• Complications

  • A Surgeon's Notes on an Imperfect Science
  • By: Atul Gawande
  • Narrated by: Robert Petkoff
  • Length: 9 hrs and 31 mins
  • 4.8 out of 5 stars (298 ratings)

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Publisher's Summary

A new unabridged recording.

A brilliant and courageous doctor reveals, in gripping accounts of true cases, the power and limits of modern medicine.

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 audio 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 and why good surgeons go bad. He also shows us 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 offers a richly detailed portrait of the people and the science, even as he tackles the paradoxes and imperfections inherent in caring for human lives.

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.

Complications was a 2002 National Book Award finalist for nonfiction.

A Macmillan Audio production from Henry Holt and Company

©2003 Atul Gawande (P)2020 Macmillan Audio

Critic Reviews

“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 and 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) 

What listeners say about Complications

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  • Overall
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    4 out of 5 stars

FALLIBILITY, MYSTERY AND UNCERTAINTY

Complications was re-recorded in 2020 in abridged and unabridged format with two different narrators. Audible lets you listen to a bit of each version before deciding which reader you prefer. Both seemed acceptable but I decided on Robert Petkoff before realizing he reads the unabridged book which was what I wanted anyway. It was a good choice.

The book is amazing. After being on dialysis, having a kidney transplant, and a few minor surgeries in the last few years, I appreciated the explanations of things I had experienced but not understood.

In three sections named Fallibility, Mystery, and Uncertainty, Gawande describes the education of surgeons, advancements in medicine, difficult diagnoses, and some fascinating (and disturbing) cases.

We always hear the joke that doctors are 'only practicing' when things go wrong. Actually Gawande explains that perfection takes practice and the "constant relearning of new techniques and technologies" and the result is that residents get practice and doctors get information but no practice.

A topic I found interesting was Morbidity and Mortality (M&M), regularly scheduled meetings where doctors take personal responsibility by discussing what they could or should have done differently. All surgeons make mistakes. Maybe you don't want to know that.

A smooth reading of a well written insider's view of today's medicine. Highly recommended.

13 people found this helpful

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Could not 'put the book down'

Note up front to editors - chapter "the man who wouldn't stop eating" at end, 1.15, needs real editing - off mic talk and end of book insert. Let me know when cleaned up and I'll revise this review.
Almost listened straight through! But reading is a side to life so I watched the chapter time frames. I would chuckle with the medical problem tease, then back ground, then deeper knowledge, then back to patient. I actually appreciate the flow with the intent of learning as I read. He does a lot of research. The real life dilemma of being human and a doctor is treated with respect and honesty.

9 people found this helpful

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Gawande does it again

You don't have to be a doctor or a scientist to find this book gripping. This is the second of Atul Gawande's books that I have listened to and I recommend them. The narrator does a fine job. If you have ever been unsure whether to go ahead with a medical procedure, it's nice to know that the doctor's aren't always 100% sure what's the right thing to do either. As the title says, it's an imperfect science and one cannot always be absolutely sure. Doctors are fallible, too, yet I found the cases described to be extremely interesting. Dr. Gawande follows up with several patients months or a year after their surgeries and shows a level of compassion that any of us would be grateful to have in our doctor.

4 people found this helpful

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Dr Guwande’s perspective is always fascinating!

As a medical professional, I’m always interested in this particular point of view. I listened to Dr Gawande’s previous books and really enjoyed the information and the presentation . I was anxious to listen to this book. I was not disappointed!

2 people found this helpful

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Hard to go wrong with an Atul Gawande book

This author has written a number of very memorable books, and this one lives up to that reputation. Loved it -- highly recommended!

1 person found this helpful

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Decisions made by Dr. and patients.

Loved the stories of Dr and patients. Really fleshed out the decisions from both sides. Narration just right. Enjoyable and sorry to reach the end. In fact will probably listen again.

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Well written

Thank you for helping me understand the many decisions that have to be made in medicine and how they can be made. I found it fascinating. The history of doctor patient relations was interesting, although I prefer the more collaborative note used these days. In the formula or decision tree leading to a recommended course of action, I think there should be some allowance for the patients expectations and wishes. For instance, don’t let me die. Amputate if necessary. Obviously, that statement should be weighed as well. Anyway, I highly recommend the book to patients and doctors.

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Excellent and Informative

A very informative and enlightening read for anyone who has to make important decisions. The information garnered spans not only medical but adds real world case scenarios that are relevant across many disciplines. Of course the "back door" knowledge and having an idea of what is actually going on within the mind of a doctor or surgeon as well as your own mindset, may very well prove to be a lifesaver should the need arise. This book sheds some light on that very subject. Thanks.
Tom G (Machine Doctor)

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I’m disappointed in the author’s discriminations

I really enjoyed “Being Mortal” so I decided to give this author another purchase.

I like the education, medical insight, and almost philosophical discussion in the book.

I dislike the author’s attitudes toward women and larger-bodied people. Perhaps it was more tolerated when this was written, and if so, it’s not aging well.

I’ve stopped giving authors my time and money if they cannot describe women as more than their appearance. This will be the last book I buy from Gawande.

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fantastic listen, but mispronunciations detract

this is an epic book, one that every healthcare worker and every patient could benefit from listening to. unfortunately, there are at least a dozen words that the professional reader mispronounces regularly. I know there are regional variations in how some medical terminology is pronounced, but I could not find these anywhere online. one would assume that a professional reader would take the time to look up the pronunciation of medical terms. the book is not all that dense in medical terminology, which makes it even more irksome that so many medical terms are mispronounced and some even way off.