from Harvard Medical School and an M.P.H. Atul Gawande works at a hospital in Boston that he'd rather not name, having been flooded with phone calls after doing so in the past. endeavor." No matter how much we yearn for medicine to be neat, Gawande argues, it's not. That means opening our eyes and taking a long look at the highest-stakes profession that exists in society-a profession that is still, for all its technological and scientific advancement, "a fundamentally human. Gawande believes that we as patients have been sheltered from the reality of medicine for too long, and as the title of his book suggests, he wants us to start confronting the full truth. And physical action means risk, confusion, complexity, and sometimes mistakes. He has imbued his prose with physicality because medicine is predicated on exactly that: physical action. We put metal retractors in place to hold the wound open and keep the liver and the slithering loops of bowel out of the way." Gross. Gawande takes his readers deep into the hospital, even leading them into the operating room and pulling back the drapes, where he shows them the knife sliding into flesh, as in this passage: "I cut down the middle of our patient's belly, through skin and then dense inches of glistening yellow fat. Tellingly, the book is divided into sections titled "Fallibility," "Mystery," and "Uncertainty." The topics Gawande takes on include the practical necessity of having surgical students train on live patients, the confusing psychology of bodily illness, the question of why doctors make mistakes, the repercussions when they descend into periods of incompetence (they often keep practicing), and the peculiarities of relying on intuition in situations of life and death.Ĭomplications is also marked by a straight-talking descriptiveness.
What makes Complications such a breath (or perhaps a gasp) of fresh air is not only the authority with which it's written-Gawande is a surgical resident in his last year of training-but also its willingness to take on subjects from which others have shied away.
Elsewhere to E.R), has been humanizing our view of the practice of medicine, and Gawande's book is perhaps the biggest and most convincing step in that direction so far. Early on in his new book, Complications, Atul Gawande describes the tasks of the men and women of the medical trade in a way that many may find unsettling: "We drug people, put needles and tubes into them, manipulate their chemistry, biology, and physics, lay them unconscious and open their bodies up to the world." This sentence has none of the antiseptic, doctor-as-deity gloss with which medicine is often painted a slow cultural shift over the past twenty years, led by television (from St.
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