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trin's review
4.0
As with his previous book, [book: Complications], Gawande offers a candid, humorous, and humanizing look at the field of medicine, with specific focus on simple ways he feels doctors could improve. (The opening section, for example, is entitled “On Washing Hands.”) Gawande seems like the type of doctor anyone would feel lucky to have: honest, thoughtful, diligent, not afraid to own up to his own mistakes. His books are fascinating, and while I don’t know how he finds the time to write them, I hope he keeps doing so.
kerinl's review
4.0
An honest look at healthcare both where we have failed and where we can improve.
hmogie's review against another edition
3.75
Very well written and interesting facts/thoughts about the medical system the US (and a bit abroad) throughout. The book felt a little disjointed. However, the analyses of the medical system was incredibly profound.
alicebme's review
3.0
Ask an unscripted question, don't complain, count something, write something, change. "So find something new to try, something to change. Count how often you succeed and how often you fail. Write about it. Ask people what they think. See if you can keep the conversation going."
ametakinetos's review
4.0
While this book is now outdated, Gawande is an excellent storyteller, providing honest and compassionate insight into his journey as a young surgeon. It's hard to stomach that many of the problems he describes have only worsened in the past two decades. If not then, let us learn now!
book_concierge's review
5.0
An excellent sequel to "Complications." Gawande continues with his thoughtful and thought-provoking essays on the art of medicine.
alidottie's review
5.0
This is an interesting nonfiction book. It is written about a surgeon who is determined to improve medical treatment in America. What is interesting is how much of what he talks about (like good hygiene and friendliness with patience that makes them real) are things that seem like they would be easy to employ.
tophat8855's review
4.0
September Book Club Book
I spent the first half of the book looking for a thesis. It starts with an introduction which makes you think there's going to be some sort of thesis, but I couldn't find it in the chapters. I gave up looking for one by the end. Some thoughts on random chapters:
He goes and shows how doctors and nurses don't wash their hands enough and lots of hospital-attained infections like MRSA could be prevented if doctors just washed their hands. One of his own patients gets MRSA under his care and admits he could have been the one who gave it to him. What does he do about this? Just says that's what happens. Couldn't find any guilt or remorse or desire to change his hand-washing ways. And I was still looking for a thesis at this point and was hopelessly let down.
Interesting discussion about medical personal at the front-lines of the war in Iraq. Something you don't think about every day.
Didn't find the chapters on litigation, doctor salaries, and professional-ity engaging. Interesting in that I don't sit around thinking about those all day, so it was interesting to consider the topics, but I didn't find it very engaging.
I found the chapter on doctors who are involved with lethal injection and death sentences really fascinating, though possibly graphic and triggering depending on the reader. And it's interesting how it's so hard to simply kill someone quickly and painlessly. Bodies are meant to preserve themselves. Also interesting that the AMA has statements concerning doctors' involvement in carrying out the death penalty.
I've been told by a couple of women at church that they are interested in my opinion of the maternity chapter. First, as always, the depiction of birth as a medical event was over-the-top. There were a few paragraphs about the process of birth and I skimmed those since I've got a pretty good understanding of how it works. Then the next couple of sentences are, "That's if all goes well. At almost any step, the process can go wrong...." Dun dun DUN!! And then lays on all the scary stuff really thick. And as I was reading all these "problems" I was thinking, "Breech? Breech isn't something that goes wrong. It just is..." And "Going over 24 hours with ruptured membranes isn't a problem... unless someone's doing cervical checks, and especially if they aren't washing their hands (see above)." Basically, birth is scary. Sigh. And we need evidence-based care. And some of his points have been nullified by a few recent studies (this book is 2007). I could go into more and touch on every sentence in that section, but I won't because it's also very exasperating. In the end, he's a doctor so he's going to favor a medical side and since he's not an OB, he's even more removed from the course of birth and labor than an surgery-minded OB. Grain of salt- but then I wondered how many other chapters need to be taken with salt. Hmm... I should probably re-read the book with that in mind, but I won't.
The chapter on cystic fibrosis and what they've done to prolong life expectancy for people with it was very interesting too. And the last couple of chapters on how doctors could improve. And that's when the thesis came together: we need doctors who actively working on "diligence, doing right, and ingenuity (the three sections together)." It just doesn't sound like he's putting that into practice (see hand washing above). It's getting 4 starts because the death chapter was so interesting as were a few of the other stories.
I spent the first half of the book looking for a thesis. It starts with an introduction which makes you think there's going to be some sort of thesis, but I couldn't find it in the chapters. I gave up looking for one by the end. Some thoughts on random chapters:
He goes and shows how doctors and nurses don't wash their hands enough and lots of hospital-attained infections like MRSA could be prevented if doctors just washed their hands. One of his own patients gets MRSA under his care and admits he could have been the one who gave it to him. What does he do about this? Just says that's what happens. Couldn't find any guilt or remorse or desire to change his hand-washing ways. And I was still looking for a thesis at this point and was hopelessly let down.
Interesting discussion about medical personal at the front-lines of the war in Iraq. Something you don't think about every day.
Didn't find the chapters on litigation, doctor salaries, and professional-ity engaging. Interesting in that I don't sit around thinking about those all day, so it was interesting to consider the topics, but I didn't find it very engaging.
I found the chapter on doctors who are involved with lethal injection and death sentences really fascinating, though possibly graphic and triggering depending on the reader. And it's interesting how it's so hard to simply kill someone quickly and painlessly. Bodies are meant to preserve themselves. Also interesting that the AMA has statements concerning doctors' involvement in carrying out the death penalty.
I've been told by a couple of women at church that they are interested in my opinion of the maternity chapter. First, as always, the depiction of birth as a medical event was over-the-top. There were a few paragraphs about the process of birth and I skimmed those since I've got a pretty good understanding of how it works. Then the next couple of sentences are, "That's if all goes well. At almost any step, the process can go wrong...." Dun dun DUN!! And then lays on all the scary stuff really thick. And as I was reading all these "problems" I was thinking, "Breech? Breech isn't something that goes wrong. It just is..." And "Going over 24 hours with ruptured membranes isn't a problem... unless someone's doing cervical checks, and especially if they aren't washing their hands (see above)." Basically, birth is scary. Sigh. And we need evidence-based care. And some of his points have been nullified by a few recent studies (this book is 2007). I could go into more and touch on every sentence in that section, but I won't because it's also very exasperating. In the end, he's a doctor so he's going to favor a medical side and since he's not an OB, he's even more removed from the course of birth and labor than an surgery-minded OB. Grain of salt- but then I wondered how many other chapters need to be taken with salt. Hmm... I should probably re-read the book with that in mind, but I won't.
The chapter on cystic fibrosis and what they've done to prolong life expectancy for people with it was very interesting too. And the last couple of chapters on how doctors could improve. And that's when the thesis came together: we need doctors who actively working on "diligence, doing right, and ingenuity (the three sections together)." It just doesn't sound like he's putting that into practice (see hand washing above). It's getting 4 starts because the death chapter was so interesting as were a few of the other stories.