Complications: A Surgeon's Notes on an Imperfect Science

by Atul Gawande

These are the moments in which medicine actually happens.

is an imperfect science, an enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line.

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.

The theory behind an EKG is that in a heart attack a portion of the muscle dies, causing the electrical impulses to change course when they travel around the dead tissue.

Maybe machines can decide, but we still need doctors to heal.

For the solution to chronic pain may lie more in what goes on around us than in what is going on inside us.

advanced as medicine has become, questions are still our main diagnostic

what patients want most from doctors isn’t autonomy per se; it’s competence and kindness.

In the absence of algorithms and evidence about what to do, you learn in medicine to make decisions by feel. You count on experience and judgment.

That our efforts succeed at all is still sometimes a shock to me.

in the midst of all the paperwork and pages and sleep deprivation, you can forget why what you do matters. The writing let me step back and, for a few hours each week, remember.