me somewhat more nervous about major medical procedures, if more people understood medicine as presented here, we would probably not be plagued with so many law suits, the resultant high malpractice insurance fees and the final result of high cost health care. At the same time, if some of the insights presented in this book were translated into new systems and practices in the medical field, we probably would also not have so much human error to begin with. A great listen I recommend highly.

    1 of 1 people found this review helpful
  •  
    Carlton Los Angeles, CA, USA 02-02-04
    Carlton Los Angeles, CA, USA 02-02-04
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    "Unqualified praise"

    Written with both emotion and objectivity, Complications is a fascinating look at the practice of modern medicine. Through actual case histories, Gawande marvels over the successes and admits the shortcomings of today's doctors, attempting all the while to explain that they are merely human beings, capable of faults but trying, often selflessly, to reduce the suffering of other human beings. Probably best for the science-savvy, or at least the 'ER' crowd, as it is rife with clinical explanations which, though excellent and accessible, may bore the average reader. Inspiring and humbling. (I am, by the way, neither a doctor nor a relative of one.)

    1 of 1 people found this review helpful
  •  
    Maggie McMeekin Arlington Heights, IL, US 07-29-14
    Maggie McMeekin Arlington Heights, IL, US 07-29-14 Member Since 2012

    I am a 27 year old nurse pursuing a nurse practitioner degree. My favorite book genres are: fantasy, science fiction, medicine and sociology

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    "Interesting"
    Any additional comments?

    An interesting perspective on how we are all human, and the sort of subjective factors that impact surgeons and doctors on a daily basis. This was a very quick listen for me. I found it well written, peppered with humor as well as touching human perspective. I recommend it to those working in the medical profession as well as anyone interested in gaining some insight on the challenges that physicians face on a regular basis. While nobody likes to be the patient that ends up the one the doctor makes a bad judgment call on, it is inevitable, there is no perfect human being and nobody performs without error in ANY profession. The pressure is high and medicine is very tricky, and I feel books like this one help warm people's hearts and break down their ignorance. Perhaps it can help reduce the knee jerk reactions of those who are quick to judge doctors harshly or immediately want to sue over medical errors or judgment calls made in tense, critical moments of life and death.

    0 of 0 people found this review helpful
  •  
    gronlandic_edit 07-20-14 Member Since 2013
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    "An unflinching look at the fallibility of medicine"
    Would you recommend this book to a friend? Why or why not?

    Yes. This book humanizes doctors and demystifies medicine, revealing its errors without provoking fear. Maybe it's paradoxical, but calling into question medicine's perfectibility is actually kind of empowering because it means we can't let doctors bear all the responsibility for a well-functioning health care system -- we have to look at the whole ecosystem of hospitals and managed care to understand why things go wrong, and then take part in improving the situation. Gawande densely layers interesting anecdotes and interweaves medical marvels with ordinary human experiences -- particularly those of patients. Despite being nominally autobiographical, this isn't a compendium of war stories. Gawande is balanced, self-aware and, surprisingly for someone so successful in the mainstream, not self-aggrandizing. He only involves himself to the extent necessary to round out the anecdotes.

    The book loses focus towards the end and does start to feel a little like an anthology of stories and/or essays, and I'm not sure the overall thesis is well sustained, but so far it's the best thing I've read on the practice of modern medicine.


    What was one of the most memorable moments of Complications?

    His account of the congress of American surgeons was funny and poignant. He clearly has a goofy sense of humour and an anthropologist's eye for professional culture -- the good and the bad. This was one of the moments that did the most for me in humanizing surgeons without making them look foolish or, worse, inept.


    Would you listen to another book narrated by William David Griffith?

    His narration was pretty good. He mispronounces stuff from time to time which can be a little distracting, but overall he was pleasant enough to listen to.


    Could you see Complications being made into a movie or a TV series? Who should the stars be?

    Not really. There's no storyline or protagonist, and it jumps around in time a lot.


    0 of 0 people found this review helpful
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    Sally Cupertino, CA, United States 04-21-13
    Sally Cupertino, CA, United States 04-21-13 Member Since 2012
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    "I couldn't stop listening!"

    This is a fabulous book for anyone with an interest in medicine. I greatly admire Dr. Gawande's candor in providing this fascinating, behind the scenes account of doctors and patients. I listen to books when I drive and there were a number of evenings when I just sat in my driveway because I couldn't put this book down.

    My only criticism is not about the story but the Audible.com use of random music throughout. There is annoying piano music at various places - not apparently tied to new topic areas or chapters. I found it distracting and irritating.

    0 of 0 people found this review helpful
  •  
    Joseph Birmingham, United Kingdom 03-14-13
    Joseph Birmingham, United Kingdom 03-14-13 Member Since 2004

    52, retired soldier and surgeon. Teach Combat Surgery and Military History and hold the rank of Brigadier. Lost wife, love dogs, ski to fast

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    "Great Read if your a medical Bod"
    Where does Complications rank among all the audiobooks you’ve listened to so far?

    Its in the top 10 and I have 100's. I does make the medical profession look human. As a Dr my self I found it so revealing. It visited feelings and concerns I had not looked at for 20 years or more. Its well written, well narrated and a moving account of how difficult being a Dr actually is. Well recommended.


    0 of 0 people found this review helpful
  •  
    christy Plano, TX, United States 03-12-13
    christy Plano, TX, United States 03-12-13 Member Since 2011
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    "Amazing!"

    It provided a whole different perspective to the idea of a Dr. They are just a working stiff like the rest of us and they can screw up. And they can succeed at amazing things. Interesting take and the stories were great.

    0 of 0 people found this review helpful
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