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| Complications: A Surgeon's Notes on an Imperfect Science | 
 enlarge | Author: Atul Gawande
Creator: William David Griffith
Publisher: Macmillan Audio
Category: Book
List Price: $34.00
Buy New: $19.44
You Save: $14.56 (43%)
Buy New/Used from $16.99
Avg. Customer Rating:  (155 reviews)
Sales Rank: 186400
Format: Abridged, Audiobook, Cd
Languages: English (Original Language), English (Unknown), English (Published)
Media: Audio CD
Edition: Abridged
Number Of Items: 6
Pages: 5
Shipping Weight (lbs): 0.5
Dimensions (in): 5.7 x 4.7 x 1.1
ISBN: 1559278587
Dewey Decimal Number: 617.092
EAN: 9781559278584
ASIN: 1559278587
Publication Date: April 5, 2003
Availability: Usually ships in 1-2 business days
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| Customer Reviews:
 I didn't finish June 2, 2008
0 out of 1 found this review helpful
I just couldn't finish this book! I thought it would be better--but as I am reading the words they are more and more unfamiliar. I don't want to read a book where you spend more than 3/4 of the time looking up the words!
 Humble Human makes a Great Doctor! May 16, 2008
2 out of 2 found this review helpful
An amazing thriller...
Dr.Atul's superb portrayal of finest qualities of a doctor, yet the limitations of an individual, their weekness,strengths, system flaws etc with vivid examples of real life cases makes "Complications" the best medical book I'v ever read.It's not the content of the book alone that deserves appreciation, it's also the flow of words that blend with the topic.
Certainly the pinnacle of the book is the story of Joseph Lazaroff, Atul's Anguish depicting the finest of human character and also the professionalism of a doctor, also his questions behind the ethics of "absolute insane rights of patient's expression". I felt a pain in the heart for that "unknown soul" ( a gist of that chapter is below)
Chapter : Whose body is it Anyway :
...I turned the ventilator off, and the suddenly the room was quiet .His breathing slowed ...Joseph Lazaroff had died.But Knowing how much Lazaroff had dreaded dying the way he died....
Chapter : Education of a Knife:
I said to the patient that there were "slight risks" involved.And the disasters weighed on my mind: the woman who had died from massive bleeding, the man who had to have a chest opened, the man who had a cardiac arrests.I said nothing of such things when I asked my patient's permission to do this
Chapter : When Doctors Make Mistakes:
At 2 A.M on a crisp friday in winter a few years agao, I was in sterile gown , pulling a teenage knifing victim's abdomen open, when my pager sounded "code trauma, three minutes"
Chapter : When Good doctor's Go bad:
Before the license of Dr.Goodman was taken away, he was a highly respected and sought after surgeon...he could do some of the best, most brilliant work around....In one case , he put the wrong-size screw into a patient's ankle,another case when he refused to do hip replacement. For the last several years, he was the defendent of a stream of malpractice suits.
Chapter : The Man Who Cannot stop Eating :
...He had to let his legs apart to let his abdomen sag between them. He cannot lie down and breath properly because of excess fat in the tongue and upper airway. He had to sleep in the recliner and every thirty minutes or so , he would wake up asphyxating, He could no longer stand up to urinate, he had to shower after moving his bowels to get clean
A Must Read book...Afterall, someday you might be an example in his future books!
I've been slashed April 18, 2008
2 out of 7 found this review helpful
I find this book which has gotten such rave reviews disappointing. Dr. Gawande addresses a number of issues which are pertinent to surgical practice. However,I found the book to be superficial and lacking of "heart".
I will elicudate. Dr. Gawande states frequently that surgeons slash their way into a patient.I suspect that this is for dramatic effect.There are other examples of this such as the description of an autopsy.He tones it down later.He treds lightly on the fact that doctors don't want to own their mistakes which is why there is no improvement in medical care over 20 years ago despite huge advances in both technology and costs.
