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Type of bind: Paperback
Dewey Decimal Number: 617.092
EAN num: 9780312421700
ISBN number: 0312421702
Label: Picador
Manufacturer: Picador
Quantity: 1
Page Count: 288
Printing Date: April 01, 2003
Publishing house: Picador
Sale Popularity Level: 3171
Studio: Picador
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Editor's Notes and Comments:
Amazon.com:
Gently dismantling the myth of medical infallibility, Dr. Atul Gawande's Complications: A Surgeon's Notes on an Imperfect Science is essential reading for anyone involved in medicine--on either end of the stethoscope. Medical professionals make mistakes, learn on the job, and improvise much of their technique and self-confidence. Gawande's tales are humane and passionate reminders that doctors are people, too. His prose is thoughtful and deeply engaging, shifting from sometimes painful stories of suffering patients (including his own child) to intriguing suggestions for improving medicine with the same care he expresses in the surgical theater. Some of his ideas will make health care providers nervous or even angry, but his disarming style, confessional tone, and thoughtful arguments should win over most readers. Complications is a book with heart and an excellent bedside manner, celebrating rather than berating doctors for being merely human. --Rob Lightner
Product Description:
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.
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Rated by buyers 
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Atul Gawande gratefully takes the reader to the back of the OR, a place open for a few, yet intriguing for many. Dr. Gawande is extremely frank and poignant, as he describes actual cases from his own surgical practice. He admits that cutting someone open for the very first time is hell, praises surgery which gives chance to obese people, wonders about doctor's intuition, and remains human in every case.
As always, Atul Gawande is not just writing about medicine; this book reaches far beyond the realm of the operating room. He touches on the most complicated ethical questions of medicine and society as a whole. Gawande speaks of mistakes and our imperfect judgment; tackling the questions of good doctors gone bad along with malpractice claims and punishments. He makes the case for autopsy as a means of learning. He admits that medical students must practice on cadavers or animals in order to cut people open; all ethical questions are answered by means of vivid examples.
For instance, in the 1980s the death rate from a particular surgery would be about 10%. When the new surgical treatment of heart pathology arose, surgeons started trying the novice. At that training period, the rate of children death from this particular intervention increased to 25% of cases. Sounds horrible? Yes, but after surgeons learned, the rate fell down to just a couple percent. Was it worth it? Sure, granted the number of lives saved in the long run. Never, granted now many kids died just due to surgeons' learning. Would any doctor let anyone practice on his own kid? Never. At the same time, learning is a necessary part of medical progress.
Those questions dominate the book; Gawande ponders at the patient's right to choose, reminds us that doctors are human and prone to mistakes, reveals mysteries of complications, which are usually open only during the M&M - Mortality and Morbidity Conference behind the closed door. Gawande is not afraid to open the doors. Moreover, he is confident that openness is the only way to reduce the complications.
I almost wanted to say the book is too idealistic, except it's written by a person whose profession is to think realistically. Great book!
Rated by buyers -
The very first part of the book is the typical medical error conversation - the system needs changes, but, instead, the last doctor to touch a patient is always ultimately responsible. The last two sections of the book are full of interesting patient stories and antecdotes, leaving the reader with a sense of "why do I pay so much for services that are not consistent and not scientifically proven?" Gawande does an excellent job pointing out some of the uncertaintaties of medicine and some of the major health disparities and inequalities - the poor are usually the ones that are used as training tools for interns and residents, and receive subpar-care compared to the well-insured.
A very easy and quick read.
Rated by buyers 
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I just couldn't finish this book! I thought it would be better--but as I am reading the words they are more and more unfamiliar. I don't want to read a book where you spend more than 3/4 of the time looking up the words!
Rated by buyers 
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An amazing thriller...
Dr.Atul's superb portrayal of finest qualities of a doctor, yet the limitations of an individual, their weekness,strengths, system flaws etc with vivid examples of real life cases makes "Complications" the best medical book I'v ever read.It's not the content of the book alone that deserves appreciation, it's also the flow of words that blend with the topic.
