Kayan : 2/26 : Complications by Atul Gawande

The book's title not only refers to the undesirable medical conditions that arise unexpectedly in an ER or an OR. In this book, Atul Gawande opens up the philosophies behind the bigger picture of surgery and medicine. In a compassionate, down-to-earth, I-am-basically-a-human-being tone of voice, Gawande reveals the complications that arise in medicine because it is, in the end, conducted by fallible human beings.

Gawande, as a surgeon himself, manages to do so without sounding defensive. Instead, as a starting point, he points to his own first days as a surgical resident and the trials and errors that surgeons must go through in order to become good surgeons. It's gotta start somewhere. With persistence and a heart to continually do better, surgeons in the end can only improve as they practice - in other words, as long as they have patients to practice on.

Gawande also illustrates other complications in medicine: For example, we can set stringent rules, build perfect machines, and conduct infallible diagnostic tests. But in the end, humans are in control. Are perfect systems the real solution then? What about cases where the odds tell you one thing, but your gut as an experienced surgeon (or sometimes a 6th sense) tells you another? Can, and should, a patient realistically make a medical decision for him or herself in the middle of a life crisis?

Gawande does all this with a fluid handle of the language and of the heart. His storytelling is gripping. One can't help but feel that this surgeon has the utmost respect for everyone he encounters - from other doctors, senior or junior; his patients; and even the system. He doesn't claim to have any or all of the answers. But he definitely claims that these questions need to be brought out into the open and given more thought, if only by his readers as individual parts of this whole system.