“Better: A Surgeon’s Notes on Performance” by Atul Gawande

Medicine is usually seen as a field where improvement is based on new innovations, where research gives the push to make things better. However, as Gawande illustrates here, improvements need to come from doctors themselves, through introspection and a willingness to be open about our areas of weakness.

He brings up a number of issues that I had never considered before. For example, there is a chapter dedicated to doctors who assist with fatal injections being used on death row inmates. I had never thought about that much, but it does make sense to have a doctor there, to make sure that the injection isn’t botched. But it also makes sense that the official stance of the American Medical Association (AMA) is against this. They see it as a breach of a doctor’s responsibility to heal and provide life to patients, not taking it away. Gawande tracked down a number of doctors involved in lethal injections and shares their stories and reasons for participating.

There are more mundane topics covered, such as hand washing and protocol for performing potentially intimate physical examinations. What makes medicine specifically so interesting is its blend of social and scientific factors. The way you handle yourself with a patient matters just as much as the care you are giving them. In the physical examinations chapter, he discusses how doctors can use chaperones to lessen this, as well as simply in general keeping their patients informed of what is about to happen to their bodies.

At the end of the book, Gawande gives some tips to those in the medical field who want to be doing the best that they possibly can. In list form, these are “ask an unscripted question,” get to know the patient or your co-worker as a person and not just a part of your job; “don’t complain,” a doctor’s life is hard but that doesn’t mean that you have to dwell on that; “count something,” observe what around you works and what doesn’t; “write something,” keep your mind sharp by noting down observations; and “change,” be willing to change yours and others behaviors to make medicine a better place. Just through these suggestions, you can see Gawande’s focus on the humanity of medicine, his desire to see his patients as people. You can also see his desire to make medicine better by using the skills we already have. By appealing to the instincts that doctors already possess, he is trying to take the resources we all have and point them towards a goal. Which builds off of a number of chapters, whether it’s doctors monitoring their hand washing or surgeons in India performing surgery with whatever meager tools around them.

I think anyone can learn from this book, whether you are involved in the medical field or not. But having an interest in medicine doesn’t hurt here, as the stories he is telling are fascinating and eye-opening. Any job can use a healthy dose of introspection to make it better, whether you are in business or just a student. The point is to learn from the work that Gawande has done here in a specific field and then apply it to whatever field of your choosing. I can’t wait to see what you accomplish.