Better: A Surgeon's Notes on Performance

Atul Gawande, Author
Atul Gawande, Author . Metropolitan $24 (288p) ISBN 978-0-8050-8211-1
Reviewed on: 02/12/2007
Release date: 00/00/0000
Hardcover - 216 pages - 978-7-5075-3278-4
Hardcover - 240 pages - 978-0-14-310256-4
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Paperback - 273 pages - 978-0-312-42765-8
Paperback - 288 pages - 978-1-86197-657-4
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Surgeon and MacArthur fellow Gawande applies his gift for dulcet prose to medical and ethical dilemmas in this collection of 12 original and previously published essays adapted from the New England Journal of Medicine and the New Yorker . If his 2002 collection, Complications , addressed the unfathomable intractability of the body, this is largely about how we erect barriers to seamless and thorough care. Doctors know they should wash their hands more often to avoid bacterial transfer in the ward, but once a minute does seem extreme. Using chaperones for breast exams seems a fine idea, but it does make situations awkward. "The social dimension turns out to be as essential as the scientific," Gawande writes—a conclusion that could serve as a thumbnail summary of his entire output. The heart of the book are the chapters "What Doctors Owe," about the U.S.'s blinkered malpractice system, and "Piecework," about what doctors earn. Cheerier, paradoxically, are the chapters involving polio and cystic fibrosis, featuring Dr. Pankaj Bhatnagar and Dr. Warren Warwick, two remarkable men who have been able to catapult their humanity into their work rather than constantly stumble over it. Indeed, one suspects that once we cure the ills of the health care system, we'll look back and see that Gawande's writings were part of the story. (Apr.)

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