Georgetown Independent

Issue date: 3/31/08 Section: Arts and Entertainment

Media Credit: nytimes.com

Media Credit: utahhealthsciences.net

They have our lives literally in their hands. Our health and survival, and that of our loved ones, depends on their expertise and on the efficiency of the system. Yet, as Atul Gawande elegantly describes in his new book, Better: A Surgeon's Notes on Performance, neither the doctors nor the system are perfect. A scary thought indeed.

Yet, if I could choose one person to break this unnerving news, it would be Gawande. His seamless weaving of stories and case studies makes the bitter truth go down easily and even enjoyably, leaving you not with a petition in hand against the healthcare system or a lawyer on the line for a malpractice suit, but with renewed hope in the future of doctors and patients everywhere. His stories leave you with the taste of introspection in your mouth, wondering how you can change the world or, first things first, your own life.

Gawande certainly knows his stuff. Aside from being a general surgeon at the Brigham and Women's Hospital in Boston and an apparent world traveler (his stories take us to Iraq, India and back to the U.S.), Gawande is a staff writer for The New Yorker, an assistant professor at Harvard Medical School and Harvard School of Public Health, and the author of the New York Times bestseller Complications: A Surgeon's Notes on an Imperfect Science. He must take a lot of notes; either that, or he really likes colons (no medical pun intended).

Jokes aside, Gawande's first-hand accounts range from the inspiring to the depressing, but all are always startlingly frank and above all, thought-provoking.

Even for those of us who avoid science at all costs and hyperventilate at the thought of organic chemistry, Gawande holds our hand through all the narratives, both in and out of the hospital. Medical jargon is used cautiously, and only when preceded by intelligible explanations. Through the stories, readers follow the thread of the section's theme-"Diligence," "Doing Right" and "Ingenuity"-making the medical details fall to the periphery. The narratives chronicle everything from the struggle to defeat polio in India, the devastating scenes from impoverished third-world emergency clinics, the patient-by-patient fight to manage cystic fibrosis in America, the absurdity of malpractice suits and the effort to find more successful techniques for child delivery. Quick and painless, absorbing and intriguing, Gawande gives just enough facts and figures to prove his point without exhausting his non-specialized readers. In fact, his stories read more like dinner party anecdotes than studies on the efficiency of current medical treatments.

At the heart of all his stories is an honest interest in examining the human quest to do "better." In other words, "What does it take to be good at something in which failure is so easy, so effortless?" he asks, about both medicine and life. As a surgeon, but above all as a person, Gawande encourages this self-inquiry and explores the meaning of failure, perfection, performance, perseverance and hope. Discussing the serious issue of hospital infections, Gawande chronicles the struggle to ensure sterilization and sanitization in his hospital, a task which seems too large for any hospital to efficiently conquer. Though the issue is presented as a possibly futile swim against the human-nature tide, to Gawande the issue distills down to a question of diligence (not surprisingly, it ends up in the "Diligence" section). But his moral revelations are not as striking as his candor. He writes, "Until that moment… it had not occurred to me that I might have given him that infection. But the truth is I may have. One of us certainly did."

Gawande's frankness, considering his position and the power entrusted to him, should be frightening. Who really wants to hear that their doctor is unsure whether he made an error in judgement, or, even worse, in sanitation? Perhaps it is the "everyone does it" context, or the willingness to admit to his (and the system's) failings, but these confessions do not readily invite attacks, or even criticisms. Instead they invite personal reflection on the part of the readers, as we start to think of our own failings and the interminable, perhaps universal quest for perfection. We forget that our lives are in the hands of doctors like Gawande, and instead remember that his hands look just like ours.


Weiner is Editor-in-Chief and an English Junior.

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