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Complications: A Surgeon's Notes on an Imperfect Science Paperback – 27 Mar 2008

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Product details

  • Paperback: 288 pages
  • Publisher: Profile Books; 2 edition (27 Mar. 2008)
  • Language: English
  • ISBN-10: 1846681324
  • ISBN-13: 978-1846681325
  • Product Dimensions: 12.9 x 1.8 x 19.8 cm
  • Average Customer Review: 4.6 out of 5 stars  See all reviews (76 customer reviews)
  • Amazon Bestsellers Rank: 2,096 in Books (See Top 100 in Books)

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Amazon Review

Gently dismantling the myth of medical infallibility, Dr Atul Gawande's Complications: A Surgeon's Notes on an Imperfect Science is essential reading for anyone involved in medicine--on either end of the stethoscope. Medical professionals make mistakes, learn on the job and improvise much of their technique and self-confidence. Gawande's tales are humane and passionate reminders that doctors are people, too. His prose is thoughtful and deeply engaging, shifting from sometimes-painful stories of suffering patients (including his own child) to intriguing suggestions for improving medicine with the same care he expresses in the surgical theatre. Some of his ideas will make health-care providers nervous or even angry, but his disarming style, confessional tone and thoughtful arguments should win over most readers. Complications is a book with heart and an excellent bedside manner, celebrating rather than berating doctors for being merely human. --Rob Lightner --This text refers to an out of print or unavailable edition of this title.

Review

I don't know if Atul Gawande was born to be a surgeon - I very much suspect so - but he was certainly born to write.This wise and exciting account of life as a surgical resident ... perfectly captures the wonder and fearful responsibility that come with cutting people open in the hope of making them whole again. (Bill Bryson)

Ever wondered how realistic ER is? Then read Gawande's superb book. The truth, you will find, is far more compelling, though the endings are never as neat ... Gawande makes the scenes far more dramatic than television ever can. He is a first-class writer. (Scotland on Sunday)

Written as tautly as a thriller. (The Observer)

Gawande draws you in with the story but leaves you wiser about science, about health, and even about the human condition. (Michael Kinsley)

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Most Helpful Customer Reviews

39 of 41 people found the following review helpful By James Bury on 29 Jun. 2004
Format: Hardcover Verified Purchase
What I particularly like about the book is that it goes beyond giving a slightly morbid peek into the medical world, and really involves you by raising all sorts of dilemmas and social issues that affect us all.
Do I want a novice surgeon operating on my child - certainly not. Do I want expert surgeons to be around when my daughter grows up - certainly do! So, who do I want them to learn on - someone elses child, the elderly or homeless??
What about medical negligence issues - if we keep punishing doctors for errors, how does that affect the treatments they're prepared to carry out or indeed the careers they're prepared to follow? Trial and error is an unavoidable part of developing new techniques. So if we want to reduce the number of errors, we have to be prepared to reduce ther level of progress in medecine. Where does that leave us when we're in dire need and only ground-breaking techniques can help?
This is a fascinating and sometimes disturbing book that should be compulsory reading for society as a whole, not just the medically curious.
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16 of 17 people found the following review helpful By Michael Canty on 10 May 2004
Format: Paperback
This is a superb book. Gawande describes the trials, tribulations, and rewards of his surgical residency beautifully, with a collection of essays, comprising anecdote and musing, on various aspects of medicine. Yet despite the fragmented nature of the structure, the book flows well and gels nicely into a whole. Particularly fascinating are his thoughts on the intractability of pain, what makes a good doctor go "bad", and the perceived invulnerability of modern medicine, which he strips away with the same skill you can imagine him stripping away layers of tissue. Never failing to surprise, educate, and emote, this is a marvellous read, definitely in the "un-putdownable" category. The only reason it doesn't receive a fifth star from me is that it isn't in my top ten greatest books ever - but that is a personal quirk, nothing more. Highly, highly recommended.
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2 of 2 people found the following review helpful By Brian R. Martin TOP 500 REVIEWERVINE VOICE on 18 Dec. 2014
Format: Paperback Verified Purchase
This volume was originally published in 2002, when the author was a junior doctor undergoing surgical training in an America hospital. It was the first of a subsequent series of books that, together with giving the 2014 BBC Reith Lectures, have established him as a household name. It consists of a series of essays based on cases he worked on. They vary very widely, but all are linked by highlighting important question about the role of the doctor in medical treatment and the doctor-patient relationship, particularly in a hospital setting where decisions often have to be taken quickly against a background of imprecise information or knowledge.

A perfect example of this, although extreme, is the final case he discusses of an otherwise healthy young woman who presents with an inflamed red leg. Is this a severe case of cellulitis (probability approaching 100%) or is the leg infected with the bacteria necrotizing fasciitis (probability vanishingly small, but with potentially devastating consequences)? The author honestly admits that hunches, gut feelings and other unscientific considerations inevitably play a role in decisions about what actions to take, however much he wishes that they didn't. He is just as frank about other aspects of medical practice, such as the need for surgeons to hone their technique on real patients, with the inevitable consequences that the less advantaged in society become the `guinea pigs' and some operations will not be done well. But when his own child becomes dangerously ill he honestly confesses that he does not want an operation to be done by an inexperienced junior surgeon, as would any parent wanting the best for their child. How do we resolve this dilemma?
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2 of 2 people found the following review helpful By Damaskcat HALL OF FAMETOP 100 REVIEWERVINE VOICE on 11 Sept. 2013
Format: Kindle Edition Verified Purchase
This fascinating book provides insights into the world of medicine. It is about the author's triumphs and failures and about his mistakes and his almost miraculous intuitions. I enjoy his writing style and he must be an interesting person to know in real life. There are strange and puzzling cases and even more strange and puzzling people - both as patients and in the medical profession. The author talks about marvellous recoveries and tragedies and about cases where medicine intervenes too much rather than letting the human body work things out for itself.

I think the one thing which comes over to me from all the medical books I read is that however much medical science advances there is just so much about the human body which remains undiscovered. Doctors are never going to get it right all the time however well trained they are and however much experience they have. I was interested to see how much of an inexact science diagnosis is and the autopsy figures quoted by the author show that the cause of death may turn out to be incorrect as many as a third of cases. The figures haven't changed in the US since the 1930s in spite of the huge increase in modern technology and ways of seeing inside the human body.

It is all too easy to assume that modern medicine has all the answers and this book will swiftly disabuse the reader of this idea. I found the chapter about patients being given all the risks and options fascinating. Do we want doctors to make decisions for us or do we want to be given enough information to make our own decisions? What should a doctor do if he/she believes a patient is making the wrong decision? This author's books are a must read for anyone who has had any dealing with modern medicine if only because it helps to remind us all that doctors are people too
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