Summary and book reviews of Better by Atul Gawande

Better

A Surgeon's Notes on Performance

By Atul Gawande

Better
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  • Hardcover: Apr 2007,
    288 pages.
    Paperback: Feb 2008,
    288 pages.

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Book Summary

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 in the face of obstacles that sometimes seem insurmountable.

Gawande’s gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors’ participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable.

At once unflinching and compassionate, Better is an exhilarating journey narrated by “arguably the best nonfiction doctor-writer around” (Salon). Gawande’s investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.

Introduction

Several years ago, in my final year of medical school, I took care of a patient who has stuck in my mind. I was on an internal medicine rotation, my last rotation before graduating. The senior resident had assigned me primary responsibility for three or four patients. One was a wrinkled, seventy-something-year-old Portuguese woman who had been admitted because—I’ll use the technical term here—she didn’t feel too good. Her body ached. She had become tired all the time. She had a cough. She had no fever. Her pulse and blood pressure were fine. But some laboratory tests revealed her white blood cell count was abnormally high. A chest X-ray showed a possible pneumonia—maybe it was, maybe it wasn’t. So her internist admitted her to the hospital, and now she was under my care. I took sputum and blood cultures and, following the internist’s instructions, started her on an antibiotic for this possible pneumonia. I went to see her twice ...

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Reviews

BookBrowse

Better offers inspiration to any of us who are tempted to settle for average.   (Reviewed by BookBrowse Review Team).

Full Review Members Only (931 words).

Media Reviews
Washington Post - Barron H Lerner

[O]ne cannot help but admire physicians who urge their colleagues to revisit their basic assumptions and who encourage patients to work with their doctors in a constructive manner. Even patients with chronic, debilitating illnesses should benefit from a better understanding of how their doctors think. And for those patients with as-yet undiagnosed conditions, such advice might prove invaluable?

Entertainment Weekly - Gilbert Cruz

Gawande's multi-topic approach makes for a gripping read, but sometimes suggests he's wandered off course. B+

Houston Chronicle - Charles Matthews

In business or government or education, in law or journalism or the arts, "settling for average" may not have such lethal consequences as it does in medicine, but it's still pernicious. And this brilliant, persuasive and even inspiring book, with its crisp writing and its abundance of well-told tales, might well be taken to heart by any reader.

Popmatters - Robert Roose MD

Better is not a book only for physicians. While medical professionals are Gawande’s subjects of Betterment, the circumstances they face involve us all. As he shows us in the conversation between Janelle and her cystic fibrosis specialist, Gawande has a talent for gracefully elucidating the issues that matter. Instead of handing out a heavy pile of research, he chooses to remains an agile writer, commenting on complex issues through a series of intimate vignettes. 

Booklist - Donna Chavez

A sparkling collection of essays about medical professionals and places where "better" either has or is becoming the norm, where excellence is a journey rather than a destination.

Kirkus

A must-read for medical professionals - and a discerning, humanizing portrait of doctors at work for the rest of us.

Library Journal

The essays are united, as they highlight opportunities for improvement within the medical community, which serves as a successful framework for Gawande's study of a profession predicated on betterment. These revealing, humanistic essays are highly recommended for all libraries.

Publisher's Weekly

Starred Review. Surgeon and MacArthur fellow Gawande applies his gift for dulcet prose to medical and ethical dilemmas in this collection of 12 original and previously published essays.

Reader Reviews
shubhamvada mathur

Better than complications!
I had attended this bookreading at the BnN near Lincoln Center in NY months ago. After that, I happened to hear the NPR podcast of the D.C. bookreading so I finally went and got the book and it's worth it! Better talks about just that, how doctors...   Read More

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Beyond the Book

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. He lives with his wife and three children in Newton, Massachusetts.

Both his parents were physicians — his father a urologist and his mother a pediatrician — and initially he resisted following in their footsteps and instead wanted to be a musician: "I wanted to be a rock star. I played ...

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