Atul Gawande: Better

19 Nov

Atul Gawande seems to have done quite well for himself. Not only that, but he has done a great deal for others in the process, especially patients. The Harvard Associate Professor, writer and general surgeon desparately wants doctors to be better at their jobs, which is the focus of his book, the aptly titled Better, published in 2007. It’s all about getting better at being doctors.

Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.

I know how often I witness  doctors who fail to do simple things like washing their hands. This is nothing new. The author explores how hard it has been throughout history to get doctors to comply with simple, obvious guidelines for infection control etc. Gawande then moves on to deal with a variety of other issues from the ethics and practicalities of intimate examinations, doctors involved in legal executions and how lucrative private practise affects clinical practice.

Gawande is all too aware of the limits of medicine, and of the potential for doing more harm than good in our attempts to push the boundaries of modern care. One of the chapters which intrigued me most dealt with how more people are living longer than ever, but with more disease than ever too. Now people are living long enough to get cancer where in the past they would have died of something else first. Gawande explores this phenomenon among horrifically wounded soldiers in Iraq and Afghanistan. He asks searching questions, not least what sort of quality of life these “saved” soldiers will have if they are kept alive with no arms and only one leg. I don’t think it’s our place to judge how someone else views their quality of life, but it does make for a thought-provoking read.

Gawande acknowledges his own failings as much as he points them out in others. Better is a good exploration of a world where mistakes happen all the time, yet where the consequences can be disastrous. Looking forward to getting my hands on his latest book The Checklist Manifesto, out soon.

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