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Complications: A Surgeon's Notes on an Imperfect Science
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Complications: A Surgeon's Notes on an Imperfect Science

4.2 of 5 stars 4.20  ·  rating details  ·  20,298 ratings  ·  1,614 reviews
A brilliant and courageous doctor reveals, in gripping accounts of true cases, the power and limits of modern medicine.

Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is --
Hardcover, 288 pages
Published April 4th 2002 by Metropolitan Books (first published January 1st 2002)
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A year or more ago, I mistakenly placed a review for Gawande's book Better under this title. I have fixed the mix up, and I have now read Complications.

Gawande is pure pleasure to read. His writing is fluid and full of germane examples as he addresses big issues like error and incompetence as well as topics that seem less significant but which he makes worthy of consideration such as blushing and nausea. The headings for each section of the book--Fallibility, Mystery, and Uncertainty--are themat
Ben Pederson
This book wss filled with about 25 anecdotes flimsily tied together by Gawande's less than inspiring reflections. I have the book in front of me at the moment and I am paging through rereading sections that I noted along the way:

"I had come into residency to learn how to be a surgeon. I had thought that meant simply learning the repertoire of move and techniques involved in doing an operation or making a diagnosis. In fact, there was also the new and delicate matter of talking patients through t
Libby Ames
Although I am interested in the medical profession, motivation to learn more about it often elludes me. Gawande was able to keep my attention and present points that I could understand in spite of my limited medical knowledge.

Admittedly, some of his information scared me. After reading some points about surgery, I wondered how I ever allowed anyone to cut into me and place a plate and seven screws in my leg. Also, some of his writing made me squeemish. I had to pause or skip places that became t
Oct 24, 2007 Elizabeth rated it 5 of 5 stars  ·  review of another edition
Recommends it for: everyone
Complications is a book of anecdotes about a surgical resident’s experiences and impressions of the current health care environment. Gawande divides his stories into three sections: fallibility, mystery, and uncertainty. The fallibility section demonstrates that doctors can make mistakes. Some fallibility arises from there being a learning curve. For example, it is hard to do a central line correctly the first time. But for a doctor to learn how to do a central line, he must have a first patient ...more
Read these sentences and tell me that this writer isn't an unbearable idiot:

"If choice [of one's surgeon] cannot go to everyone, maybe it is better when it is not allowed at all."

"Taking time to bond with patients is fine, but every X ray must be tracked down and every drug dose must be exactly right."

"Hospital lawyers warn doctors that, although they must, of course, tell patients about injuries that occur, they are never to intimate that they were at fault, lest the 'confession' wind up in co
Hmmm... I love surgery, it means.. when a handy book of more-humanity-and-less-cut of surgery was published.. how can i resist?

Well.. for being honest, it makes me feel bored when i've red the middle-part. it turns 'in' again in a few last chapter. I agree to middle-rating, (in Indonesia means, lumayanlah.. bukan buku sampah) of this book. but i truly disagree when sumone gave only one star rating to this stuff. (Cari deh di tinjauan lain. Huh. You make me angry dude.. pelit amat sih. Gue nggak
this was a very interesting book. i liked his writing style, too. it was far more engaging than the stupid tree book. isn't this author bio a bit sickening, though? "atul gawande, a 2006 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 a frequent contributor to the new england journal of medicine. gawande lives with his wife and three children in newton, massachusetts." t ...more
Aug 10, 2007 Katie rated it 4 of 5 stars  ·  review of another edition
Recommends it for: Everyone
An very well written book in which Gawande argues that surgery is an evolving and imperfect art. He begins by describing in compulsively readable detail some occasions during which it has failed its patients. An overarching theme in the book is an idea of what makes a good surgeon; Gawande points out that it's not about innate talent. It's about practice, commitment, a willingless to learn new things, a willingness to teach others, specialization, and perhaps attentiveness to the patient. (I als ...more
Wow! I loved this and I love Dr. Gawande.

The first section is about how it is necessary for medical residents to learn how to do procedures on people, but how it's just as necessary to sort of glide over that fact with patients. This was the most exciting part of the book because he went over his own early surgeries and the complications that arose.

