Complications: A Surgeon's Notes on an Imperfect Science

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Henry Holt and Company, Apr 1, 2003 - Medical - 288 pages
16 Reviews

A brilliant and courageous doctor reveals, in gripping accounts of true cases, the power and limits of modern medicine.

Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is -- complicated, perplexing, and profoundly human.

Atul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur and why good surgeons go bad. He also shows us what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause; a young woman with nausea that won't go away; a television newscaster whose blushing is so severe that she cannot do her job. Gawande offers a richly detailed portrait of the people and the science, even as he tackles the paradoxes and imperfections inherent in caring for human lives.

At once tough-minded and humane, Complications is a new kind of medical writing, nuanced and lucid, unafraid to confront the conflicts and uncertainties that lie at the heart of modern medicine, yet always alive to the possibilities of wisdom in this extraordinary endeavor.

Complications is a 2002 National Book Award Finalist for Nonfiction.


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Awesome book
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Atul Gawande grabbed my attention when he was given the MacAurthur fellowship (nicknamed 'The Genius Award') in 2006. Later I read an Op-Ed piece that he wrote in the New York Times, titled 'The Power of Negative Thinking' (Read it here: which I deeply appreciated.
This book presents real life cases in medicine and surgery. However, many truths that emerge from Dr. Gawande's experiences as a surgical resident are applicable to almost any professional discipline, including mine (information technology).
The book is divided into three parts: Fallibility, Mystery and Uncertainty. From the perspective of a person trained to think scientifically, Gawande analyzes how people become good at what they do, how failures occur, why good professionals suddenly become bad, how everything cannot be explained by the application of cold logic, and how sometimes one's luck and instincts can be as important as one's skills while performing one's professional responsibilities.
There are many reasons why I liked this book. All the cases presented in it are real ones that Gawande has had first-hand experience dealing with. The stories are human and humane. Gawande's descriptive ability is astounding. His presentation of medical theory is lucid and understandable to the lay man. He has organized each of the chapters logically. His observations are documented with the appropriate amount of detail. Many times, I found myself underlining some truly remarkable sentences for later reference, something I rarely do while reading a book.
'Complications' is a book that has transformed my thinking to a great extent, and will hopefully help me become a better professional.

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Authors Note
Education of a Knife
The Computer and the Hernia Factory
When Doctors Make Mistakes
Nine Thousand Surgeons
When Good Doctors Go Bad
Full Moon Friday the Thirteenth
The Pain Perplex
A Queasy Feeling
Crimson Tide
The Man Who Couldnt Stop Eating
Part IllUncertainty
The Dead Baby Mystery
The Case of the Red Leg
Notes on Sources

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About the author (2003)

Atul Gawande is the author of The Checklist Manifesto and Better. Complications was a National Book Award finalist. He is also a MacArthur Fellow, a general surgeon at the Brigham and Women's Hospital in Boston, a staff writer for The New Yorker, and an assistant professor at Harvard Medical School and the Harvard School of Public Health. He served as a senior health policy advisor in the Clinton presidential campaign and White House from 1992 to 1993. He received his B.A.S. from Stanford University, M.A. in politics, philosophy and economics from Oxford University, M.D. from Harvard Medical School, and M.P.H. from the Harvard School of Public Health. He lives with his wife and three children in Newton, Massachusetts.

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