Complications: A Surgeon's Notes on an Imperfect Science

Complications: A Surgeon's Notes on an Imperfect Science

by Atul Gawande


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Product Details

ISBN-13: 9780312421700
Publisher: Picador
Publication date: 04/01/2003
Edition description: REV
Pages: 288
Sales rank: 22,884
Product dimensions: 8.06(w) x 11.28(h) x 0.80(d)

About the Author

Atul Gawande is a surgical resident at a hospital in Boston and a staff writer on medicine and science for The New Yorker. A graduate of Harvard Medical School and the Harvard School of Public Health, he has had his writing selected to appear in The Best American Essays 2002. Gawande lives with his wife and three children in Newton, Massachusetts.


Newton, Massachusetts

Date of Birth:

November 5, 1965

Place of Birth:

Brooklyn, New York


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.

—Malcolm Gladwell, author of The Tipping Point

"Complications is a uniquely soulful book about the science of mending bodies."

—Adam Gopnik, author of From Paris to the Moon

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Complications: A Surgeon's Notes on an Imperfect Science 4.3 out of 5 based on 0 ratings. 178 reviews.
Anonymous More than 1 year ago
This is a great read from a very respected surgeon. As a physician myself, I've always enjoyed reading books by physicians. Dr. Gawande has emerged as quite possibly the most reasonable, insightful, and even poetic of all physician writers. This book is a great read for anyone interested in the ethics of being a surgeon. Dr. Gawande's other books are also interesting reads, especially for doctors. Other books by surgeons I highly recommend are Dr. Anthony Youn's "In Stitches," which is his absolutely hilarious and heartwarming story of becoming a doctor, and "Hot Lights Cold Steel" by orthopedic surgeon Dr. Michael Collins. These are geared towards a general audience and very worthwhile reads.
MaestraD More than 1 year ago
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.
DocT More than 1 year ago
Written very well, not quite as good as his other book 'Better', but still very good.
Anonymous More than 1 year ago
I love to read memoirs and this was one that I couldn't put down. I want to read all of his books.
photodoc More than 1 year ago
Atul Gawande is a great writer and some of his stories are really page-turners, especially the last one about the patient with flesh-eating bacteria. He brings to his readers an in-depth understanding of what surgical residents go through during their training. Anyone who has ever been or ever will be (that is all of us) a patient should read this book.
Anonymous More than 1 year ago
What an incredible look into both the expertise and fallibility of surgeons. The larger application is that we all need to aspire to learn as much as possible about our own areas of interest or professional endeavors, but in the final analysis we must trust our intuition. While reading Dr. Ben Carson's "Gifted Hands," I notice how often he prays and actually senses or truly knows God's leading. With both authors, there is a keen awareness of human imperfection.
Anonymous More than 1 year ago
GarycUT More than 1 year ago
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.
Anonymous 25 days ago
Relatable, readable, disturbing in that how much we don't know. And how much faith we put in others. I have often told anyone who would listen. Never go to the Doctor's office or hospital alone. You need an advocate.
chellerystick on LibraryThing 8 months ago
Parts of this book, especially in the middle, primarily appeal to our curiosity about the body. All well and good, but what takes this to the next level is Gawande's willingness to tackle the philosophical question of how to resolve the paradoxes of medical practice. Of course, there is no simple answer to this, but his discussions add to our ability to choose and understand our doctors.Highly recommended, especially for those who enjoy things like Oliver Sacks and medical mysteries.
meggyweg on LibraryThing 8 months ago
An excellent collection of essays (they need not be read in order). Atul Gawande is a great writer and his method was very approachable; you don't have to be a doctor to understand and appreciate what he's trying to say. He also has a talent for making you feel like you're right there by the body, watching what's happening -- maybe not such a good thing for those with squeamish stomachs.I think I will recommend specific essays from the book to friends of mine. The ones on chronic pain, gastric bypass and "when good doctors go bad" should interest a wide audience.
lmnalban on LibraryThing 8 months ago
Reading this book has not raised my confidence in the medical field, but it has made me a better patient. I read this book when it was first published, and the stories, the characters, and the lessons influence my behavior as a patient today.
TheAmpersand on LibraryThing 8 months ago