The rest of the book is about how, even though medicine is a 'scientific' field, it's ultimately human and fallible. My anxiety was high during mos
Atul Gawande writes for The New Yorker, and I always read his articles as soon as I spot the by-line. I read "Better" last year and think it is even, yes, better. But both books have rare qualities. Gawande is a physician who can step back from his ego and write with compassion and insight about the relationship between vulnerable sick people and those whose skill and judgment they are compelled to trust.
With honesty and humility Dr. Gawande provides the reader an insight into the practice of medicine. A general surgeon at Boston's Brigham & Women's Hospital, Dr. Gawande writes movingly about the challenges and uncertainties doctors face each day as they strive to provide the best treatment possible for their patients.

The book jacket aptly sums up this outstanding book, "In gripping accounts of true cases, surgeon Atul Gawande explores the power and limits of medicine... Complications lays b
Recently I had to see a doctor for something that was bothering me. I went to my normal family physicians group, who referred me to a gastroenterologist, and eventually had to have a couple procedures in the hospital before I was offhandedly diagnosed with IBS. I say "offhandedly" because that's what it was: the gastroenterologist at first said I seemed to have had some kind of stomach bug that threw me out of whack, and then, when I asked further, finally said "Yeah, I think you have IBS." He d ...more
This book only got three stars from me mostly because even though I enjoyed it as I was reading, I didn't love it as much as I thought I was going to.

I think the thing I liked the most about Complications was that it was really thought-provoking. Gawande does an excellent job at poking and prodding your mind to get you to think about the answers to questions that don't necessarily have a right or wrong answer. For as much as we all seem to think that medicine is this black and white area of lif
A very worthwhile if somewhat demanding read about the often underestimated margin of error in medicine. Gawande's book describes understandable human error when split-second decisions need to be made, doctors who burn out with others (colleagues, supporting staff, patients, and most of all the doctors themselves) slow to realize it and failing to make the necessary changes, mysterious ailments like chronic back pain, nausea, and uncontrollable blushing with elusive (nonexistent?) physical cause ...more
This is a fascinating collection of essays by a young surgeon about various aspects of surgical medicine. For me, the most interesting chapter dealt with surgeons who go bad -- not dramatically terrible surgeons, just those who start out as excellent and slowly sink to mediocrity and eventually malpractice. I think people who enjoyed the medical chapters of Stiff might find this one equally interesting.
Amber Alerta
Complications is a book O rate as 4 stars. It really delved into the world of surgery, yet I was still able to understand a majority of the topics he elaborated on. It is divided into three sections Fallibility, Mystery and Uncertainty. The first section, Fallibility, I would rate as four stars. It is personal, honest and very scary look at Gawande’s life and observations as a surgical resident. He talks about how despite a surgeon’s public face of knowing exactly what they are doing they are of ...more
Gawande gave a captivating look into the truth behind being a surgeon. He illustrated stories that were hard to imagine and put the reader into perspective of not only a doctor who is responsible for saving human lives, but for the patients as well who are trying to deal with the difficulties of illness and disease. He expertly gave readers a look into how the practice of medicine is still so unknown and uncertain. His novel humanizes surgeons and is a must read for anyone even remotely interest ...more
Elliot Ratzman
Except for hypochondriacs, everyone should read this book. The surgeon-scribe Gawande is the perfect Virgil, escorting us through the Hell and Purgatory (and many happy endings) of uncertainties, mysteries and ambiguities of medicine. He shows us how physicians deal with learning curves in surgery, how they evaluate and deal with mistakes (discussed in large weekly sessions), what their trade conferences are like, and how institutions deal with bad doctors. Using unforgettable cases—a girl with ...more
First book of its kind that I read.. Interesting and did not regret reading it.
I consider it a new different perspective to look at the medical fields, surgery in particular.

The process of the decision making has been described perfectly !
It is not about how to do surgery, it is when to do it..

Most of the time, you make a judgment based on your feelings, and is hard to describe how you reached such diagnosis or conclusion.

"Judgment is rarely a calculated weighing of all opinions, which are n
This is a fascinating book about the doctors and their decisions, patients and theirs, and if you're someone who worries about being the 5% of people who have X reaction to Y drug, this is not the book for you. This is a book about instinct and hunches as much about science, and it would give anyone pause, I think, to consider how little science is employed in hospitals, and how medicine is an art. That said, the book also has much to say about the things we can do to heal the human body that we ...more
Ellen Keim
I've read several books by doctors about the medical profession and always find them intriguing. My favorites are those by Richard Selzer (Confessions of a Knife, Letters to a Young Doctor, etc.), who, like this author, is a surgeon.

