Better

A Surgeon's Notes on Performance

By: Atul Gawande

Narrated by: John Bedford Lloyd

Length: 7 hrs and 34 mins

Publisher's Summary

National best seller 

The New York Times best-selling author of Being Mortal and Complications examines, in riveting accounts of medical failure and triumph, how success is achieved in a complex and risk-filled profession

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 this book, 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" (Salon). 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

Critic Reviews

"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)  

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.

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.

Dr. Gawande is great as always

If I was going to suggest an Atul Gawande book, it wouldn't be this one. His others are better. But even at his worst Dr. Gawande is head and shoulders above the best

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.

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

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.

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

Atul Gawande delivers. Very well written.

If you could sum up Better in three words, what would they be?

Engaging, eye opening, thought provoking

Which scene was your favorite?

Doctors of the Death chamber. This is the most interesting scene i've listened to. It is very interesting hearing about doctors that have are not only involved in saving lives but also involved in taking away lives. I know, but in this scene, Atul examines or interviews doctors in order to get answers as to why they are involved in prosecutions.

Did you have an extreme reaction to this book? Did it make you laugh or cry?

Im a premedical student trying to find answers on whether medicine is something for me. This book gives a very detailed insight on the life of being a doctor and somewhat compares it to other careers. If you are unsure/sure about doing medicine, this book is a great read.

Excellent, crisp even for anyone interested in exc

wish all author's were half as crisp, half as coherent. this is for anyone working to improve the way they live a good life.

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.