Complications: A Surgeon's Notes on an Imperfect Science
Complications - Atul Gawande
by Atul Gawande
Complications: A Surgeon's Notes on an Imperfect Science is a selection of musings - essays - thoughts - call them what you will, on the art and practise of surgery. Written by a surgeon Atul Gawande, it is in effect a series of unconnected chapters all linked by the common theme of surgery. Each tells the tale of a real case that he has encountered during his eight-year surgical training.
These vary from cancerous tumours to bullet wounds, from morbid obesity to excessive blushing. Often these cases involve strange symptoms and unexpected outcomes. The book is written from the viewpoint that surgeons are only human. Their work leaves them permanently skating a thin line between success and catastrophe and mistakes can - and frequently do - happen. There are chapters dealing with such diverse subjects as Friday the thirteenth, nausea and vomiting, medical conferences and autopsies. Thrown in for good measure are the details of cases that baffled everyone involved such as "The Case of the Red Leg".
Complications is a serious book rather than a straightforward account of life on the wards of the Boston hospital where the author works.At times it almost borders on a scientific work although the science is always user-friendly. Reading it, it is evident that Gawande is a conscientious surgeon, yet a humble one who sees his skills as a blessing not a God-given right. He candidly discusses some of the mistakes that he has made while training due to his inexperience, often being called upon to perform a procedure that he has only previously practised on a goat. He writes of having to make decisions in a hurry, often with very little in the way of concrete information, when the life of a patient is at risk. He talks about the successes, the failures and the near misses of this complex science. Most of all he makes it easy to understand why doctors sometimes make mistakes and how those errors can be decreased, if not eliminated altogether. As he points out, it is not just bad doctors who slip up, but all doctors and, when the subject of their mistake is a human being, the stakes are high.
"Perfectly captures the wonder and fearful responsibility that come with cutting people open in the hope of making them whole again", is Bill Bryson's comment on the book and it is a comment that summarises Complications far better than I ever could. It's a difficult book to review because it's quite unlike anything I've ever read before - an intelligent, candid, often cynical, sometimes sad and even sometimes funny, look at surgeons and surgery.
NB: Details given below are from a different edition to that shown available from amazon.co.uk which also has a different jacket illustration:
Publisher: Profile Books
ISBN: 1 86197 4132
Price: £12.99 h/b
Date Reviewed: October 2002
My Rating: 3/5
