Better – A Surgeon’s Notes on Performance by Atul Gawande

Rating - Read

I first came across Atul Gawande a few years ago when I picked up a ridiculously discounted The Best American Essays of 2003 from the Landmark sale. (A slight detour since I will never finish my growing collection of the The Best American Essays and review it here but its existence needs to be broadcast. This awesome book is released yearly and is a collection of really good essays published in various magazines and journals that particular year in the U.S. The topics can be wide in range or circle around a particular theme. Either way, the reading is great.) Gawande’s essay on learning how to be a doctor was funny and touching.

So when I happened upon this book, I promptly bought it.

It is quite interesting to read about a field which you constantly see only one side of – as a worrying patient. The fact that for doctors this is a profession and they would have professional concerns the way the rest of us do had never actively crossed my mind. The book was a wonderfully guided tour into unchartered territory.

Gawande groups his essays around three topics.

The first part, Diligence, is an eye-opener on how the small things can save millions of lives. The essay about doctors washing hands between patients, the continuous improvements that hospitals keep trying to do to get doctors to wash their hands, the historical figures who were ahead of their times in identifying the absence of handwashing as a source of spreading infection..all of this makes you think about the larger place a very simple act can have in the world.

The next part on Doing Right has essays on doctor litigations, maintaining professionalism and dignity of patients when they are naked/nearly naked and so on. The most moving essay in this part was on doctors who work in administrating the death penalty. A philosophical discussion on how as a citizen you may want some people to really be given the injection, but then as a doctor you are betraying your profession’s fundamental principles to save people. I got wondering how it felt for a normal human being to have to deliberately kill another human being.

The final part is on Ingenuity, which includes a piece on the amazing ways in which underequipped, understaffed hospitals in rural India cope with a flood of patients. From having berated government hospitals, it made me think about the few good men (and women) who do the best knowing that they cannot possibly do the theoretical best for their patients.

Tucked in somewhere was also an interesting piece on why C-sections are now used more commonly compared to the 60s in America. I thought all the arguments made perfect sense.

Infact his arguments throughout the book are well-presented, well-thought out and though-provoking. Gawande does not always have answers to questions but it is nice to hear the questions that doctors face. Besides, for a book that dwells into the complex world of people saving lives, the issues are seen logically and somewhat, gently. Not to mention, Gawande is an engaging writer.

This was probably my first unputdownable non-fiction book (not counting the masala-filled Barbarians at the Gate and similar near-fiction stuff).