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In This Issue:
BWH surgeon Atul Gawande, MD, MPH, looked to professionals at BWH, battlefield surgical tents in Iraq and a polio outbreak in India to determine how success is achieved in medicine.
This struggle to improve in a field where failure can be so easy is the focus of Gawande’s second book, “Better: A Surgeon’s Notes on Performance,” available in bookstores on Tuesday.
“This is a book about how lives are actually saved in medicine,” said Gawande, whose first book “Complications: A Surgeon’s Notes on an Imperfect Science,” was a New York Times bestseller. “At bottom, success comes out of a constant struggle between the details of how the world works and the character and ability of the people in it—out of the human struggle to do better,” he writes.
In “Better,” Gawande delves into three core elements he believes essential for success in medicine: diligence, doing right and ingenuity. He recounts the history of hand washing, examines the influence of money on modern medicine and discusses the ethical dilemmas of doctors’ participation in lethal injections.
His observation of treatment of polio in India was especially eye opening. “I didn’t understand what diligence required until I followed a team that managed to eliminate polio in some of the poorest parts of the world,” he said.
For more information, visit www.gawande.com
Betterment is a perpetual labor. I write about medicine not just because it matters to all of us as mortal beings but also because inside it, in the stories of doctors and nurses and patients, one can find the beauty of human striving. The life of a clinician is an intense life. We are witnesses and servants to human survival. The difficulty is that we are also only humans ourselves. We are distractible, work, and given to our own concerns. Yet still, to live as a doctor is to live so that one’s life is bound up in others’ and in science and in the messy, complicated connection between the two. It is to live a life of responsibility. The question, then, is not whether one accepts the responsibility. Just by doing this work, one has. The question is, having accepted the responsibility, how one does this work well.
-Excerpt from “Better: A Surgeon’s Notes on Performance,” by Atul Gawande, MD, MPH