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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

4.24  ·  Rating details ·  43,732 ratings  ·  2,666 reviews
In gripping accounts of true cases, surgeon Atul Gawande explores the power and the limits of medicine, offering an unflinching view from the scalpel's edge. Complications lays bare a science not in its idealized form but as it actually is--uncertain, perplexing, and profoundly human.

Complications is a 2002 National Book Award Finalist for Nonfiction.
Paperback, 270 pages
Published April 1st 2003 by Picador USA (first published 2002)
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 ·  43,732 ratings  ·  2,666 reviews

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Nov 12, 2008 rated it it was amazing
Shelves: non-fiction
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
Feb 04, 2008 rated it did not like it
Shelves: have-read
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
Oct 24, 2007 rated it it was amazing
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
Sonja Arlow
Jul 03, 2019 rated it really liked it
I finished this book about a week ago and the next day my mom fell and f#*$*%* broke her hip. So, this is NOT the type of book to read or even think about when you have someone in the hospital.

Most doctors, especially surgeons, are viewed as infallible but in reality they are just like us. They have bad days, they make mistakes and some of them should really change careers.

The author writes eloquently, with compassion and a clear love for surgery, which made this a fascinating book to delve into
Libby Ames
Apr 10, 2008 rated it really liked it
Shelves: contemporary
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
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
Oct 10, 2015 rated it really liked it  ·  review of another edition
Not quite a 4 star read, but close enough. It's fairly short & does make his major points fairly well. They boil down to medicine isn't perfect.

Doctors are humans, so need to learn & will make mistakes, even with the best intentions. Do I want a doctor to learn on me or mine? Hell no! Gawande admits that he doesn't either & he makes sure they don't, BUT we won't get any new ones if they don't start somewhere. So what's the solution? There isn't a good one. Deal with it.

Patients are humans, so th
Jun 24, 2019 rated it really liked it  ·  review of another edition
4.5 stars

I had a great time reading this with Heidi from My Reading Life. The book is broken up into three sections named for ideas that vex doctors - Fallibility, Mystery, and Uncertainty. He looks at the way surgeons are educated, advancements in medicine, hard to pin down diagnoses, and more with a liberal sprinkling of fascinating cases.

The pacing is perfect, there are edge of your seat moments to see if a patient makes it, and he brings up ethical issues that appear in his later books, such
 Sarah Lumos
“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.”

I have always been intrigued by medicine. I know it’s a scary thought, but inevitably, illness will impact each of us in one way or another. Either we will get sick or somebody we love will get sick. Which is why learning about medicine and healthcare is so important. How
Jul 19, 2019 rated it it was amazing
Let’s play the “who wants to be horrified” game. Complications made it hard to sleep. Not because of gore necessarily but because it made clear to me that doctors are just people who were given a scalpel. Yes, they have a ton of education but at some point, they must get experience.

In one section Gawande discusses a procedure in which he must put in a central line which goes into a major vein in your chest which can technically kill you. All he tells the patient is that he must put in a central
Aug 10, 2007 rated it really liked it
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
Apr 09, 2009 rated it really liked it
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. ...more
There was a time in my life when I looked to Reader's Digest as a more credible source of information; I even garnered some sort of feeling of being in the presence of wisdom when the correct stars were in alignment. The time when I felt such is as long ago as is the date of publication of this book, so perhaps, had I read it then, I would have liked it a great deal more. As it stands, I don't read nonfiction for the express purpose of being coddled into a feel-good view of a certain section of ...more
Sep 01, 2020 rated it it was amazing
Shelves: medical, non-fiction
Brilliant!!! Many of the topics covered were close to my heart. This was the second time I am reading this book after abandoning it once but after the halfway mark found it engrossing especially the pain and nausea parts.
Jan 07, 2021 rated it really liked it
Shelves: non-fiction
I like this author. I like his candid approach to healthcare and to surgery. This book starts out with a picture of physicians learning procedures by practicing on willing patients. I live in an area where we have teaching hospitals and that it so common. But when you are the one haveing to make the decision to be practiced upon, it is so easy to tell them to move along.

