Title: Complications: A Surgeon’s Notes on an Imperfect Science
Author: Atul Gawande
Review: For the last five weeks, my grandfather has been in and out of the hospital. He’s 85-years-old, but up until the last month he’d been in relatively good health, still out working on projects in his yard and reading books that I would recommend. But five weeks ago (really, longer, it’s hard to tell when things started going awry), he became very weak, started falling frequently, and became more and more confused.
He ended up in the ICU when the levels of nutrients in his blood went totally haywire. After a couple very serious nights when it seemed like we might lose him completely, or lose all of the things that mentally made him my grandpa, he started to pull out of it. Things are still uncertain right now, but after some fits and starts in his care (including frustrating miscommuncation between different doctors that have caused some relapses), he seems to be on the mend and just recently moved back home (we hope for the long term).
I tell that story because it’s what was happening while I decided to read Complications by Atul Gawande — a collection of essays written when Gawande, a writer and surgeon, was completing his surgical residency. In the book, Gawande grapples with three of the complications that are fundamentally a part of modern medicine:
… the fallibility of doctors, asking, among other things, how mistakes happen, how a novice learns to wield a knife, what a good doctor is, how it is that one could go bad. … [the] mysteries and unknowns of medicine and the struggles with what to do about them… [and] uncertainty itself. For what seems most vital and interesting is not how much we in medicine know but how much we don’t — and how we might grapple with that ignorance more wisely.
I’m not sure why I decided to pick up a book about medicine during a time when my family was reeling from a medical emergency. It doesn’t seem like reading about medical uncertainty would be a smart choice when my grandfather’s illness and recovery were so uncertain, but I actually found Complications to be an oddly comforting read.
Our current conception of doctors and medicine (or, at least mine, since I watch a lot of Grey’s Anatomy) is that diagnosing a patient should be simple (0r, if you watch House, at some point every illness looks like lupus). But in the real world, medicine is very human, full of questions that don’t always have answers. Getting that more fallible perspective, although a little scary, made what was happening to my grandpa seem less out-of-the-ordinary.
Part of the reason Complications works is that Gawande has such a distinctive voice — confident, humble, curious, and willing to admit his own mistakes. He’s funny when the situation calls for it, and serious when he needs to be. And he writes about his patients with a compassion and care. I really, really fell for his voice (as have others — Gawande is also a staff writer at The New Yorker).
Anyway, this review has gotten kind of person and gushy, so I’m going to wrap it up. Although it seems strange, I thought reading Complications during a medical crisis was good for me. But, I don’t think that needs to be context to make this book a worthwhile, informative, and engaging read about the complicated world of modern medicine and the people who strive to care for us when we are the most vulnerable.
If you have reviewed this book, please leave a link to the review in the comments and I will add your review to the main post. All I ask is for you to do the same to mine — thanks!