The only Surgeon I have ever known who "slashed" his way into a patient ended up losing his privileges...thank God but it took many years and a yeoman's effort and those who spoke up were alienated and shunned. It was not as simple as is portrayed in this book.I do laud him for bringing up the "good doctors going bad" issue. It is a huge problem and bad doctors are often covered for years and years while patients are repetitively injured. It is also very harmful to the doctor who is creating the problem. The cost of this problem to patients, hospitals and society is staggering.
I looked up the reference that computers were better than doctors at diagnosis. It is not about medical diagnosis, it was about psychologists' diagnosis. The second article was from 1954...A bit dated. before the computer era.
I laud him for the courage in mentioning his screwed up tracheostomy attempt. There are numerous methods for both intubation and percutanous guided tracheostomy techniques that have been available for 20 years. I have to wonder why he was unaware of these. The technique that he describes for subclavian vein cathethers is also not as safe as other methods which use a small guage finding needle. I have to wonder why 20-30 years after these problems were identified that this young doctor was not being instructed in these techniques.
His chapter on bariatric surgery is notable for his mentioning of the commercialization of medicine an increasingly dangerous trend is appropriate. At this point bariatric surgery has been shown to be helpful for a large number of patients, but without question medicine has been commercialized.
His section on uncertainty is the best part of this book. He saved the best for last.
Nonetheless, I find his "laissez-faire" attitude to these problems even more worrisome.I find little actual feeling that he cared about his patients in this book. This is not surprising as it pervades medicine today.
I haven't found this book to be a thriller.It lacks depth of character. If he had connected with us and his patients emotionally I believe that it would have been a much more powerful work.
Complications; A Surgeon's Notes on an Imperfect Science April 3, 2008
Open, honest, sometimes frightening, sometimes amazing. An outstanding and humble reminder to readers that medicine is an imperfect science and doctors are not God. Not only worth reading, worth re-reading.
Surgery Patient Weighs in on Surgery Book March 31, 2008
As a double lung transplant recipient, I am bewitched by stories told from the medical professional perspective. Not unlike when I was in my early twenties and discovered the shocking truth that my parents were in fact human just like me, I have grown increasingly aware that those who perform superhuman tasks like surgery are also just people--neither superior or inferior to myself. This is both a comforting and scary realization and one that has prompted my new found hunger to understand life on the other side of the exam curtain.
Atul Gawande's book "Complications" seemed a perfect choice on this quest to discovering a window into the world of medicine and, in particular, surgery. While this proved true, I never anticipated the honesty with which Dr. Gawande writes of his experiences as a surgeon in training. At times his ability to expose the facades medicine uses to shield us patients from a physician's true lack of experience or confidence was almost too disturbing to take. I had to ask myself, "Do I really want to know this?" At other times, I felt vindicated in knowing that a suspicion I had about how things work was right on target. Often, I felt as though I was gathering useful inside information that would help me in advocating for myself in the future.
As a patient, it is obvious that the world of medicine is both astounding in what it can do and broken in the way patients are treated and systems are run. Perhaps what I appreciated most about "Complications" was Gawande's willingness to investigate some of these "elephants in the room." With the intelligence of a surgeon and the heart of a compassionate man, he takes an honest look at medicine's tendency to blame the patient (psychologically) when no other solution can be found for chronic pain. In an in-depth and unique way, he explores the delicate balance of physical conditions and human emotion in relation to obesity. Gawande walks the thin line between using all that medical science has to offer while still allowing room for the mysterious. He does not blame anyone, physician or patient, for what is unknown--he only analyzes it in such a way that this reader could not help but be changed. There are many parts of this book which have altered my perspectives forever.
I highly recommend this book--it is not overly technical and rarely boring.
Overall, I find myself hoping that Gawande is not a physician out on a limb by himself, but a representation of the evolution of medical attitudes and approaches to complex problems. A hospital full of Atul Gawandes? Now, that's a place I'd like to go for my healthcare.
Tiffany Christensen
Author of "Sick Girl Speaks!"
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