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Complications: A Surgeon's Notes on an Imperfect Science

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Customer Reviews
Rating:

- Excellent writing and will challenge your assumptions about medicine
Gawande is a wonderful, vivid writer and this book was well chosen as a National book Award finalist. He is not afraid to admit some errors he made along the way, including some regretable hubris that harmed some patients but he also writes about the way doctors learn - and the limits and challenges they still face in the imperfect world of medicine, where so much depends on following one's instincts, in spite of so many advances.
Whether learning about how autopsies first came to be used (for religious reasons) or how a newscaster dealt with a disabling case of blushing or about how and why "Good Doctors go Bad" (and how they are treated), I found this book a rich compendium of useful facts and information.
It will also help you ask the right questions next time you have to face a medical decision, large or small, guiding you to ask the right questions of your doctor.

Rating:

- A peak inside
I always appreciate a well written book that lets me into the inner circle of a group I will never know. "Reading Lolita in Tehran" served in much the same way....discussion between Muslim women in Iran behind closed doors. An American man will never hear those discussions. "Complications" is similar. I know physicians have their own argot...the secret language if you will, of their profession. They will never allow non-physicians to hear them speak/think candidly...to be allowed into their clubhouse without the degree. Gawande let me lurk...be a bit of a fly on the wall and I appreciate that. I rated this book four stars instead of five because he still hides out a bit behind his pride of profession. Wanting to show us without really letting us in. Hubris is too hard a word, but it's close.
I've recommended this book....this one and Gawande's other, "Better" to physician friends. I haven't heard back, so I can't say how they will be received, but I suspect he'll get a five from a member of the fraternity."

Rating:

- About More Than Surgery
This book is only ostensibly about surgery, and it achieves brilliance on many levels. Often it is the engineers, the lawyers, the doctors, who are the best writers. These types of people tend to care for the important details, and, when they choose to be writers, get these details down on the page. Atul Gawande, a surgeon from Boston, is the archetype for this rule. His prose is crisp, clean, and efficient. Needless to say, from a technical point of view, he also knows his stuff.

Gawande structures his essays so that they create suspense. For example, in many essays he does not go right out and say what happens to a patient. He first frames a dire situation, then takes the reader on a tour of the problems, fallacies, and circumstances, and finally, only after the reader knows all the isses, Gawande constructs a climax. In other essays we read about his honesty in describing how difficult it is to master certain medical procedures. In the final part of the book (the last four essays) we learn about human decision making fallacies, and how they apply to human doctors making split-second decisions. These insights are typically wrapped around a heart-stopping narrative involving patients on the verge of death -- or, in the final essay, on the verge of losing a leg.

COMPLICATIONS asks a lot from its reader. We think about philosophical issues facing Gawande's patients; we learn about decision making and psychology; we learn about the human drama of life -- what it means to live and die; we learn about the pressures 20th century professionals are under to perform well in an ever less empathetic world (see the essay "When Good Doctors Go Bad"). Gawande really brings it.

Rating:

- Gawande is an asset to both the layman and the entrenched physician
Atul Gawande has a keen eye for the fallibilities and eccentricities of medicine. While inherently clinical and precise, his prose is accessible and engrossing. This book should be on the must read lists of anyone who goes to a physician, and to physicians in practice. I laud Gawande for showing that medicine is far from a perfect science and is often more art than science. Medicine is often a guessing game based upon probabilities unclear studies. We treat our doctors with such a severe double standards. We expect doctors to be able to cure all of our health problems no matter the cost and yet we fail to take care of ourselves. We expect them to never make a mistake and yet often we are unable control our own diets, exercise every once in a while, or to follow medical orders properly. Gawande's ultimate purpose coupled with his gift of story telling, is to educate us all that doctors are not perfect, nor do they always have the right answer, in fact they often guess. Most of all doctors are just like you and me, do you ever make mistakes at your job? Do you think doctors are somehow exempt from this? Unfortunately the magnitude of their mistakes are often grave. Doctors cannot be perfect, but they must always try to be, what more can we ask.

Rating:

- AMAZING!
This book is plain EXCELLENT!

A friend of mine suggested it, and wow, I found I had to force myself to stop reading and go back to work!

Dr AG somehow has been able to combine extremely interesting and compelling medical cases with deep considerations about the field, about being a doctor, about the limitations of medicine and how we cope with them.

Even more amazing is the humility and simplicity of the author's writing. No bragging, no self-praise, just an extremely intimate conversation on the experiences he had as a doctor, the lessons he learned and the meaning he saw through them.

The feel of the book is that of an incredibly fascinating conversation with a close friend in a warm café.

thank you Dr.!

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