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Summary: Should be required reading for any adult
Review: Gawande is an outstanding writer who gets right to the heart of some of the most difficult, painful, and controversial issues in modern medicine. Is there any way train new doctors without giving them the chance to work on real, live people (and thus make potentially fatal erros)? Why do even experienced doctors make serious mistakes, and why do we expect them to be infallable? Who should make critical medical decisions: the patient or the patient's doctor? Both my mom and my former wife were register nurses (RNs), so I tend to have a somewhat skeptical view of doctors. Gawande did much to give me greater sympathy for the medical profession and the challenges it faces, without understating or rationalizing away the critical issues within the profession. Read it. ..bruce..
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Summary: A Great Read
Review: Atul Gawande writes with great ease and honesty about some of the most interesting and pressing issues in medicine today. In a typical chapter he first defines an issue by introducing an anecdotal account (either his own, or someone he has met). As soon as the main issues of the story become clear through his "novel-like" style he pulls the reader away for a minute to analyze these issues with statistics and a world of scientific data that he handily interprets for the non-physician. Without bias, he educates the reader on the many angles different people have looked at the issue from, then he returns to the unfinished story to let you know what decisions were finally made and why, and, often, what could be done the same or differently. He bravely and openly critiques certain aspects of medicine and defends others, and even addresses alternative methods of delivering health care that might seem somewhat odd in today's society, such as the account of a team of Canadian doctors who do nothing but hernia repairs. Such "assembly line" medicine has been debated, but he presents a fair, evidence based interpretation of their results. Gawande is a surgical resident who has obviously taken great efforts to understand the world of medicine in which he is immersed, including not only issues of training, and practice, but also of ethics and humanism in a money-conscious society. This book will benefit the health care worker as well as the non-health care worker, since it touches on many issues that people will sooner or later deal with in their own lives. I highly recommend this book - it will make you think about the world in which we live.
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Summary: A review from a medical student
Review: Atul Gawande's book, Complications: A Surgeon's Notes on an Imperfect Science, is a great read for anyone involved in the world of medicine: patients, nurses, medical students, or even physicians. I feel just about anyone can take something away from this account of medicine's triumphs, fallbacks and mystery.
In the book, Gawande analyzes medicine as seen through his own medical training and professional career. The reader discovers throughout the collection of true stories that medicine is not the highly tuned and infallible body of knowledge and procedure that it seems to be, but a system riddled with uncertainty, error and complications; an imperfect science applied by fallible hands... the hands of human physicians.
But with this unsettling presentation of the drawbacks of medicine, Gawande also gives some indications of the virtues of the practice: its empathy for the people it serves, its genuine drive to help, and its struggle for perfection.
Again, to read this collection of short stories, the reader will surely come away with not so much a sense of skepticism of the practice of medicine, but rather a finer appreciation for its art and humanity.
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Summary: IS A DOCTOR'S LIFE COMPLEX?--YOU GOTTA READ THIS
Review: This is a most entertaining book, yet, an educational one too. You read of the doctor's side of things pertaining to health care and the challenges that an M.D. meets through a regular working day...particularly a surgeon. A liberal display of case histories are used that pertain to a certain subject like: surgery, overweight, pain,when good doctors go bad, etc. Many times I told meself, "There but for the grace of God go I." You will like this book.
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Summary: Fourth Year med student says: READ THIS BOOK!
Review: "Complications" is a compendium of essays by surgeon Atul Gawande, with their overriding theme being the fallibility of medical science / the medical system. This is a great book, first and foremost because it is an engrossing read. This is a work of nonfiction, but each essay has a plot that will keep the reader transfixed. This book is also a careful and honest examination of many of the important issues with which modern medicine struggles. As a physician-in-training, I can empathize with "Education of a Knife," in which Gawande grapples with the fact that medical procedures are skills which require real-time practice... meaning that in order to have well-trained doctors, not-yet trained doctors have to practice risky procedures on real-life patients (one of whom might be you someday). My favorite essay is one near the end in which Gawande reviews the case of a woman who had a slight possibility of having the dreaded necrotizing fasciitis (that's "flesh-eating bacteria" to you non-medheads). Had the decisions in her case been based on strict empirical medicine or decision analysis, rather than a vague clinical hunch, her outcome may have been much different. The essay ties together the themes of the book perfectly, underscoring the fact that that the "human factor," the cause of errors in so many cases, still cannot be discarded because our empirical methods and other diagnostic tools are still so primitive. Although Gawande focuses more on questions than on answers, I think that this may well be a milestone book in medicine. Merely exploring the fallibility of medicine in such an honest, careful way is extremely valuable in that it teaches great humility -- something many doctors could use a little more of. Moreover, discussion of the limits of medicine is what will ultimately improve it. (Note that it is the recognition of the inevitability of human error that has led the field of anesthesia to develop failsafe systems which have so dramatically improved anesthesia safety over the past few decades.) Awesome work -- thought provoking and actually fun to read. I can't believe that a surgical resident (with KIDS!!!) found the time to produce such great writing -- when does this guy sleep? Medical schools should consider making some of these essays required reading.
