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Complications: A Surgeon's Notes on an Imperfect Science Paperback – Apr 1 2003

4.8 out of 5 stars 77 customer reviews

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Product Details

  • Paperback: 288 pages
  • Publisher: Picador; 1 edition (April 1 2003)
  • Language: English
  • ISBN-10: 0312421702
  • ISBN-13: 978-0312421700
  • Product Dimensions: 14.9 x 2 x 20.8 cm
  • Shipping Weight: 204 g
  • Average Customer Review: 4.8 out of 5 stars 77 customer reviews
  • Amazon Bestsellers Rank: #2,092 in Books (See Top 100 in Books)
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Product Description

From Amazon

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 theatre. 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 --This text refers to an out of print or unavailable edition of this title.

From Publishers Weekly

Medicine reveals itself as a fascinatingly complex and "fundamentally human endeavor" in this distinguished debut essay collection by a surgical resident and staff writer for the New Yorker. Gawande, a former Rhodes scholar and Harvard Medical School graduate, illuminates "the moments in which medicine actually happens," and describes his profession as an "enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line." Gawande's background in philosophy and ethics is evident throughout these pieces, which range from edgy accounts of medical traumas to sobering analyses of doctors' anxieties and burnout. With humor, sensitivity and critical intelligence, he explores the pros and cons of new technologies, including a controversial factory model for routine surgeries that delivers superior success rates while dramatically cutting costs. He also describes treatment of such challenging conditions as morbid obesity, chronic pain and necrotizing fasciitis the often-fatal condition caused by dreaded "flesh-eating bacteria" and probes the agonizing process by which physicians balance knowledge and intuition to make seemingly impossible decisions. What draws practitioners to this challenging profession, he concludes, is the promise of "the alterable moment the fragile but crystalline opportunity for one's know-how, ability or just gut instinct to change the course of another's life for the better." These exquisitely crafted essays, in which medical subjects segue into explorations of much larger themes, place Gawande among the best in the field. National author tour.

Copyright 2002 Cahners Business Information, Inc.

--This text refers to the Hardcover edition.

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Format: Paperback
I've enjoyed Gawande's work with The New Yorker for a number of years - his subject material is fascinating, and his honesty is compelling. As always, he makes his way to the heart of the matter - the fallibility of highly skilled physicians and why everyone pretends this isn't so - in an elegant spiral that takes us through numerous case studies. The case study approach seems to have an inherent fascination (at least it does for me), and Gawande puts this model to excellent use.

What I find remarkable, among other things, is that Gawande doesn't sacrifice his own honesty for the sake of a clear conclusion. What happens to the woman with "The Red Leg" leaves us in a quandary - the decision tree said not to investigate further, Gawande's own instinct was heavily influenced by the sheer chance that he had seen a similar case recently, so what are we left with? Is it just sheer chance? We may not want to think so, but the book ends with marvelous ambiguity.
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this book is really interesting. I originally bought it after reading a book called Confessions of a Surgeon, which was also great, and wanted to read more in this type of reading. I stumbled upon this book and ended up reading it at home, and work! It has a mix of personal experiences and research. though at times it can feel more like a research paper or like a text book with all the information about other papers and studies, it is very interesting!
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Format: Paperback
It is Dr. Gawande's honesty that is remarkable, for example, he gives a candid confession of a difficult airway case, which he judges that he could have managed better. He realized that the young woman’s airway was lost and called for anaesthesiology help. Then he proceeded to perform a surgical airway. In this he failed and he later puzzled why he had not called his senior who had been operating in the floor below him? He reflects on this moment: “ I should have called Dr. Ball for backup…But for whatever reasons-hubris, inattention, wishful thinking, hesitation, uncertainty of the moment- I let the opportunity pass.“
Afterwards, he writes “I felt a sense of shame like a burning ulcer. This was not guilt: guilt is what you feel when you have done something wrong. What I felt was shame: I was what was wrong.”
Later Dr. Gawande reasons “…why many doctors take exception to talk of system problems,” “continuous quality improvement,” and “process re-engineering.” It is the dry language of structures, not people. I’m no exception: something in me, too, demands an acknowledgement of my autonomy, which is also to say my ultimate culpability.”
Many of us physicians do not acknowledge our culpability and so let the opportunity pass to improve.
Striving for aequanimitas,
John Mary Meagher author of Medicine, Mistakes and the Reptilian Brain
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Format: Paperback
Complications: by Atul Gawande
A Surgeon's Notes on an Imperfect Science
Surgery is often perceived as the most respected of all the medical professions, but one surgeon's bravely written insiders essays paints a bittersweet picture of the medical practice of surgeons. In fact, "practice" is the operational word in describing what makes for a "good" surgeon - and Dr. Atul Gawande describes how the surgeon needs plenty of opportunities to wield the scalpel before he or she feels as competent as they look when they use one. "Complications: A Surgeon's Notes on an Imperfect Science" by Atul Gawande is a personal collection of spell binding first person medical stories. Gawands presents the reader with a physician who's as creative with prose as he appears to be with surgical sutures. Gawande is a frequent contributor to The New Yorker Magazine. Usually retrospective physicians in a reading group I participate in were unusually animated about "Complications" and validated some of Gawande's stories with similar versions of their own.
"Complications" is not a medical "who-done-it"; nor is it a non-fiction version of the popular television show "ER". It's about one surgeon's practice, but the stories are, to a certain extent, similar to the shared experiences of all physicians, regardless of their specialty. A surgeon must have a good medical education, lots of practice doing procedures that develop proficient skills and a fair amount of good luck.
Sometimes surgery helps patients to physically recover but the psychological side effects cannot be measured as easily as physiologic symptoms. One essay brings that point home titled, "Crimson Tide", about a girl who seeks a surgical cure for uncontrollable blushing.
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Format: Paperback
If you have ever been a surgical patient, or expect you might become one in the future, I highly recommend that you read Dr. Atul Gawande's "Complications: A Surgeon's Notes on an Imperfect Science". If you are a medical student, I highly recommend that you read the book twice - once for you and then again for your patients.
Gawande, as a seventh year Harvard surgical resident, offers reflective insight regarding his observations and experience as a surgeon. From failed attempts to insert a central line as a new resident, to his pride of attending his first medical conference with more senior house personnel, readers easily share in his frustrations, delights, and challenges.
This book will encourage you to appreciate the ethical dilemmas surgeons face as they evaluate new procedures and self-police their own performance and that of their peers. Gawande reveals that even surgeons are mystified by the amazing human body and sometimes cannot explain how or why our bodies react the way they do to surgery.
This book should not be mistaken for a gruesome account of risky surgical procedures performed late at night by sleepy-eyed residents. Gawande's descriptions of his patients and their surgical cases are detailed, but he provides them as intellectual case-in-points rather than the yellow journalism of blood and guts shown on TV and in the movies.
This book will make you think...sometimes harder than you want to...it may even make you realize that surgery is not perfect and neither are even the best surgeons.
A real page turner and a fast read. Don't cheat yourself by skipping over this one!
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