Complications: A Surgeon's Notes on an Imperfect Science

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Overview

A brilliant and courageous doctor reveals, in gripping accounts of true cases, the power and limits of modern medicine.

Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is — complicated, perplexing, and profoundly human.

Atul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur and why good surgeons go bad. He also shows us what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause; a young woman with nausea that won't go away; a television newscaster whose blushing is so severe that she cannot do her job. Gawande offers a richly detailed portrait of the people and the science, even as he tackles the paradoxes and imperfections inherent in caring for human lives.

At once tough-minded and humane, Complications is a new kind of medical writing, nuanced and lucid, unafraid to confront the conflicts and uncertainties that lie at the heart of modern medicine, yet always alive to the possibilities of wisdom in this extraordinary endeavor.

 

Complications is a 2002 National Book Award Finalist for Nonfiction.

Finalist for the 2002 National Book Award, Nonfiction.

Editorial Reviews

From Barnes & Noble
“No one writes about medicine as a human subject as well as Atul Gawande,” says Adam Gopnik of this Boston surgeon whose articles appear regularly in The New Yorker. Gawande’s descriptions of everything from clumsy surgical mishaps to new cutting-edge operating room techniques are rendered with grace and wonder. Reading his accounts of pain experiments (in which female dancers excel) and medical-convention huckstering, one gains a sense of his stately, sometimes surrealistic profession.
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. (Apr. 4) Copyright 2001 Cahners Business Information.
From The Critics
"Complications is a uniquely soulful book about the science of mending bodies."
—Adam Gopnik, author of From Paris to the Moon

Product Details

  • ISBN-13: 9780312421700
  • Publisher: Picador
  • Publication date: 4/1/2003
  • Edition description: REV
  • Pages: 288
  • Sales rank: 29,207
  • Product dimensions: 8.06 (w) x 11.28 (h) x 0.80 (d)

Meet the Author

Atul Gawande
Atul Gawande
A rock n’ roll loving surgeon who writes for The New Yorker, Atul Gawande has a gift for describing both medical mishaps and awe-inspiring surgical techniques with authoritative ease. Gawande’s gift was recognized when his first collection of essays, Complications: A Surgeon's Notes on an Imperfect Science, was nominated for a 2002 National Book Award.

Good To Know

In his interview with Barnes & Noble.com, Gawande described a shining memory: "I believe that one version of the good in life can be defined by the moments I sometimes had playing tennis as a sixteen-year-old," He recalled. "You’d be out on the court and for an hour, two hours, sometimes an entire roasting hot day, and every single thing you hit would go in. Hit that ball as hard as you wanted, wherever you wanted, and it went in. It was effortless power, achieved out of practice. But my game’s gone to hell. And I have not had a moment like that since high school."

A serious surgeon and writer by day, Gawande has been known to rock out. He told Barnes & Noble.com, "I have always believed that there is nothing greater than a life in rock n' roll -- it has to be good rock n' roll -- and I still think it is true."

Gawande claims not to have any one source of inspiration for his writing. I don’t write out of inspiration," he told us. "I write because it’s my way of finding cool ideas, thinking through hard problems and things I don’t understand, and getting better at something. I was never born to write. I was taught to write. And I am still being taught to write."

    1. Hometown:
      Newton, Massachusetts
    1. Date of Birth:
      November 5, 1965
    2. Place of Birth:
      Brooklyn, New York
    1. Education:
      B.A.S., Stanford University, 1987; M.A., Oxford University, 1989; M.D., Harvard Medical School, 1995

Read an Excerpt

When you are in the operating room for the first time and see the surgeon press his scalpel to someone's body, you either shudder in horror or gape in awe. I gaped. It wasn't the blood and guts that enthralled me. It was the idea that a mere person would ever have the confidence to wield that scalpel. I wondered how the surgeon knew that all the steps would go as planned, that bleeding would be controlled and organs would not be injured. He didn't, but still he cut.