Some of the stories made me a little squeamish. TMI I thought. But overall, an interesting listen this evening. So 4 stars.
Left Coast Justin
Mar 30, 2017 rated it really liked it
Shelves: medical
"Emesis" is a pretty little word, two palindromes side-by-side, but until I read this book I could never quite find the proper words to describe the actual process: "intensely aversive".

Dr. Gawande occupies a rarified Valhalla of people who understand medicine, who understand public policy and who understand how to write. You want facts? Got 'em:
She was in what physicians call the "prodomal phase of emesis." Salivation increases, sometimes torrentially. The pupils dilate. The heart begins to rac
Jul 26, 2007 rated it really liked it  ·  review of another edition
Shelves: 2007
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
Riling Chen
May 09, 2021 rated it it was amazing
This book made me question expertise, and not just in medicine. He shows that doctor's titles can be stripped away when good doctors become less fastidious about treating their patients with utmost care. They can be overcome with issues that everyday people face—alcoholism, depression. He is candid in his account of how he learned to do a central line, his fumbling, and tentativeness in the beginning. I always love to read about people looking back at their own mistakes in hindsight. Most of all ...more
Jun 20, 2021 rated it really liked it
"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 neve cease to aim for it"

One of the most profound books I have read on Surgery - which we get to know, not so comfortingly, is an imperfect science. Credit to the author for not making things too technical and covering a wide range of discussion points.

I loved the cases chosen for discussion and even better the musings on the rightnes
Mar 08, 2013 rated it it was amazing
An exhilarating insight towards a mythical realm that is as much art as it is science. Awe-inspiring tales by a surgeon who wields his pen as he does his scalpel. A must read for every medical student, or anyone within the medical field. This book cemented my passion for surgery, and made my decision to be a surgeon a vivid one. It eradicated the notion I had about a profession centered around an innate talent and good manual dexterity; as I learned what it takes to be a surgeon is much more tha ...more
Valerie Kyriosity
Jan 11, 2018 rated it really liked it
Shelves: audiobooks
Fascinating. I only wish Gawande brought a biblical worldview into the topic. It was the missing dimension in many stories—What role does human depravity play here? How could prayer make a difference there? What if we applied basic principles of wisdom in this case? What if the gospel were presented in that one? Man is so complex—body, mind, and spirit so inextricably intertwined—that we're never going to understand the complexities of any one of them without bringing our knowledge of the others ...more
Jul 28, 2011 rated it really liked it
Great. Reminds me of why I wanted to do medicine.
Nov 02, 2017 rated it really liked it
Disturbing. Fascinating. Illuminating.
Mar 29, 2008 rated it liked it
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
Jul 29, 2009 rated it liked it
Shelves: non-fiction
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
Lukasz Pruski
Jul 15, 2021 rated it really liked it
"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."

Atul Gawande's Complications (2002) strongly resona
This was probably the best book I have read for Atul Gawande yet. Atul has a great way of laying out his ideas and experience through story-telling. He takes the reader into journeys around a particular topic very smoothly and in an enjoyable way.
He's got a nice approach to writing. He starts with an interesting introduction on something he wants to discuss and shed light on, lays down the background and fundamentals, without neglecting to convey across any intricacies involved. This often has t
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
Book Concierge
Nov 04, 2008 rated it it was amazing
Recommends it for: EVERYONE
This National Book Award finalist REALLY makes you think! It opens your eyes to the imperfections in our system of medical care.

Gawande is a surgical resident (when he wrote it), a thinker and a poet. He uses case histories to explore the thinking, the philosophy, of medicine. He speaks of mistakes and intuition, luck and skill, good outcomes despite bad treatement, and devastating outcomes despite excellent care. This should be required reading for all medical students and regularly re-read by
Jenny Covey story
Jun 24, 2014 rated it really liked it
The timing of this book couldn't have been better. I was able to read it while sitting beside my husband on a beautiful beach in Mexico. Totally relaxed and without interruptions I was able to pepper him with frequent questions. "What do you think about this? Does he accurately portray residency? What about surgery?" and on and on. I learned so much about medicine and even more about my husband. ...more
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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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“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.” 207 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.” 55 likes
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