Better: A Surgeon's Notes on Performance / Atul Gawande

Better: A Surgeon's Notes on Performance

Atul Gawande

יצא לאור ע"י הוצאת Metropolitan Books,
שפת הספר: אנגלית







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The New York Times bestselling author of Complications examines, in riveting accounts of medical failure and triumph, how success is achieved in a complex and risk-filled profession
 
The struggle to perform well is universal: each one of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable.

Gawande’s gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors’ participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable.

At once unflinching and compassionate, Better is an exhilarating journey narrated by “arguably the best nonfiction doctor-writer around” (Salon). Gawande’s investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.
Atul Gawande, a MacArthur fellow, is a general surgeon at the Brigham and Women’s Hospital in Boston, a staff writer for The New Yorker, an assistant professor at Harvard Medical School and the Harvard School of Public Health. His first book Complications, was a New York Times bestseller and a finalist for the National Book Award. Gawande lives with his wife and three children in Newton, Massachusetts.
The struggle to perform well is universal: each one of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable.
 
Gawande's gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, labor and delivery rooms in Boston, a polio outbreak in India, and malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors' participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable.
 
At once unflinching and compassionate, Better is an exhilarating journey narrated by "a writer with a scalpel pen and an X-ray eye" (Time). Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.
"'What does it take to be good at something, when failure is so easy?' asks writer/physician Gawande . . . Diligence, ingenuity and 'doing right' . . . Gawande illustrates each of these qualities with stories from his own experience, [and] his observations of and conversations with other physicians . . . For young doctors . . . Gawande suggests five strategies: Ask unscripted questions, don't complain, 'count something' (be a scientist as well as a doctor), write something (to make yourself part of a larger world) and change in response to new ideas. A must-read for medical professionals-and a discerning, humanizing portrait of doctors at work for the rest of us."—Kirkus Reviews
"Gawande provides a cleareyed view of the medical profession that both resonates and gives pause. Once again, he spares no one, himself included. Gawande, a surgeon, manages to capture medicine in all of its complex and chaotic glory, and to put it, still squirming with life, down on the page . . . Gawande's meditation on performance is not only an absorbing collection of essays but also an exhilarating call for the rest of us to do the same . . . Gawande has the ability to deconstruct and explain the most difficult issues while preserving, even celebrating, their complexity. He applies a sly sense of humor to even the most unsettling topics. And his voice is so direct that at times it borders on painful (at least from the perspective of a fellow doctor) . . . With this book, Gawande inspires all of us, doctor or not, to be better."—Pauline W. Chen, The New York Times Book Review
 
"Better is a masterpiece, a series of stories set inside the four walls of a hospital that end up telling us something unforgettable about the world outside."—Malcolm Gladwell, author of Blink
 
"Better is a mesmerizing book with fascinations on every page, told with mastery, insight, compassion, and humility by a surgeon who doesn't flinch from taboo subjects or self-examination. His topics range from the invisible to the unspeakable, and some chapters are exciting medical mysteries. On every page, one meets a candid and thoughtful man, who pays close attention, and who somehow manages to find the right balance between intimacy and respectfulness, in a world that can be inhospitable to both."—Diane Ackerman, author of An Alchemy of Mind
 
"It's hard to think of a writer working today who makes such good use of man's quest to avoid pain and death. Atul Gawande is not only adding to the small shelf of books by doctors that every layman should read. He's using medicine to help anyone who hopes to do anything better."—Michael Lewis, author of The Blind Side
 
"'What does it take to be good at something, when failure is so easy?' asks writer/physician Gawande in his follow-up to Complications (2002). Diligence, ingenuity and "doing right," he answers. Gawande illustrates each of these qualities with stories from his own experience, as well as his observations of and conversations with other physicians. Being diligent about the simple act of hand-washing dramatically reduces hospital infections, he demonstrates, and through diligence, army surgeons in Baghdad have greatly enhanced the survival rate among casualties in Iraq. The section on doing right tackles such troublesome moral issues as whether doctors should participate in executions and at what point treatment of a patient becomes mistreatment and should be stopped. Discussing ingenuity, Gawande shows how the rating scale devised by Virginia Apgar, neither an obstetrician nor a mother, transformed the practice of obstetrics. A similar rating scale for every medical encounter, he believes, would inform patients and improve the performance of doctors and hospitals. He lauds the innovative thinking of Don Be



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