Alan Marchant's Reviews > Complications: A Surgeon's Notes on an Imperfect Science

Complications by Atul Gawande
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Jul 19, 09

bookshelves: nonfiction
Read in August, 2006

an inner journey

Atul Gawande's book "Complications" is a rewarding read on many levels. The reader is drawn in smoothly along a thread of entertaining medical vignettes. These anecdotes serve as the framework for a set of well reasoned essays that explore the inner life of the surgeon. Gawande's primary purpose is to convey the various challenges, surprises, and contradictions that he has encountered as a surgical resident. His scrupulous honesty in describing the motivations, limitations, exhilarations, foibles, and challenges of the surgical profession is refreshing.

I was disappointed by two omissions. Firstly, Gawande does not deal in this book with the issue of tort reform and malpractice insurance. Perhaps this will become a more significant issue for him as he moves into independent practice. Secondly, thoughout the book I kept wondering why he did not apply decision analysis to his difficult medical decisions. When in the last chapter Gewande describes an unsuccessful attempt to apply decision analysis, it is clear that the analysis methods had not been correctly taught to him. Maybe these are issues that he can address in a future book - a book which I look forward to reading.
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