Complications

February 25, 2002
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.

March 1, 2002
" New Yorker" readers will recognize writer-physician Gawande because of his article on the TV anchorwoman with an almost career-ending blushing problem. He exhibits the same smooth, engaging style and choice of unusual subjects in the 13 pieces in this collection, many of which amount to medical detective stories. Typical of those is the last piece, about a young woman who had, it seemed, a simple rash on her leg. But Gawande had earlier seen a patient with necrotizing fasciitis, the flesh-eating bacteria of tabloid fame, and had an uncomfortable hunch that he pursued with his fellow surgeons and a dermatologist. The rest of the tale illustrates the emotions and reactions of the patient and her father as well as the role of the hunch in science. Several entries deal with medical ethics, considering doctors who "go bad" and the long-time failure of doctors and their organizations to police the profession, and whenever Gawande depicts the regular morbidity and mortality conferences in hospitals, he is downright riveting.(Reprinted with permission of Booklist, copyright 2002, American Library Association.)

January 1, 2010
Surgeon, MacArthur fellow, and New Yorker staff writer Gawande follows his best-sellers Complications (2002) and Better (2007) with an electrifying manifesto that pairs the most advanced medical science with the humblest of tools: the checklist. Concerned about medical mistakes, an array of which Gawande describes in dramatic passages guaranteed to raise your blood pressure, Gawande investigated the nature of ineptitude and found that the more complex our lives and work becomea raging side effect of technologythe easier it is for us to overlook details and to err, sometimes catastrophically. Hence the well-thought-out to-do list. Overwhelming torrents of details and demands are by no means restricted to medicine. In fact, Gawande discovered the power of the checklist in his research into aviation, and he extends his inquiry to architecture, finance, and legal cases. Back on his turf, Gawande credits nurses with creating the first health checklists and describes his own quest to make and properly use a safe-surgery checklist. With numerous tales from the front and striking anatomies of cognition and distraction, Gawandes back-to-basics credo is invaluable.(Reprinted with permission of Booklist, copyright 2010, American Library Association.)