BookBrowse Reviews Better by Atul Gawande

BookBrowse:

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

It was inevitable that Better and How Doctors Think by Jerome Groopman would be widely compared by reviewers when they published in hardcover just weeks apart last year. While both share a similar premise, that the performance of physicians is less than perfect and can be improved by close scrutiny, the scope of Better is wider, from a medical, geographical and ethical point of view which, in this reader's opinion, makes it the more interesting book.

Following on from his 2002 collection of essays, Complications, Gawande's latest book consists of 12 essays, some original and some previously published, in which he whisks the reader around the world from medical facilities on the cutting edge of science to doctors performing miracles with the barest of supplies. Five of the previously published essays are available to read in full online (see sidebar) and the Introduction is reproduced in full at BookBrowse.

While Better explores a number of practical ways in which doctors can improve the survival rate of their patients, such as the hospital that reduced the number of patients infected by MRSA* from a national average of 10%+ to zero, it is Gawande's focus on ethical dilemmas and his strategies for improving medical success rates that make for the most interesting reading, not least because much of what he has to say can be applied to fields other than medicine.

Better offers inspiration to any of us who are tempted to settle for average. If you're looking for an inspiring graduate gift this year, instead of falling for the tired old retreads that publishers target specifically at the graduate market, consider giving Better!

*MRSA is a particularly virulent bacteria resistant to most antibiotics.

Essays from The New Yorker that are reprinted in Better

• The Bell Curve: One of three essays in Part III: Ingenuity: Explores the success rates of different medical facilities in treating cystic fibrosis.
• Piecework: One of five essays in Part II: Doing Right: A fascinating essay showing the cost of medicine and how most doctors aren't as rich as we might think, and certainly not as well off as if they'd chosen to go to business school for 2 years and become bankers, instead of medical school for 12 years!
• The Score: One of three essays in Part III: Ingenuity: Childbirth, caesarians vs forceps deliveries and the Apgar score.

Essays from the New England Journal of Medicine that are reprinted in Better

• Casualties of War: One of three essays in Part I: Diligence: Battlefield medicine in Iraq.
• When Law and Ethics Collide: One of five essays in Part II: Doing Right; retitled "The Doctors of the Death Chamber" in Better.

This review was originally published in The BookBrowse Review in April 2007, and has been updated for the February 2008 edition. Click here to go to this issue.

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