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  ·  16,007 ratings  ·  1,438 reviews
Drawing from compelling true accounts of patients and doctors, a provocative examination of the power and limits of modern medicine reveals a world where science is uncertain, information is limited, and deadly mistakes occur. 60,000 first printing.
Title: Complications
Author: Gawande, Atul
Publisher: Henry Holt & Co
Publication Date: 2002/04/01
Number of Pages: 269
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...more
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...more
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...more
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
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
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...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
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.
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
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
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...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
Well worth the read, as the author details several medical topics with interesting stories from inside the OR. I learned things like: the reduction in the frequency of autopsies is limiting medical advances; citing the wrong cause of death happens about 1/3 of the time, the same frequency as it did 40 years ago, despite the advances in nuclear medicine, imaging, etc.

If you blush too much you can have surgery to stop it all together. However, you won't be able to sweat above your chest any longe...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...more
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...more
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...more
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...more
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
Jess Michaelangelo
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...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
As a medical student, I searched for a book to read about medicine, other than our textbooks, until a friend recommended this book to me, and that was exactly what I wanted.

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...more
Vinod Peris
Atul Gawande has been in the news a lot recently, whether it is for his bestselling books, incisive articles in New Yorker and Slate Magazine or his involvement in Public Policy in the US. His most recent book "Checklist Manifesto" didn't seem an interesting enough topic to fill a whole book with, and so I picked an earlier book of his "Complications" to get a peek into what Atul is all about.

I expected a technical book about surgery, written in clinical prose and was happy that it was only arou...more
Atul Gawande is such a talented writer. Reading this book was not only enjoyable, it was effortless. And is was immensely refreshing to have someone write something like this about medicine, which has such stigmas about mistakes, and to make it utterly human by being honest about the difficulties, the unknowns, and the challenges associated with medical science. His frankness and honesty about the humanness and mistakes of doctors and patients alike was just wonderful. Far from feeling a sense o...more
Rachel Brown
A medical memoir/set of essays and case studies, very much in the tradition of Oliver Sacks' The Man Who Mistook His Wife for a Hat, only less technical and about surgery rather than neurology. Specifically, it's about the human element in medicine: how errors occur and how to prevent them, how and why doctors learn, succeed, and fail, and areas of medicine about which very little is understood. It's fascinating.

One of the essays which I thought has particularly broad resonance was on how anesth...more
I've been on the very outer fringes of the medical profession for years now, with a mom as a nurse, a girlfriend studying to be a doctor and having several hundred hours training myself as a massage therapist. I was a big fan of the 1990's television series, "The Operation". So I confess up front to being the target audience for a first-hand account of what it's like being a surgeon today.

The author, Dr Atul Gawande, does not flinch away from controversy and contradiction. He discusses at length...more
I loved this book. The thesis is simple: Medicine is an incomplete, uncertain, mind-bogglingly complex science. But there's also a fair amount of "Doctors are people, too" and not in the "cut us some slack" sense, but in the "everybody makes mistakes" sense. If you have an infallible faith in doctors and medicine, read this book. If you think doctors are just regular Joes who don't know much more than the rest of us, read this book. If you're like me and you just like to read about medical stuff...more
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Lorenzo's Oil 2 46 Apr 18, 2013 11:56AM  
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Atul Gawande is a general and endocrine surgeon at Brigham and Women's Hospital in Boston, Massachusetts, and associate director of their Center for Surgery and Public Health. He is also an assistant professor at the Harvard School of Public Health and an assistant professor of surgery at Harvard Medical School.
More about Atul Gawande...
The Checklist Manifesto: How to Get Things Right Better: A Surgeon's Notes on Performance The Best American Science Writing 2006 Being Mortal: Medicine and What Matters in the End Salvo complicazioni. Appunti di un chirurgo americano su una scienza imperfetta

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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.” 90 likes
“Practice is funny that way. For days and days, you make out only the fragments of what to do. And then one day you've got the thing whole. Conscious learning becomes unconscious knowledge, and you cannot say precisely how.” 17 likes
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