Later, I was allowed to make an incision myself. The surgeon drew a six-inch dotted line across the patient's abdomen and then, to my surprise, had the nurse hand me the knife. It was, I remember, still warm. I put the blade to the skin and cut. The experience was odd and addictive, mixing exhilaration, anxiety, a righteous faith that operating was somehow beneficial, and the slightly nauseating discovery that it took more force than I realized. The moment made me want to be a surgeon — someone with the assurance to proceed as if cutting were routine.

Table of Contents

Author's Note 1
Introduction 3
Pt. I Fallibility
Education of a Knife 11
The Computer and the Hernia Factory 35
When Doctors Make Mistakes 47
Nine Thousand Surgeons 75
When Good Doctors Go Bad 88
Pt. II Mystery
Full Moon Friday the Thirteenth 109
The Pain Perplex 115
A Queasy Feeling 130
Crimson Tide 146
The Man Who Couldn't Stop Eating 162
Pt. III Uncertainty
Final Cut 187
The Dead Baby Mystery 202
Whose Body Is It, Anyway? 208
The Case of the Red Leg 228
Notes on Sources 253
Acknowledgments 265
Customer Reviews
Average Rating 4.5
( 128 )

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  • Anonymous

    Posted February 21, 2010

    I Also Recommend:

    Great Read

    An inspirational book that is a must read. Insightful and original, Gawande depicts the reality of complex problems that arise in the medical profession.

    2 out of 3 people found this review helpful.

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  • Posted February 13, 2010

    Grey's Anatomy

    I loved this book. At times, it felt like I was reading an episode of my favorite T.V. program, Grey's Anatomy. I am not in the medical profession but Dr. Gawande writes so well that his explanations and storytelling are easy to read and follow.

    2 out of 2 people found this review helpful.

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  • Posted December 27, 2009

    informative info on real surgeons actions

    Very good. Easy writing style, many new concepts, many chuckles also. Still biased as a surgeon, but tells many incidents from real life. Wish my doctor would read it.

    1 out of 1 people found this review helpful.

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  • Posted December 12, 2009

    Overly hyped and I fell for it

    Although eager to learn something from this physician's account, I found I was willing to leave the book after 50 pages. I did not, I did read it entirely but it was a waste of time. Some physicians can write, some cannot. This is a "not".

    1 out of 2 people found this review helpful.

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  • Posted August 2, 2009

    more from this reviewer

    Great literary analysis of the art of surgery

    Written very well, not quite as good as his other book 'Better', but still very good.

    1 out of 1 people found this review helpful.

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  • Anonymous

    Posted December 11, 2011

    Loved it!

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  • Posted August 27, 2011

    Great book

    Very good book. Not boring like some books in this genre can be. All of his books are good. I only posted 2 reviews thus far, in 9mo, this book is worth a positive review!

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted March 2, 2011

    Great author - great book!

    This was my favorite of Atul Gawande's books, but I loved them all!! Would recommend them to everyone!

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  • Anonymous

    Posted November 10, 2010

    Complications: Always Kept me on the Edge of my Seat!

    Atul Gawande's Complications, is a view on the less publicized uncertain half of the medical field. The half that attempts new surgeries and ideas most of which turn out to be failures rather than successes. And who better to test these new methods out on than the common patient who enters the hospital for an ordinary reason. Gawande, who is a doctor himself, discusses how this is helpful and hurtful to today's society and the overwhelming mystery that still surrounds medical science. He tries to get across the message that medicine and surgery is a necessary evil. We will never be able to improve unless we practice. The lives of some experiments are not as important as the many that could be saved in the future. He wants to get across the point that this is a harsh fact society needs to accept. I like the way he wrote the story giving examples of patients, then explaining the controversy that surrounds decisions and techniques that surgeons use. I like how he explains what really happens in the medical world. I dislike how the book rarely shows who Gawande is. By the end of the book you have no idea what he does for a living after residency or about his family or anything else. I think the story could have benefited from a personal touch. People should read this book because not only is it a good story, but it reveals many things about the medical field one would not expect. In this sense, readers can be informed when making their own medical decisions. I give the book an overall rating of 5 stars because it was informative and entertaining.

