Gawande, Atul - Complications: A Surgeon's Notes on an Imperfect Science

[oyceter]

I ran to get this after I finished Gawande's Better. I think I may like it a smidgen better than Better, even though this is an earlier book, but most of that is simply subject-matter preference on my part. Both books are very well-written, compulsive reads.

While Better is on improving systems, Complications is about when systems fail, particularly systems in the medical industry. That said, Gawande also looks at imperfections in medicine overall, from uncertainty in diagnoses to the need for residents to get practice vs. the right of patients to get the best care possible to who is to blame when something in a hospital goes wrong.

As in Better, I enjoy reading Gawande partly because of his prose, but mainly because of how he manages to talk about things. In most of his essays, I can't actually tell how the cases will go or what the outcome will be, which is a nice change. I also like the way Gawande discusses issues; he gives the impression of having thought a lot about various angles and pros and cons.

I suspect some parts of this book may gross people out, given that Gawande goes into surgery, flesh-eating bacteria, and the medical procedure for inserting a line into a patient's chest vein (I think it was the vena cava? But I may be wrong). Parts of it made me twitch, but I am also fascinated by things like this. For reference, my favorite parts of Peeps were the parasite chapters. Still, even if you can't read the more graphically detailed sections, I'd rec the other essays anyway, as they're fascinating looks into the world of surgery and into how the medical system works in practice, successes and failures alike.

I vaguely remember someone on the flist posting about Gawande not talking about big pharma? Anyone? Bueller?

Anyway, very cool book, hope Gawande writes something new soon.

Comments

[cychi.livejournal.com]

His books sound interesting, I think I might see if I can get my hands on them some how :P the vena cava is the major vein that attaches to the heart, so you are right on track =)

[oyceter]

You should read them! I think you might find them interesting, though there's not much talk of biotech.

[fannishly.livejournal.com]

I read a chapter from this book ("Whose Body Is It, Anyway?") for my medical ethics class! I have my final in this class tomorrow! At 8:30 a.m.! There are going to be four essays! I have to prepare twelve essay questions to be safe! I am going crazy! AAAAAAHHHHH!!!

[oyceter]

Cool! Neat to know it's being assigned!

Good luck on finals.

[kchew.livejournal.com]

He publishes articles in the New Yorker, and I always enjoy reading them. I just gave this book to my mom for her birthday, and she was thrilled.

[oyceter]

Yeah, I had a lot of fun going through his archived articles!

interesting

[anleedruid.livejournal.com]

he was probably placing a central line....though he wouldn't be using the vena cava, i don't think. the other large veins (internal jugular, femoral vein) would be more accessible. i love gross stuff like that! this book sounds very interesting. i think i will look for it in the bookstore.

hope things are going well for you! (i've been trying to keep up with your posts.) i was on spring break this past week, and i've enjoyed every minute of it. the thought of going back to school on monday is ehhhh...... anyhow, i was talking to some high school classmates recently, and we were talking about planning a reunion for 2009. everyone seems to be really busy, but we'll see if this pans out.

Re: interesting

[oyceter]

Yeah, it was a central line! He does specifically mention the chest, since he was trying to get the needle under the clavicle and also trying to not poke into an artery, but other than that, I have no clue.

Check out his books! They are very cool and fun.

Ooo spring break, yay! I am so happy -- I will have actual vacation soon!

[rachelmanija.livejournal.com]

I recently read How Doctors Think, which was not as good as Gawande (because no is in the field, as far as I can tell) but interesting. It picked up on some similar themes, like the dangers and values of certain mental models involved in diagnosis. (Stereotyping patients in various ways, ignoring evidence that doesn't fit your hypothesis, etc.)

[oyceter]

Ooo, I will check that out too. I also found a book of short stories written by a Chinese-Canadian doctor!