Wednesday, July 14, 2010

Complications, by Atul Gawande

4 out of 5 stars
Total read in 2010 so far: 79
(Also posted on my Goodreads profile here.)

Recently I had to see a doctor for something that was bothering me. I went to my normal family physicians group, who referred me to a gastroenterologist, and eventually had to have a couple procedures in the hospital before I was offhandedly diagnosed with IBS. I say "offhandedly" because that's what it was: the gastroenterologist at first said I seemed to have had some kind of stomach bug that threw me out of whack, and then, when I asked further, finally said "Yeah, I think you have IBS." He didn't tell me what kind of foods I might try avoiding, only to take a probiotic every day, and didn't give me much more information.

I walked out of his office feeling a little confused. The doctor seemed almost dismissive of everything I had explained to him even though he was willing to do tests in the hospital. So when I read this book, I kept thinking of that office visit, which was rather unlike other visits I have had with other doctors, who have always seemed willing to listen and be open. By the end of the book I was kind of wishing that Atul Gawande (or any of the other good doctors mentioned in the book) were my doc. I enjoyed Dr. Gawande's openness and his very thoughtful approach to medicine. So often doctors are looked upon as omniscient beings with the whole of medical science at their fingertips, but Gawande blasts away this notion and effectively conveys that they are just as human as the rest of us.

A few things bothered me about the book: at times Gawande seems almost too thoughtful, making him seem hesitant and ineffectual; many of his stories are from him just starting out, which may have contributed to this impression. Also, he seemed at times a bit reserved from the patient themselves, reporting simply the facts and very little emotion. It seemed at odds with the way he made sure to follow up with many of his surgical patients at their homes, and the way he still remembers such specifics years later. Perhaps some of the emotional writing would have gotten in the way of the story, but it was hard for me to see the patients beyond simply what was wrong with them.

I was surprised to see that this book was published in 2002. A few things about it seemed somewhat dated. I would have pegged it at 1995 or thereabouts.

All in all, a solid book. I enjoyed it even if I didn't get much insight into why my gastroenterologist was so rushed (unless he's like the surgeon in the book who works 80 hours a week to pull in a $400k income and seems surprised when he gets burned out). But I certainly learned a lot about the way hospitals work and the way doctors think.

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