Complications by Atul Gawande

complications“In gripping accounts of true cases, surgeon Atul Gawande explores the power and the limits of medicine, offering an unflinching view from the scalpel’s edge. Complications lays bare a science not in its idealized form but as it actually is–uncertain, perplexing, and profoundly human.”

I work at a college bookstore, and every quarter I see this book on our shelves, being used by several writing courses and several different professors.  Having an interest in science myself, I finally decided to pick it up and see what a bunch of writing teachers found so fascinating about it.  The answer is: a lot.  This book is less of a memoir and more of an exploration of a puzzling dichotomy.

On the one hand, Gawande explores the mindset of the surgeon as someone who must have confidence in their decisions and in their diagnoses.  He details some of the training he received as a resident, learning procedures that he had previously only read about in textbooks. and carrying them out with at least the appearance of knowing what he was doing, even as he fumbled through the first few times.  Every doctor starts somewhere, and something as simple as putting in an IV must be learned at a teaching hospital under supervision.  Readers get a feel for how these young people develop the know-how and trust in their own abilities to go forward on their own.

On the other other hand, the author is up front about the fact that medicine is an inexact science and mistakes are made.  He discusses his own mistakes without sparing himself, but also without emotional self-flogging.  He admits that sometimes diagnosing an illness or injury is dependent on factors beyond anyone’s control, and that this can lead to tragedy.  He doesn’t seem to be doing so with the intent to scare; rather, he comes across as giving readers an honest assessment of the all-too-human people who take our lives in their hands.

Gawande manages to take these two very different views of doctors and marry them into a thoughtful and insightful look at the reality of surgery and critical care.  He goes into cases that stumped everybody who came across them, injuries that baffled surgeons with their suddenness and severity, and the occasional triumph when a hunch proved life-saving.  Gawande proves that he not only has the writing chops to tackle this subject, but he has the self-awareness to delve deep and explore the subject in a way that is both honest and respectful.

Now I understand why so many of our professors assign this book.  There’s a huge amount of skill on display in the writing, both in the technical aspects and in the storytelling.  If you have any interest in science, or in the realities of medicine beyond what you see on TV shows like ER, pick up this book.

This book was a personal purchase.

(Description nicked from Amazon.com.)

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