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Better: A Surgeon's Notes on Performance

4.24  ·  Rating details ·  28,789 ratings  ·  2,156 reviews
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 ...more
Hardcover, 288 pages
Published April 3rd 2007 by Metropolitan Books
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Average rating 4.24  · 
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 ·  28,789 ratings  ·  2,156 reviews

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Nov 24, 2012 rated it really liked it
I have had a lot of doctors in my life. The best one I ever had was the surgeon who failed. Before I went under, he told me it would take about 2 hours and had an 85% success rate. When I woke up, nearly five hours had passed, I was in far more pain than I had been led to expect, and he was waiting to tell me that I was in the 15%, that he hadn’t saved my eye, and that he would be ready to talk to me as soon as I was back on my feet.

When he retired several years later, I wrote him a thank you no
David Singerman
May 20, 2007 rated it it was ok
Shelves: medicine, journalism
Not nearly as good as his first, in a number of ways.

What made Complications so exhilarating was that we were learning about being a doctor just as Gawande was learning about being a doctor. Literally: he wrote most of those essays while still a resident. The humility this brought to Gawande's essays makes all the difference. We were forced to consider the ethical implications of a healthcare system that has to deploy inexperienced doctors so that they can be trained and become better doctors.
Jun 09, 2020 rated it really liked it
Shelves: nonfiction, science
At a time when coronavirus has shifted medical care and delivery to a forefront of public discourse, and a messy combination of research and misinformation is pouring out at the leading edge of science, I feel myself prone to wrapping myself in a blanket of scientific security. No other science writer can I turn to more readily than Atul Gawande. Having become a fan of his New Yorker articles and books, I respect him more and more as I become further acquainted with his work. Better, though not ...more
Jun 12, 2016 rated it it was amazing  ·  review of another edition
This is my 4th book by Gawande. It's good, very similar to most of the rest. His best so far has been Being Mortal: Medicine and What Matters in the End, but the rest are well worth listening to. I'm listing the TOC below & will try to note anything of significant interest. It's all interesting, though.

Introduction Doctors are human, but are held to very high standards & often fail to meet them. No surprises.

-- pt. 1.
Diligence - Keep on trying to do everything exactly right.
On washing hands -
Jul 19, 2020 rated it really liked it
"Betterment is a perpetual labor. The world is chaotic, disorganized, and vexing and medicine is nowhere spared that reality. To complicate matters, we in medicine are also only humans ourselves. We are distractible,weak, and given to our own concerns".

Very accessible and thoroughly interesting book, shedding light upon the inner workings of health professionals. It also explores how one can be a "better" doctor, improve performance, ethics in medicine, what doctors owe. It's easy to read; n
India M. Clamp
Oct 28, 2018 rated it it was amazing
Better is a collage of essays by Atul Gawande, MD, MPH and its’ intent is to enrich outcomes via mindful application of “Diligence,” “Doing Right” and “Ingenuity” as it applies to his profession. Listening---but not really listening---and filtering are qualities of an astute surgeon knowing exactly what the patient needs. On one such case of a hydrocephalic child requiring immediate resolution.

“Unless surgery is performed to provide a new route out of the brain and skull for the fluid, the resu
Ashok Rao
Feb 24, 2020 rated it it was amazing  ·  review of another edition
Your life would definitely become better after reading this book.
 Sarah Lumos
"...To complicate matters, we in medicine are also only human ourselves. We are distractible, weak, 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..."

I’m writing this review from the perspective of a patient who has spent years in the medical system. After reading this book, I have more empathy for the doctors that
Nov 11, 2016 rated it really liked it
Shelves: medicine, audiobooks
The science of performance - doing things better and smarter. Gawande applies this directly to medicine and public health as he shares stories of health care around the globe - I particular liked his history of cystic fibrosis treatment, and the continued work on eradicating polio in southeast Asia and the subcontinent.

The afterword on 'postitive deviance' was quite good and can be applied widely.

While not the same gravitas as 'Being Mortal', this book solidifies Gawande's place as an importan
Nov 07, 2008 rated it it was amazing  ·  review of another edition
"Better" collects surgeon Atul Gawande's recent essays on medicine in three categories--Diligence, Doing Right, and Ingenuity. Each essay, on topics as diverse as washing hands to minimize infections in hospitals and doctors participating in executions, is a marvel of case study and comparative assessment, shifting back and forth between the particular and the general.