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  • Posted November 4, 2010

    more from this reviewer

    Highly Recommend ---and I haven't even read the whole book yet!

    I haven't finished this book yet and it is the greatest book. But then again I want to be a surgeon so that is an unfair advantage for liking this book. I probably would recommend this for someone that doesn't enjoy the anatomy of the human body... But is still best book ever!!! :)

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  • Anonymous

    Posted April 9, 2010

    An amazing read for anyone involved in medicine in any capacity!

    Complications is an engaging informative book about Dr. Gawande's accounters with the medical system. He sheds light on many issues in medicine that most people probably aren't too familiar with. It's a great read for anyone who is interested in medicine or even interacts with the medical system in any way, which is pretty much all of us. I learned so much about what it's like to be a doctor and a patient from reading this book. I found the first section the most interesting as it is the most applicable to patients but the last two sections are also really engaging when Gawande discusses different interesting medical phenomena. Overall, I think this book is a must read for everyone!

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  • Posted March 20, 2010

    more from this reviewer

    I Also Recommend:

    Inside Workings of the Medical Field

    I read Atul Gawande's Complications a while ago and greatly enjoyed it. Dr. Gawande is an amazing writer and creates a detail image of topics in the medical field. It is very apparent that Dr. Atul Gawande is very educated and has extensive knowledge in what he writes about. Complications has the information and knowledge of a well-written peer-reviewed journal article but a writing style that is easy for anybody to read. I find that the information that Dr. Atul Gawande discusses are important for everybody to be familiar with. As a health educator I find the topics very interesting. His other book, Better, is just as good. The topics are similar in nature and just as interesting. Very well written and I recommend Complications for people who liked Better and vice versa. I believe those who are interested in the medical field will benefit and be entertained by Complications.

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  • Anonymous

    Posted December 10, 2009

    very informative

    shows that we all are not perfect, but we can build a team around us to prevent dilemmas.

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  • Posted November 15, 2009

    complications from Surgery

    T. his book was a true story about a surgeon in the making some of the detail was not needed. I feel unless you are in the medical profession you would not have liked this book it gets boring. I have read better books written by doctors about their practice.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted July 10, 2009

    Excellent

    Truly inspiring for anyone considering a career in the health professions.

    Was this review helpful? Yes  No   Report this review
  • Posted June 18, 2009

    jr82

    Great book for anyone in the medical profession

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  • Posted May 2, 2009

    Wonderful, enlightening book, Well Written

    The "take home": Be pro-active and involved with your health care. Your physician/Surgeon is a trained human and wants you informed, but most people are blindly passive when it come to their heath care. Knowing medical limitations should make you more understanding when things go wrong.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted March 28, 2008

    Very Intriguing and Insightful

    As a senior nursing student getting ready to start work in the Cardiac Surgery Intensive Care Unit, I wanted a book that took a look into surgery and the practice of medicine. This book satiated my interests in the two, and I would recommend it to anyone. Easy to read, informative, intriguing...couldn't put it down (even with two young kids and a husband around!)

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted March 12, 2008

    Fascinating in the Horror and the Reassurance

    I was horrified by what I read, and also greatly reassured. We often wonder of doctors and surgeons the question, 'why?' Well, this author attempts to tell us why, and he does so in a language that is both simple and beautiful. I couldn't NOT finish this book. When I was through I immediately advised my mom to read it. I recommend it to anyone, especially those who have found themselves in a sea of medical personnel.

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  • Anonymous

    Posted December 6, 2007

    Amazing

    This book is the best book I have ever read. Atul Gawande has great storytelling skills and excellent stories to use them on. Now I'm off to read Einstein by Walter Isaacson.

    Was this review helpful? Yes  No   Report this review
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