A brief, eloquent, and thoughtful book that describes the messy and occasionally miraculous business of surgery and traces the author's own development from greenhorn resident to accredited surgeon. Clearly written for a general audience, "Complications" makes surgery seem like a very human endeavor, not the domain of mysterious, infallible wise men in white coats. In Gawande's telling, surgery full of unknowns and anxiety for both the doctors and their patients, it takes a great deal practice to get good at it, and everyone involved is faced with tough choices that they sometimes come to regret. The author never seems to forget that both the doctors and patients he describes were people before the operating table and have lives to go back to after the surgery is finished. Gawande makes a point of putting the practice of surgery in a larger context and takes several chapters to describe how new technologies and current social trends, like the idea that patients should have the final say about their treatment, have affected the way doctors do things. While he's aware that he has his own professional prejudices, his descriptions of these debates seem admirably fair minded and sensitive to his patients' interests. Gawande's book also might give some readers a new perspective on their own bodies. While we tend to think that we know our own bodies pretty well, it's fair to say that surgeons have seen more of more human bodies than most people have, or care to. His descriptions of surgical procedures are clear and straightforward and free of unnecessarily technical language The author deserves some credit for not going in for shock value, even when he describes operations that would amaze doctors that practiced just a few decades ago. The human body, which is, perhaps, the real main character of "Complications" is made to look both eminently functional and endlessly strange, sometimes too delicate and sometimes surprisingly resilient, Gawande succeeds, I think, in convincing his readers that its thanks to the surgeons like him that we know as much about it as we do.
SqueakyChu on LibraryThing 8 months ago
For anyone interested in the world of medicine and doctors, I heartily recommend this eloquently written and fascinating book of medical essays. At the time Dr. Atul Guwande wrote this book, he had been a surgical resident at a Boston hospital. The book is divided into three parts, each dealing with different facets of ¿complications¿ in modern medicine. My guess is that, for the general public, the middle section of the book, the part which addresses medical superstition, pain, nausea, blushing, and morbid obesity, would be the most interesting. For me, however, I was more captivated by the topic of fallibility of the world of medicine. I like how Dr. Guwande tackled this subject head on in a forthright and honest manner. Some of the subjects with which he deals through the book are unintentional medical errors, medical errors made through inexperience, medical diagnostic intuition, and the decreasing use of autopsies to correlate the cause of death diagnosis. Each topic he discusses is a world unto itself, fully described and offering much food for thought. I think a book such as this one is important for a variety of reasons. It is a way for patients to understand a different side of medicine. It ¿humanizes¿ medical practitioners who often no longer have the time to ¿really¿ get to know their patients. However, the most important reason for an individual to read this book would be to see how important it is for each person to be an advocate for his or her own health care. Patients and doctors should be full partners in medical care with both sides bringing honesty and thoughtful consideration into the course of any medical treatment.
Jenners26 on LibraryThing 8 months ago
Brief Overview: The subtitle of the book pretty much says it all: ¿A Surgeon¿s Notes on an Imperfect Science.¿My Thoughts: First things first, I wouldn¿t recommend reading this book if you or a loved one are scheduled for surgery as Gawande is utterly forthright about the fallibility of physicians (and surgeons in particular). As much as we like to believe that our doctors know what they are doing, Gawande reveals that, all too often, medicine is a combination of luck, guesswork, timing and instinct. After all, physicians are human and prone to the same weaknesses as the rest of us: pride, arrogance, fatigue and distraction. But Gawande doesn¿t just focus on the ¿hidden¿ side of surgery, he also explores how much of medicine is just plain mysterious¿that some conditions just don¿t ¿follow the rules¿ or behave as expected. This was a fascinating and gripping read, and I highly recommend it. However, as I said at the start, it may not be the best choice if you¿re about to undergo surgery. The book was a finalist for the National Book Award, and Gawande also wrote Better: A Surgeon¿s Notes on Performance, which I fully intend to read.
