He also shows us what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause a young woman with nausea that won't go away a television newscaster whose blushing is so severe that she cannot do her job. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur and why good surgeons go bad. This audio is exploratory surgery on medicine itself, laying bare a science not in its idealized form, but as it actually is - complicated, perplexing, and profoundly human.Ītul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made. Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. He lets us all in to this remarkable world and I only wish that exceptionally reflective practitioners in other fields would do the same.A brilliant and courageous doctor reveals, in gripping accounts of true cases, the power and limits of modern medicine. The author, the son of two physicians, is steeped in how being a physician actually works.

There is much more here for anyone interested in how practices work and how to do better within an established practice. He discussses the values of counting things in one’s work, of writing things down, of listening to everyone who has important things to say, and becoming an early adopter, always searching for new things to try and say and do.

Gawande, in several essays, discusses the interesting concept of being a “positive deviant”–someone whose performance is exceptional without having more knowledge. This emphasis on performance can be just as valuable to managers as to physicians. The book focuses on two main questions: how does one improve a practice and how can we do things better when we don’t have all the information we’d like. The book consists of a dozen short essays, many originally published in The New Yorker. The beauty of Better is that it lets you see and feel what it’s like to face the near-constant uncertainty of being a physician. But there aren’t, so let’s be grateful for this book (as well as its excellent predecessor, Complications: A Surgeon’s Notes on an Imperfect Science). With so many people in these professions, one would think that there would be thousands of books like Dr. Think law, management, medicine, teaching, many types of engineering. Atul Gawande’s Better: A Surgeon’s Notes on Performance does a wonderful thing that is rarely done: it tells us what it is like to be in a practice.Ī practice is uneasily poised between a profession and a craft, with some science and art mixed in.

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