The simplicity and directness of Gawande's prose mirrors his mode of thought: always looking for the basic truth, the underlying
Jan 12, 2017 rated it really liked it  ·  review of another edition
Excellent. He writes well.

This covers several subjects that are core to current medicine as it is presently practiced. Ones which are RARELY discussed. Like when are 3rd parties as witness in the room during exams deemed mandatory. This varies with extreme difference for culture nuance or governmental law. England has different practice for this as common, for instance. And the paper drape issue!!

There are several subjects of doctor experience now/ then and how change in medical practices occur.
Petra's mechanic says her car isn't worth fixing
The first chapter of this book was on the effect that hand-washing has on infection rates of MRSA and VRE in hospitals. It was fascinating! I never thought I would find twenty pages on hand-washing so engrossing - I have high hopes for this book!

The book got better and better. Proper review will be forthcoming, definitely. But when?
Jul 30, 2012 rated it really liked it
Takes the reader comfortably into the world of medicine's challenges under the theme of how efforts to improve performance can save a lot of lives. Like the good chef he proved to be in his earlier set of essays on his experience as a surgical resident, , "Complications", he again makes tasty and nutritious dishes out of a wide variety of ingredients. How has public health gotten so close to eradicating smallpox? How has the casualty death rate for American military medicine gone from about 20% ...more
Dec 02, 2008 rated it liked it
Shelves: science
If I had to pick just one of Gawande's books to read, it would be Complications. But this is still a great collection of stories on fascinating fields of and issues related to medicine.

What I admire so much about Gawande is his ability to wrap his analytical mind so effortlessly around storytelling. His writing is conversational, straightforward and thoughtful. Medicine isn't a topic that would necessarily appeal to me, but with Gawande at the helm, it's fascinating.

In this book, his stories inc
Sep 23, 2007 rated it liked it
Recommends it for: doctors, patients, politicians
I really like Gawande's writing style, and for the most part feel like he gives a very rational, nuanced look at medical care in the US. The only exception to this is the essay "The Score." Although his main point in this essay, that a concrete, replicable measurement of baby health led to great improvements in infant mortality in the US, is well-taken, his description of the history of obstetric care and the near inevitability of an increasing c-section rate in the US is shockingly uninformed. ...more
Oh, I wanted this to be great! Alas, only part of it is. To wit: Gawande’s umbrella themes dominate the book, but they are a distraction from his best conclusions, which are tucked quietly in the afterword.

In his introduction, Gawande asks, “What does it take to be good at something in which failure can be so easy, so effortless?”—and even though he says, “This is a book about performance in medicine,” the question applies not just to medical practitioners. All of us can ask the same question ab
Feb 06, 2017 rated it really liked it  ·  review of another edition
Recommended to shanghao by: Petra's review
Motivational and practical, sans self-help spiel.

Dr Gawande writes with a measured voice, but his curiosity and enthusiasm to basically be the best you can be at what you do is infectious.

Regardless of your vocation or even during your vacations, his tips should be applicable for a more positive and fulfilling experience, and hopefully, results. Not every section interested me equally (I was most drawn in by the Ingenuity section). But then I came to realise that the section which didn't fascina
John Stepper
Jun 16, 2019 rated it it was amazing
I've now read all of Atul Gawande's books and each one is excellent. Surgeon, writer, philosopher (and now CEO?) What a polymath! This book gave me insights not only into improvement opportunities in medicine but into enhancing effectiveness in general. (The story and research on hand-washing alone is incredibly useful.)

I can't wait for whatever Gawande does next.
Sam LeFew
Jan 02, 2021 rated it it was amazing
a brilliant collection of anecdotes and research outlining that sometimes our ability to do better (in medicine and life) doesn’t always rely on groundbreaking scientific advancement. diligence, ingenuity, and re imagination of existing systems and processes can sometimes be far better. wash your hands ;)
Nov 21, 2018 rated it really liked it
This is the 3rd book by this author that I’ve read and it’s good, albeit similar to the previous ones. In this book, he explores what it takes to be good at something (medicine) in which failure is so easy and effortless. He talks of 3 virtues - diligence, doing right and ingenuity - which when practiced with earnest, will profoundly impact performance.

Some of the most engrossing bits of the book are where he talks about the following:
- Polio eradication drive in India
- Efforts undertaken to re
May 19, 2018 rated it liked it
Atul Gawande is one of those people who seems infuriatingly good at a wide variety of things. He's not only a surgeon operating (har har) out of Boston, but he's also a staff writer for The New Yorker, a professor, a public policy advocate, and a New York Times best selling author. I think his most famous book is The Checklist Manifesto, where he describes how simple tools like pen-and-paper checklists can drastically improve performance in high stakes jobs like surgery or piloting.