Certainly the pinnacle of the book is the story of Joseph Lazaroff, Atul's Anguish depicting the finest of human character and also the professionalism of a doctor, also his questions behind the ethics of "absolute insane rights of patient's expression". I felt a pain in the heart for that "unknown soul" ( a gist of that chapter is below)
Chapter : Whose body is it Anyway :
...I turned the ventilator off, and the suddenly the room was quiet .His breathing slowed ...Joseph Lazaroff had died.But Knowing how much Lazaroff had dreaded dying the way he died....
Chapter : Education of a Knife:
I said to the patient that there were "slight risks" involved.And the disasters weighed on my mind: the woman who had died from massive bleeding, the man who had to have a chest opened, the man who had a cardiac arrests.I said nothing of such things when I asked my patient's permission to do this
Chapter : When Doctors Make Mistakes:
At 2 A.M on a crisp Saturday in winter a few years agao, I was in sterile gown , pulling a teenage knifing victim's abdomen open, when my pager sounded "code trauma, three minutes"
Chapter : When Good doctor's Go bad:
Before the license of Dr.Goodman was taken away, he was a highly respected and sought after surgeon...he could do some of the best, most brilliant work around....In one case , he put the wrong-size screw into a patient's ankle,another case when he refused to do hip replacement. For the last several years, he was the defendent of a stream of malpractice suits.
Chapter : The Man Who Cannot stop Eating :
...He had to let his legs apart to let his abdomen sag between them. He cannot lie down and breath properly because of excess fat in the tongue and upper airway. He had to sleep in the recliner and every thirty minutes or so , he would wake up asphyxating, He could no longer stand up to urinate, he had to shower after moving his bowels to get clean
A Must Read book...Afterall, someday you might be an example in his future books!
Rated by buyers -
I find this book which has gotten such rave reviews disappointing. Dr. Gawande addresses a number of issues which are pertinent to surgical practice. However,I found the book to be superficial and lacking of "heart".
I will elicudate. Dr. Gawande states frequently that surgeons slash their way into a patient.I suspect that this is for dramatic effect.There are other examples of this such as the description of an autopsy.He tones it down later.He treds lightly on the fact that doctors don't want to own their mistakes which is why there is no improvement in medical care over 20 years ago despite huge advances in both technology and costs.
The only Surgeon I have ever known who "slashed" his way into a patient ended up losing his privileges...thank God but it took many years and a yeoman's effort and those who spoke up were alienated and shunned. It was not as simple as is portrayed in this book.I do laud him for bringing up the "good doctors going bad" issue. It is a huge problem and bad doctors are often covered for years and years while patients are repetitively injured. It is also very harmful to the doctor who is creating the problem. The cost of this problem to patients, hospitals and society is staggering.
I looked up the reference that computers were better than doctors at diagnosis. It is not about medical diagnosis, it was about psychologists' diagnosis. The second article was from 1954...A bit dated. before the computer era.
I laud him for the courage in mentioning his screwed up tracheostomy attempt. There are numerous methods for both intubation and percutanous guided tracheostomy techniques that have been available for 20 years. I have to wonder why he was unaware of these. The technique that he describes for subclavian vein cathethers is also not as safe as other methods which use a small guage finding needle. I have to wonder why 20-30 years after these problems were identified that this young doctor was not being instructed in these techniques.
His chapter on bariatric surgery is notable for his mentioning of the commercialization of medicine an increasingly dangerous trend is appropriate. At this point bariatric surgery has been shown to be helpful for a large number of patients, but without question medicine has been commercialized.
His section on uncertainty is the best part of this book. He saved the best for last.
Nonetheless, I find his "laissez-faire" attitude to these problems even more worrisome.I find little actual feeling that he cared about his patients in this book. This is not surprising as it pervades medicine today.
I haven't found this book to be a thriller.It lacks depth of character. If he had connected with us and his patients emotionally I believe that it would have been a much more powerful work.
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