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Home » Medical » Free Complications: A Surgeon's Notes on an Imperfect Science

Free Complications: A Surgeon's Notes on an Imperfect Science

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Medical
Sunday, December 2, 2012

Complications: A Surgeon's Notes on an Imperfect Science

Author: | Language: English | ISBN: B00009KEJ7 | Format: EPUB

Complications: A Surgeon's Notes on an Imperfect Science Description

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.

  • Product Details
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  • Audible Audio Edition
  • Listening Length: 7 hours and 48 minutes
  • Program Type: Audiobook
  • Version: Abridged
  • Publisher: Macmillan Audio
  • Audible.com Release Date: April 25, 2003
  • Language: English
  • ASIN: B00009KEJ7
"Complications", by Dr. Atul Gawande is a very gutsy and honest discussion about medicine in general, and surgeons in particular. The book is also unique, for unlike others of its type it is written by a surgeon that is starting his career, and not looking back upon it. I would imagine that the book caused some consternation amongst his peers. The book does nothing to minimize the skills and accomplishments of the men and women who can reach in to the body and do some pretty spectacular work. The book does portray them as human beings that come with all the normal traits that any of us do. The pressure they must deal with is that when they make a mistake, it can irreparably harm or cause the death of the patient they are trying to help.
The vast majority of careers that people practice does not involve decisions that can cause the outcomes I mention above. And few occupations require of their practitioners near perfection, that if not delivered has a major legal industry prepared to hammer them with lawsuits. Incompetent or negligent doctors should be punished and removed from practice, but what about a human error, or a doctor that makes every single decision that is correct and appropriate for the patient he or she sees, and misses the 1 in 250,000 cases where doing everything correctly can cause a patient to die. The final chapter of this book deals with exactly those type of odds. Whether those odds are beaten often depends on the instincts of the physician. And these intuitive feelings they may or may not act upon are certainly helped by experience, but younger doctors without the years that familiarity brings can often make a decision largely because they are so new. Dr.
Rarely do I think a book is so important and so good that it should be read by everyone. Atul Gawande has written such a book.
America has the best health care in the world and yet our health care system is a mess. High insurance rates and malpractice suits make for a situation where patients often cannot get the help they need and many doctors are afraid of taking risks because of the chance of being sued. With a willingness to realize certain things and make some changes, America could turn it's medical services into a true blessing for all of its citizens.
What is the most important realization? That doctors are human beings and even the best of them are going to make mistakes from time to time. This is probably the most important point Gawande makes in his book. It is a sad state of affairs when every single doctor in this nation expects to be the defendant in a major lawsuit at least once in their careers. How many possible brilliant doctors has this single fact driven from the profession? It is one thing when a doctor makes an error through maliciousness but a doctor who makes an honest mistake should not have to fear career destruction. If something could be done about all this litigation, it would likely be easier to drive truly bad doctors from the profession because doctors and hospitals would be more like to start admitting when things go haywire and actually make a concerted effort to try to make things better.
Though his insights into what it's like to be a doctor are incredibly valuable, I find his views on the psychology of being a patient interesting as well. His articles on the mystery of pain, the horrors of nausea & blushing (yes, blushing) and the results of a patient who has undergone gastric bypass surgery for obesity are eye-openers.

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