Title: Complications: A Surgeon’s Notes on an Imperfect Science
Author: Atul Gawande
Genre: Memoir
Year: 2002
Acquired: Owned
Rating: 
Review: For the last five weeks, my grandfather has been in and out of the hospital. He’s 85-years-old, but up until the last month he’d been in relatively good health, still out working on projects in his yard and reading books that I would recommend. But five weeks ago (really, longer, it’s hard to tell when things started going awry), he became very weak, started falling frequently, and became more and more confused.
He ended up in the ICU when the levels of nutrients in his blood went totally haywire. After a couple very serious nights when it seemed like we might lose him completely, or lose all of the things that mentally made him my grandpa, he started to pull out of it. Things are still uncertain right now, but after some fits and starts in his care (including frustrating miscommuncation between different doctors that have caused some relapses), he seems to be on the mend and just recently moved back home (we hope for the long term).
I tell that story because it’s what was happening while I decided to read Complications by Atul Gawande — a collection of essays written when Gawande, a writer and surgeon, was completing his surgical residency. In the book, Gawande grapples with three of the complications that are fundamentally a part of modern medicine:
… the fallibility of doctors, asking, among other things, how mistakes happen, how a novice learns to wield a knife, what a good doctor is, how it is that one could go bad. … [the] mysteries and unknowns of medicine and the struggles with what to do about them… [and] uncertainty itself. For what seems most vital and interesting is not how much we in medicine know but how much we don’t — and how we might grapple with that ignorance more wisely.
I’m not sure why I decided to pick up a book about medicine during a time when my family was reeling from a medical emergency. It doesn’t seem like reading about medical uncertainty would be a smart choice when my grandfather’s illness and recovery were so uncertain, but I actually found Complications to be an oddly comforting read.
Our current conception of doctors and medicine (or, at least mine, since I watch a lot of Grey’s Anatomy) is that diagnosing a patient should be simple (0r, if you watch House, at some point every illness looks like lupus). But in the real world, medicine is very human, full of questions that don’t always have answers. Getting that more fallible perspective, although a little scary, made what was happening to my grandpa seem less out-of-the-ordinary.
Part of the reason Complications works is that Gawande has such a distinctive voice — confident, humble, curious, and willing to admit his own mistakes. He’s funny when the situation calls for it, and serious when he needs to be. And he writes about his patients with a compassion and care. I really, really fell for his voice (as have others — Gawande is also a staff writer at The New Yorker).
Anyway, this review has gotten kind of person and gushy, so I’m going to wrap it up. Although it seems strange, I thought reading Complications during a medical crisis was good for me. But, I don’t think that needs to be context to make this book a worthwhile, informative, and engaging read about the complicated world of modern medicine and the people who strive to care for us when we are the most vulnerable.
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Our family has been dealing with medical issues this year too and it’s very frustrating. They have my mother-in-law seeing so many doctors and they all say something different. You don’t know who to believe.
It’s really hard, especially when they can’t figure out what’s wrong and you just want someone you love to get better.
sorry to hear about your grandfather. it’s probably good you picked this book at this time — helped with all your thoughts. hope his health improves
I think the book did really help, at least help me understand why medicine can be fallible and be more accepting of those areas of uncertainty.
I think it’s very important to realize that doctors and others in the medical field aren’t perfect, especially when someone you know is undergoing treatment. For me, knowing that taking someone to the doctor won’t result in an immediate solution helps me cope better when things aren’t necessarily improving. I guess it’s a lowering of expectations in a way.
A little bit, yes, or maybe just getting a set of more realistic expectations about what doctors can and can’t do.
My step-mother, who is a retired nurse, always says that there’s a reason they call it the “practice” of medicine. It’s a learning process that never ends. I gave her this book for Christmas a couple of years ago, and she said it really rang true to her, and then she passed it along to various former colleagues who said the same.
Yes, so true. I have a lawyer friend who says the same thing about law, it’s the “practice” of law. It’s important to be reminded that no one is perfect, even if we want them to be.
I picked this up a few times at the bookstore when it first came out, but never followed through, which is probably a good thing as I’m the opposite of you right now…after all of HB’s time in hospitals last year I have no desire to read about medicine.
And good luck to your grandpa!!
Lol, I can totally see that! I don’t think I’d have loved all books about medicine, but I found this one comforting 🙂
I hope your grandfather is home for the long-term!
I haven’t even heard of this book. I guess I missed it along the way.
I hadn’t heard of it until my mom bought it for me for Christmas a couple years ago. I think I missed it too.
Best of good wishes and hopes for your gandfather.
I am looking forward to reading this. Someday. I just spent the weekend with my BIL’s new girlfriend who is studying to be a nurse – you can never run out of things to talk about when someone is studying medicine, I think.
So true — medicine is full of crazy stories.
I’m glad to hear your grandfather’s doing better! I’m sorry y’all have been having a hard time recently — spending time in hospitals is miserable, even if you have all the vending machine quarters and reading material you need.
Atul Gawande has been on my list for a while. I never hear anything but good things about him. I just need to steel myself to be able to think about hospital things a very great deal some weekend.
Hospital things can be sort of scary, I think. But Gawande’s writing is just beautiful and funny and smart. I really connected with it.
sorry to hear about your grand-pop and hope he is feeling better. I work in health care and have reads thousands of medical records. Physicians and surgeons are not infallible but if they are honest, and speak to the patient and their family in a compassionate way, then I think the whole experience would go a lot better, even when they are not sure what the diagnosis is. There are times when they have no idea what is wrong and they treat the patient the best way they can. The “practice” of medicine is so true.
Thanks for reminding me about this book.
Honesty is a good point — it’s always better to admit what you don’t know, even if that’s not entirely comforting.
Yes, I’ve heard it’s called “the art of medicine” as opposed to “the science of medicine”… Sorry to hear about your grandfather but he is feeling better now. And I love Gwande’s work. He has another about the importance of check lists which is also good, but “Complications” is definitely my favorite book of his.
I think I have his other book on one of my shelves too, but it will be hard to beat this one 🙂
I’m sorry to hear about your grandfather, it’s always tough dealing with those things. Sounds like an interesting book and I can certainly understand that it would be helpful. It’s like learning up on the situation, always helps right?
Yes, exactly. Getting a better sense of doctors as people really helped me cope, I think.
Sorry to hear about your grandfather. I hope his health has continued to improve. Our bodies are such wonderful things until we get older and then it doesn’t seem to take much to throw the whole system out of whack. I’m glad this book was a comfort to you.
Yes, me too! He seems really determined to get better, so I hope that continues to happen.