Complications by Atul Gawande

A friend at work first gave me this book years ago -it was a riveting read then, and still is now.

In a measure of how much I like this book, I’ve since bought 9? 10? copies, each time to replace the copy I’ve given to yet another friend; most recently another one last week. Each of those friends has, in turn, also been blown away by this book.

On one level, it is about how people make critical decisions when they only have partial information. As an engineer, I feel most comfortable making decisions when I have all the data to make an informed decision. But how do you make informed decisions when the act of gathering all the data will take too long; situations where there is no test, or the patient will die before all the test results come back? And as a doctor, how do handle it if your guess was right and the patient was treated successfully? Or live with yourself when your educated guess turns out wrong, and your attempts to make things better actually make the situation worse?

This book, like his other book “Better“, is written as a series of short stories – each chapter covering a different topic with a different patient. This made the book easy to pickup, and stopping after a chapter is a great way to mull over some of the issues raised. But I find the book hard to put down, even after all these years, and all these re-reads. Atul has quite a skill, being able to describe all the nuances of a complicated field like medicine, and medical diagnosis, in a way that is readable, understandable, and totally fascinating, to someone who knows very little about medicine.

The stories include his failed attempts at a routine procedure when starting his residency, the startling twist in the story of a child who had trouble breathing, a debate about how doctors train new doctors, and the very humble, personal stories of patients who died when they should have lived, and lived when they should have died.

Buy it.

(ps:the last chapter gives a great description of part of a rare-enough situation that I had to deal with once, a few years ago, and am very happy to have survived.)