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Summary: That's not what they do in surgery... really?
Review: Unbelievable. Atrocious. Unimaginable. Oh my God! I said all these and more when I was done reading Complications. I couldn't put it down. Great reading. I didn't already have to know any medical terms to find this book interesting. I now realize what else could go on in a surgery room that's different from what we think happens in there.
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Summary: Excellent and accurate work.
Review: As as an Emergency Medicine Physician, I am very impressed with this work, and also that Dr. Gawande was able to pen this while in residency. The clinical portraits are impressive. All this is remarkable for an author working 110 clinical hours a week. From within the circles of medicine, I understand that Dr. Gawande is an equally accomplished surgeon. Very impressive combination, and well workth the read from someone in the clinical tranches.
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Summary: an imperfect review
Review: When I entered medical school, friends and relatives sent numerous articles about medicine from a wide variety of sources. While many were interesting, Atul Gawande's "Final Cut" from The New Yorker caught my attention. His writing style invited me into the world of autopsies, historically and currently, with all of the underlying questions that they entail. While autopsies are not generally considered standard dinner conversation material, I found myself discussing the article with friends both in and outside of the medical community. Needless to say, having the chance to read Gawande's Complications, which includes "Final Cut", as part of my medical training was wonderful. Gawande addresses many issues of medicine from an informed perspective, and gives us a window into a world most of us will never see. Yet, the issues affect us all as patients. In particular, his essay "Education of a Knife", exploring the unspoken and often unknowing consent patients give to have physicians in training 'practice' on them, generated a lot of conversations between my classmates, as we saw bits of his descriptions within our own experiences with patients. Other chapters took on less specific topics, using illustrative case histories to illuminate chronic pain, the limitations of our scientific/medical knowledge and abilities, the culture of medical professionals, and even the important issue of when things go wrong. All of these essays stand well on their own, but together they make for a powerful collection. While Gawande offers no specific answers or even strong opinions on the topics, his thorough descriptions invite the reader to ponder the issue for themselves, and linger long after the final page has turned. Gawande, as a surgeon, has seen a great deal of the system, and has found a way to share that with the rest of us. This fact, perhaps, makes this collection of essays one of the best parts of my medical education, and I guarantee it is worth reading and thinking about for anyone.
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Summary: Wonderful Insight
Review: Gawande does a superb job of showing how modern medicine isn't the exact cut and dry science that we wish it to be. By taking various surgical cases and placing them into a new light, he creates short stories that are both antedotal and a exciting to read. From chronic pain to supersitions, Gawande gives wonderful insight into broad topics. I always find myself starting novels, but never finishing them--that's what's nice about the short story approach--each chapter is a separate case or story which makes it almost impossible to get lost. Finally, I enjoyed Gawande's perspective on medicine. It is truly amazing how observant he is. Everyone would like to believe that his/her doctor is perfect, that the advice or diagnosis or surgery is always correct, however we know that behind the white coat lies a fallible human. Gawande's advice for the doctor: "No matter what measures are taken, doctors will sometimes falter, and it isn't reasonable to ask that we achieve perfection. What is reasonable is to ask that we never cease to aim for it."
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Summary: Complications= Great book for a small-group discussion
Review: I found Complications by Atul Gawande to be an exciting read from cover to cover. It is filled with a variety of topics centering around medicine's fallibility, mystery, and uncertainty, as perceived by Gawande who is himself a surgeon. Gawande's mastery of language makes each chapter come to life by developing the situation and revealing topics often ignored by the medical community. He also does a great job of leaving his own bias or opinions out of the chapters. This undirected, yet thought-provoking prose was ideal for our small-group discussion class which read his book. We found many topics to discuss and ethical issues to ponder. Although our time was limited as a class, I believe we could have spent much more time digging deeper into the issues Gawande addressed. Issues that we especially enjoyed pondering included the idea of "practicing" medicine on patients as part of the educational process, the robot feel of sub-specialty medicine vs. primary care medicine, and the stories of patients living with medical problems such as the "man who couldn't stop eating." Overall, I highly recommend this collection of short stories both because it is a delight to read, and because it raises some very interesting ideas that I hope to further investigate. Jordan Wilson Medical Student
UMD School of Medicine
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