Complications
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I have no idea why I bought Complications by Atul Gawande. I’m not particularly interested in medicine and a book about “a surgeon’s notes on an imperfect science” wasn’t bound to get me in the holiday spirit. Nevertheless, I plucked it off my bookshelf and pretty much devoured it. While it’s backed by stats and research, it’s anecdotally driven based on Atul’s experience as a surgeon. The stories are unique and suspenseful, which made me consume them more quickly. Gotta find out why Eleanor’s entire leg is red and swollen after dancing barefoot at a wedding!
The book’s takeaway is fairly simple albeit disconcerting: there’s a lot of unknowns in medicine and a lot of room for improvement. The book is split into three sections: fallibility, mystery, and uncertainty. The fallibility section emphasizes that all doctors are human and while expertise requires experience, a lot can go wrong in the early experience phase. The mystery section focuses on what medicine hasn’t fully figured out, like the mechanisms behind pain, nausea, blushing and hunger. The uncertainty section highlights misdiagnoses and dives into an ethical discussion of patient autonomy vs. doctor authority.
I appreciate that Complications gives a peek behind the medicinal curtain. For example, academic hospitals hold weekly Morbidity and Mortality Conferences (M&Ms) where they go behind closed doors and talk candidly about deaths that occurred on their watch so as to take responsibility and learn from their mistakes. Still, for all of these interesting factoids, I’m not quite sure what I’m supposed to take away from this book. Honestly, it leaves me feeling quite uncomfortable. I’m not naive enough to believe that my doctors are perfect, but I am willing to succumb to a bit of ignorance-is-bliss in order to avoid anxiety about my care.
Atul is clearly a very smart guy and a talented writer, and I think that his anecdotes have real value, but I wish he had proposed solutions to some of the problems he spotlights. I don’t expect him to have fully formed, ready-to-go answers, but if he’s compelled enough to speak on the issues, I’d like some semblance of next-steps. Instead, I’m left feeling a little discouraged. So, would I recommend this book? Well, do I want you to also feel discouraged? Am I a sadist? Atul’s anecdotes are persuasive and his writing is engaging, but the message, while honest and well-intentioned, is a bummer. I don’t believe that everything we read should be uplifting, but I do think that this book would be more well-rounded if it had a final section on possible solutions– even if it meant calling in reinforcements from another doctor/writer. Overall, Complications receives 3 out of 5 flames.
