Complications

A Surgeon's Notes on an Imperfect Science

By: Atul Gawande

Narrated by: William David Griffith

Length: 7 hrs and 48 mins

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

Critic reviews

"Gawande's sharp eye, crisp prose, and insightful understanding make his book as enjoyable as it is edifying." (Los Angeles Times)

"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)

"Diagnosis: riveting." (Time)

Honest description of an imperfect science

Would you let a young inexperienced surgeon operate on your child or yourself, even if it involved a greater risk of complications, so that they could become better surgeons? Almost everyone would answer no to this question and indeed when the authors own son experienced a complication, he insisted on an experienced surgeon. Despite this it is an unavoidable fact that surgeon need practice and if they are not allowed to practice there will be no good surgeons in the future.

The reader of this book will receive an insight into the dilemmas faced by surgeons. It is a book that acknowledges the fantastic benefits of surgery while simultaneously acknowledging the fact that doctors are merely human beings and that even with the best of intentions mistakes are frequently made.

Some questions discussed (without aspiring to provide a definite solution):
● How can you provide young surgeons with practice opportunities without compromising the care of patients (and on how many animals do you let them practice before allowing them to operate on humans)
● How much should you trust a doctors “intuition” - and how does it compare to neural networks and machine algorithms.
● How should you deal with bad doctors - doctors who compromise the care of their patients because they have a depression, are stressed out or have a drinking problem (again doctors are just human beings and are affected by such things too).

Gawande takes on these and other questions. He is consistently honest about the limitations as well as the benefits that surgery involves and it seems that he does not hide unpleasant truths. All in all, Complications is a good intriguing book which I would recommend to anyone interested in surgery or medicine in general.

thoughtful book that makes you think

This is a thoughtful, engaging and entertaining account of a doctor's experiences with the imperfect art of practicing medicine. It makes you think about human decision making, ethics, medical mistakes, the psychology of healing, etc. If only all doctors (and people) were as sensitive and thoughtful as Atul Gawande. I would recommend it to almost anyone because many of the topics apply to situations outside of medicine. If you like this book or want to read something similar I enjoyed, "Better," Gawande's newer book just as much or more.

Inspiration

A must read for those considering a heath care career. He simplifies the complexity of hospitals. After reading I knew I had go to medical school...

Interesting and Entertaining

I was worried this book was going to be boring, but I really enjoyed it. The stories are interesting, and the author did a good job of arranging the topics, etc. I definitely recommend this one.

Remarkable

Another superb piece of literature from the mind and experience of Atul Gawande. He invites us into territory only a compassionate and contemplative doctor could.

Great book

I enjoyed this book but there was very poorly placed background music that drove me crazy.

Great book

The book was great and the narrator was good. Not too long. Would highly recommend

A great book!

A great read/listen specially for any physician in trainee but also for anyone who is interested and intrigued by complexity of medicine in current days. Enjoyed this title very much and kudos to Dr Gawande for this great book!

Title doesn’t truly fit the content of the book

I think this book overall had pretty interesting content and vignettes however it seemed to lack structure and focus. I would attribute the content to be more of a memoir with some medical science thrown in. No logical sequencing and random topics.

Insightfully written,

Complications is a thoughtfully and intelligently written account that is helpful for any of us that work in professions where we have to exercise a lot of judgment in the gray areas of uncertainty. You will be encouraged if you find your work in Calling often puts you in a position to choose between extremes.