You need to sign in or sign up before continuing.
Take a photo of a barcode or cover
4.21 AVERAGE
4.21 AVERAGE
Not as good as the checklist manifesto, but still all in all, an accurate reflection of the medical profession.
Maybe a little disorganized, but a incredibly deep, nuanced and painful look at the the fallibility of medical science. Done with a lot of empathy and interest in the perspectives of both doctors and patients.
I love Gawande's writing. He brings humanity to surgery in this little volume. Some of the surgical procedures he describes have now been superceded (e.g. gastic stapling), but the principles of the decisions faced by surgeons and patients, and what can go horribly wrong regardless of all the preparation in the world, still ring true.
Books like these are a part of the always necessary process of reality checking that humans need to undertake constantly to make sure that we remember our humanity, our fallibility and our unfortunate tendency to deify those to whom we must turn for advice in our hours of extreme need. Gawande is a brave man, unbaring his soul and his conscience to the reader, and I can imagine that he has lost some friends for his stripping bare of the medical profession's mistakes.
Gawande reminds us that doctors are human beings with all of the faults and inconsistencies that we find in ourselves. That, like many of us, they are in a profession which wears the trappings of efficiency and certainty to reassure its clients, but the knowledge, treatment and advice that they dispense is born out of a series of trials and errors, of practice tries and stuff-ups and miracles that work sometimes despite the humans who deliver them, and sometimes to their complete bemusement.
This is an autobiography, in essence, of Gawande's time as a resident at a teaching hospital, a time comfortingly long gone for him, but full of the horror of remembrances of practising his skills on live sick humans (and stuffing up quite often, to his humiliation), slowly improving, saving lives regularly through skills which become routine, and the odd wondrous instance of an ethereal insight into an ordinary looking wound/issue, act on it and save a body part, or a life, without ever really getting a handle on where the insight came from, or what it consisted of, or how to repeat it. And he is haunted by the feeling that if his day hadv'e progressed differently, if he had been more tired, or not seen that similar case a few months ago, or if he hadn't listened to his intuition that time, it would not have happened. And always the consequences of failure are at least, humiliation, and frequently, death or permanent disability of his patients.
There are lots of stories of people who lost their will-to-care, or their self belief, alongside stories of surgeons who took tender care (and at considerable risk to their patients)to preserve the limbs of their more young and beautiful patients, out of mercy and kindness that could have been seen (and sued) as foolish sentiment.
We are reminded by this book, as we need to be, of the bittersweet chance of live and saviour, of chance and serendipity, and of the limits of human knowledge and skill, and the infinite, unrelenting company of our inconsistent, inefficient and imperfect efforts.
Gawande reminds us that doctors are human beings with all of the faults and inconsistencies that we find in ourselves. That, like many of us, they are in a profession which wears the trappings of efficiency and certainty to reassure its clients, but the knowledge, treatment and advice that they dispense is born out of a series of trials and errors, of practice tries and stuff-ups and miracles that work sometimes despite the humans who deliver them, and sometimes to their complete bemusement.
This is an autobiography, in essence, of Gawande's time as a resident at a teaching hospital, a time comfortingly long gone for him, but full of the horror of remembrances of practising his skills on live sick humans (and stuffing up quite often, to his humiliation), slowly improving, saving lives regularly through skills which become routine, and the odd wondrous instance of an ethereal insight into an ordinary looking wound/issue, act on it and save a body part, or a life, without ever really getting a handle on where the insight came from, or what it consisted of, or how to repeat it. And he is haunted by the feeling that if his day hadv'e progressed differently, if he had been more tired, or not seen that similar case a few months ago, or if he hadn't listened to his intuition that time, it would not have happened. And always the consequences of failure are at least, humiliation, and frequently, death or permanent disability of his patients.
There are lots of stories of people who lost their will-to-care, or their self belief, alongside stories of surgeons who took tender care (and at considerable risk to their patients)to preserve the limbs of their more young and beautiful patients, out of mercy and kindness that could have been seen (and sued) as foolish sentiment.
We are reminded by this book, as we need to be, of the bittersweet chance of live and saviour, of chance and serendipity, and of the limits of human knowledge and skill, and the infinite, unrelenting company of our inconsistent, inefficient and imperfect efforts.
I’m not sure I liked it more than Being Mortal. Then again, they broach two vastly different subject matters. This one felt valuable and timely for me to read. A reassurance that continuing to push re: some medical issues I have is, perhaps, wise. And reminds me to have grace for the medical professionals I encounter. Some, sure, are crusty and burnt out. Most are doing the best they can with the data they have in an ocean of otherwise uncertainty.
Interesting stories, and a very realistic discord on the human side of the health system and the people who work in it. Don't read this if you want to go to hospital with a blind faith that doctors are infallible! Read if you want to understand the human side of the caring professions and the dedication and care that most health professionals show.
I should not have been surprised to learn from the Author's Acknowledgement that Gawande is friends with Malcolm Gladwell -- this book is the doctor's equivalent of a Gladwell book. I really learned a lot from this book and have found myself sharing some of the points with others as I've read it. I should say that Gawande is very graphic in decribing medical procedures and conditions, and there were times I felt a little squeamish (Like reading the chapter on nausea as I was eating lunch; also I'll never be able to hear that TV doctors are about to "put it a line" without wincing) and realized I didn't want to know all this detail, but I'm still glad I read this book.
Some of my favorite points were:
That every patient wants an experienced doctor, but the only way a young doctor becomes an experienced doctor is by performing procedures (very much like a teacher).
The evolutionary purpose of morning sickness
The role of intuition in medicine
How some doctor's go "bad"
The ways doctors try to police themselves
How much doctors and medical researchers still don't know -- the amount of uncertainty and subjectivity.
Other doctors have much to learn from palliative doctors, who take the patient's suffering as seriously as the symptoms.
I also liked reading Gawande's descriptions of his role as a surgical resident -- although how he managed to juggle writing this book with his work and family life (he has a wife and 3 kids) boggles my mind.
Some of my favorite points were:
That every patient wants an experienced doctor, but the only way a young doctor becomes an experienced doctor is by performing procedures (very much like a teacher).
The evolutionary purpose of morning sickness
The role of intuition in medicine
How some doctor's go "bad"
The ways doctors try to police themselves
How much doctors and medical researchers still don't know -- the amount of uncertainty and subjectivity.
Other doctors have much to learn from palliative doctors, who take the patient's suffering as seriously as the symptoms.
I also liked reading Gawande's descriptions of his role as a surgical resident -- although how he managed to juggle writing this book with his work and family life (he has a wife and 3 kids) boggles my mind.
You'e read these essays in the New Yorker, but they are still excellent "insider" pieces about the medical culture.