Complications: A Surgeon's Notes on an Imperfect Science

I’m reading an excellent book, Complications: A Surgeon’s Notes on an Imperfect Science. First off, the author is a great writer. The book is thoughtful, easy reading and hard to put down. Second, while written by a surgeon much of it is very relevant to the world of EMS.

Among his subject matter:

Mistakes by doctors: “No matter what measures are taken, doctors will sometimes falter, and it isn’t reasonable to ask that we achieve perfection. What is reasonable is to ask that we never cease to aim for it.”

The new science of pain: “Yes, injury produces nerve signals that travel through a spinal-chord-gate, but it is the brain that generates the pain experience, and it can do so even in the absence of external stimuli.”

The ability of computers/and or algorithms to become better at diagnosis than doctors: “as ‘systems’ take on more and more of the technical work of medicine, individual physicians may be in a position to embrace the dimensions of care that mattered long before technology came — like talking to their patients. Medical care is about our life and death, and we’ve always needed doctors to help us understand what is happening and why, and what is possible and what is not. In the increasingly tangled web of experts and expert systems, a doctor has an even greater obligation to serve as a knowledgeable guide and confidant. Maybe machines can decide, but we still need doctors to heal.”


“Medicine reveals itself as a fascinatingly complex and ‘fundamentally human endeavor’ in this distinguished debut essay collection by a surgical resident and staff writer for the New Yorker. Gawande, a former Rhodes scholar and Harvard Medical School graduate, illuminates ‘the moments in which medicine actually happens,’ and describes his profession as an ‘enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line.” Gawande’s background in philosophy and ethics is evident throughout these pieces, which range from edgy accounts of medical traumas to sobering analyses of doctors’ anxieties and burnout.”
-Publishers Weekly


Note: Since I posted this review I have heard from several people praising Gawande’s second book, Better. I have ordered it myself and look forward to reading it.

“A surgeon at the Brigham and Women’s Hospital in Boston and an assistant professor at the Harvard School of Public Health, Dr. Atul Gawande succeeds in putting a human face on controversial topics like malpractice and global disparities in medical care, while taking an unflinching look at his own failings as a doctor. Critics appreciated his candor, his sly sense of humor, and his skill in examining difficult issues from many perspectives. He conveys his message—that doctors are only human and therefore must always be diligent and resourceful in fulfilling their duties—in clear, confident prose. Most critics’ only complaint was that half of the essays are reprints of earlier articles. Gawande’s arguments, by turns inspiring and unsettling, may cause you to see your own doctor in a whole new light.”
-Bookmarks Magazine



  • Eddie says:

    Thanks. I’ve got this on order with my library. 🙂

  • Medix311 says:

    I picked this up and put it down a few times last time I was at Powell’s. Thanks for the positive review. I’ll be adding this to my library.

  • DavisEmt says:

    I read this a little over a year ago, I ended up picking up his newest “Better” too. Both fantastic reads. I’m glad you found them. He rights well, you know information that could easily be seen has dry and hard to page turn, he’s quite humble too. Realistic.

  • Rogue Medic says:

    For the more ADD crowd, BookTV has Dr. Gawande talking about his book Better for about an hour. You need Real Player to watch it. The site is a great one for learning about nonfiction books. Every weekend CSPAN2 broadcasts BookTV.

  • PC says:

    Thanks for the comments. I will definately be reading his second book and checking out the Book TV segment.PC

  • Edward says:

    I think the book is EXCELLENT. I especially enjoyed the section on machines in medicine. (Chapter 2, I think.)