Better is a m
Oct 13, 2019 rated it really liked it  ·  review of another edition
Why don't we do it better? Why don't we wash our hands when we know it makes a difference? Why don't people give their children polio vaccines? Why do some doctors, who are doing everything right, only have middling results – and what helps others do better? As Atul Gawande concludes, in Better: A Surgeon's Notes on Performance, You go into this work thinking it is all a matter of canny diagnosis, technical prowess, and some ability to empathize with people. But it is not, you soon find out. (p. ...more
Oct 03, 2020 rated it really liked it
Shelves: non-fiction
This is the third book by this author that I've read. He is a solid 4 stars for me. The author is a doctor and a writer because he writes about his experiences in a kind and dignified manner. His books get me thinking, and for some reason, I always feel like I'm better off having read it.

I like his research, his ideas, and tI also like that it doesn't feel like he is trying to hide anything. I have one other book by him that seems to be the favorite of many of his readers. So I hope I can get t
Jun 04, 2019 rated it really liked it
No matter how bad things get at work, I’m always that person who says, “it’s not like we’re saving lives.” In this book, Atul Gawande discusses just how stressful improving performance in order to save lives actually is. He starts with something as simple as washing hands (which we should all apparently do 500% more often), and moves on to more complicated topics such as providing care amidst a polio outbreak in India, confronting medical needs of soldiers injured in Iraq, and the frustration do ...more
Oct 25, 2008 rated it it was amazing
Shelves: non-fiction
Atul Gwande's Better: A Surgeon's Notes on Performance is a collection of essays that probe skillfully and poignantly into the depths of medical ethics and the performance of doctors. He is a fine researcher and an astute observer who carefully delineates many facets of each issue that he explores, be it washing hands, malpractice concerns, or the Apgar score.

As a non-fiction writer, I was acutely aware of how adept Gawande is at using narrative to illustrate and discuss complex moral and ethica
Tiffany Peña
Jun 03, 2018 rated it it was ok
2.9 stars
For some reason I can't quite put my finger on, the book was kind of dull to me. The writing was great, the stories were interesting, and I really liked the concept. However, I had to drag myself through it and fell asleep multiple times while reading, I have no idea why. I would still recommend it tho, its a pretty neat book.
Barbara Carter
May 30, 2019 rated it it was amazing
better: A Surgeon’s Notes on Performance

This is another book that I picked up at a used bookstore, and so glad that I did!

The book is divided into three parts: diligence, doing right, and ingenuity

It’s an interesting read if you like learning more about what it’s like as a doctor, a surgeon or working in a hospital. Or just interested in knowing more about the medical profession.

I learned that stethoscopes are notorious carriers of infection between patients.

In eighteen forty-seven a twenty-eig
Asmara Malik (TheDoctorReads)
As a student of medicine, your appreciation of the years of research and clinical diligence that go into making those bulky textbooks is infinitesimal-- those books are meant to be rote memorized in time for a plethora of examinations, damn it! Dawdling to appreciate them means losing time to do assignments on them! Gotta study, gotta study, gotta study!

It is exactly this mind-set as a student which makes us we miss actual gems like Atul Gawande's 'Better: A Surgeon's Notes on Performance'-- may
Jun 14, 2008 rated it it was amazing
Recommends it for: anyone interested in the medical profession, people who like the New Yorker
Shelves: essays, non-fiction
This is a great book. From it's title, I thought it was about how doctors figure out how to make their patients better. But instead, it is about how the medical profession makes itself and its performance better. Gawande classifies the methods he sees in several ways. First, there is diligence, doing right, and ingenuity. He explores these ideals while discussing the campaign to get doctors and nurses to wash their hands in hospitals, improving the field of obstetrics, saving the lives of more a ...more
Feb 24, 2018 rated it liked it  ·  review of another edition
Shelves: medicine
I was hoping this book would blow my mind away just like' When Breath Becomes Air ' did but I have to be honest that I was slightly disappointed with the content of this book .

I thoroughly enjoyed Atul Gawande's style of writing but the book itself wasn't that interesting . It's definitely entertaining and very informative but I was constantly comparing it to WBBA and I couldn't help but feel disappointed .

However , I'm intrigued by his other books so I'm surely going to read them as soon as I
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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

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