cmbohn on LibraryThing 8 months ago
Various essays and stories on the more complicated part of medicine. He covered everything from obesity and gastric bypass surgery, to chronic pain and end of life decisions. The surgery to correct blushing was very interesting. Lots to think about in here, but maybe don't read if you are expecting to have surgery in the near future. It will just freak you out.
TheBookJunky on LibraryThing 8 months ago
Great. Reminds me of why I wanted to do medicine.
jellyish on LibraryThing 8 months ago
Fascinating look at medicine.
gooutsideandplay on LibraryThing 8 months ago
I've pretty much decided that I would read a telephone directory if this man wrote it. I didn't think there could be a, well, better book than his previous work, Better, but I think this tops it. Complications is about the imperfections in medicine -- the unexplained mysteries, the screw ups and the inconsistencies in decision-making. Reading this book is almost like being faced with a terrifying medical decision for a loved one, but while you face it Gawande has his hand on your shoulder. His compassion and wonder at what we don't understand about the human condition -- both of patients and of doctors -- is on full view -- but in such a way that you feel hopeful and brave. The chapters about morbidly obese patients, and also the one about doctors who have "gone wrong" are written with respect and almost tenderness that is as touching as it is illuminating and clear-eyed.
jngrl7 on LibraryThing 8 months ago
I thought this book was fascinating. I had to read it for a medical sociology class in college, but I found it to be one of the most interesting books I "had" to read. I would definately recommend this book to anyone looking for an inside view into the imperfect science of medicine.
oldman on LibraryThing 8 months ago
A book of scenes from a surgeon's years of residency. He writes well, but the format is not all that different from other books of this genre. The topics covered are truly those causing the most difficulty to those who provide care to us. The most interesting aspect of his chapters is his going to the effort to find how the patients did after going home. Few surgeons do this when discharged back to our regular physicians. Because I work in medicine and understand the issues, the complexity and the "art" besides the science I found the book somewhat a review of my day-to-day work. It is a truer view than many such books I have read. I would recommend this book, if only for the different scenes and how decisions are made in medicine.
yourotherleft on LibraryThing 8 months ago
Complications is a collection of essays about Atul Gawande's experience as a surgeon and his acute observations of how the medical establishment is failing and succeeding. Gawande's essays offer us a look into the murky depths of practicing medicine that we fail to understand and appreciate despite our often frequent contact with the system. Broken up into three sections, Gawande's essays explore doctors' fallibility, unknowns and mysteries that often crop up in the treatment of patients, and, finally, uncertainty itself, a prospect we often fail to consider given the perpetual technological advancement that seems inherent in practicing medicine. Gawande engages the reader using frequent case studies of patients he and his colleagues have encountered. These serve to draw the reader in and also as great jumping off points for Gawande to tackle the struggles and questions that plague both doctors and patients about the state of medicine today. In Complications, Gawande contemplates the mystery of pain, questions how we do and essentially must entrust patient care to doctors in training, the improbable victory of a surgeon's instinct over facts and logic, and many more fascinating topics. Complications is an important book. It's a book that asks us to consider the fact that even the doctors who are treating us are merely fallible human beings who know a lot but are often forced to rely on gut instinct in a crunch which may work to the benefit of the patient but may also work to their detriment. It's a book that reminds the rest of us, as patients, that we have an important role to play in our own healthcare. All this, and it also features the sort of compelling, easy to understand writing that makes Complications almost impossible to put down.
caitykai on LibraryThing 8 months ago
This book captivated me. I would definitely read this again.
karenzukor on LibraryThing 8 months ago
The man is amazing, surgeon, gifted writer, father, and he seems to track down the subjects of his essays years later regularly. Some good insights into what medicine is doing, and what its limits are.
markbstephenson on LibraryThing 8 months ago
Compelling accounts of a surgeon's experiences some of which originally appeared in The New Yorker. I was particularly moved by the chapters on pain and nausea.