Where Selzer is more literary, this author is more informative and practical about the realities of medicine, such as the necessity of practicing on patients, the role that class plays in quality of treatment received, and the shot-in-the-dark nature of making diagno
Mark Dodson
Fantastic. This is a very insightful view of the medical profession and healthcare from the perspective of a surgical resident from the beginning of his career to probably mid-career. Each chapter covers a different incident or situation from the perspective of how the physician or surgeon approaches it, and how it plays out.

One chapter that really stands out deals with how a surgeon learns his craft to a great extent by operating on a patient. An ongoing theme throughout is how uncertainty and
I'm not sure if "liked" is the correct word, but it was fascinating - and somewhat disturbingthough there were positive aspect as well. It is a series of anecdotes by a resident doctor at a teaching hospital that illustrate how complicated medicine is, and the learning curve involved - a lifetime learning curve. It was sometimes hard to listen to for me sometimes. The first anecdote involved learning to put in a central line, which is learned by doing, on a patient, and when he described scrapin ...more
Richard Williams
This review has been hidden because it contains spoilers. To view it, click here.
Marília Bonelli
Scary for how true it is in the simplest ways. Doctors are human beings, we know that. But we also forget how human sometimes.

This is not the type of book I read or even gravitate towards. My professor got it as a gift and lent it to me. I read a random paragraph and immediately liked it.

If you're scared of doctors, don't read this. :) If you are a doctor or anything involved with the profession, or even if you're a veterinarian, like me, read it, you'll probably see yourself or your colleag
This book was so fascinating... one of those page-turner nonfiction books, this one about doctors and medical mistake-making. He basically analyzed mistakes in medicine and their causes--imperfect human decision-making, fatigue, incompetence, and just the natural complexity of the human body. Don't read it if you are skittish about going to the doctor though. :-) But I found it completely fascinating. Of course, doctors make mistakes, just like everyone else, and I've always been irritated by th ...more
Wendy Burks
Must read for those in the medical profession (where it was first recommended to me) as well as anyone touched by it, i.e. everyone! This is a fantastic read sprinkled with fascinating anecdotes, peppered with just the right amount of empirical support. The strength of this book is in Gawande's unique perspective as a surgeon himself and his forthcoming, honest approach to medicine being an imperfect science, yet him always striving to understand and learn more. The book is a refreshing, insight ...more
Complications deals with the mysteries and uncertanties of medicine, beginning with a reminder that doctors are (like the rest of us) fallible humans, and ones who often have to pretend they know more than they really do. He brings up difficult questions, like the quandary of giving a patient full disclosure ("Hi, I'm Dr. Gawande, and this is the first time I've ever performed this complicated surgery. But don't worry! The other doctor in the room has done it plenty of times and will be here to ...more
Oday Abu Ajamieh

First, I have to say that I enjoyed every page of the book, and more importantIy, I learned a lot from it. I feel like this book, somehow, has to be taught in a course in med school.

This surgery resident started his book by describing the step-by-step learning of some basic surgical procedure. And in a nice way, he described his feelings of doing these procedures for the first time.

In the first part of the book, the author discussed "Fallibility", when " Good doctors go bad ", and how doctors- a
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Atul Gawande is author of three bestselling books: Complications, a finalist for the National Book Award; Better, selected by as one of the ten best books of 2007; and The Checklist Manifesto. His latest book is Being Mortal: Medicine and What Matters in the End.

He is also a surgeon at Brigham and Women’s Hospital in Boston, a staff writer for The New Yorker, and a professor at Harvard
More about Atul Gawande...
Being Mortal: Medicine and What Matters in the End The Checklist Manifesto: How to Get Things Right Better: A Surgeon's Notes on Performance The Best American Science Writing 2006 Scoot Over, Skinny: The Fat Nonfiction Anthology

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“We look for medicine to be an orderly field of knowledge and procedure. But it is not. It is an imperfect science, an enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line. There is science in what we do, yes, but also habit, intuition, and sometimes plain old guessing. The gap between what we know and what we aim for persists. And this gap complicates everything we do.” 113 likes
“No matter what measures are taken, doctors will sometimes falter, and it isn't reasonable to ask that we achieve perfection. What is reasonable is to ask that we never cease to aim for it.” 27 likes
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