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A surgeon’s notes on an imperfect science

Atul Gawande

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Complications Summary

Hi, welcome to Bookey. Today we will unlock the book ‘Complications: A Surgeon’s Notes on An Imperfect Science’.

In the minds of the general public, the terms “surgeon" and “medicine” are always associated with rationality, accuracy, and order. Whenever people discuss these topics, the first images that appear in their minds are angels working in white robes, clinics, medicine, machines, surgeries that fight diseases, and amazing scientific breakthroughs that could extend human life. These impressions are certainly correct, but do not reveal the whole story. People often come to surgeons as patients who want to be healed. However, people don't have the opportunity to actually get close to them: to see their eyebrows furrow when faced with complicated medical cases, or to learn about the other side of both them and medicine.

Today, this book is going to show you that other side. The title of this book, “complications”, is a pun: it both functions as the medical term “complication" and the commonly used word “complication”. The title encapsulates the complexities doctors face. It vividly captures the world surgeons are in a world full of uncertainties. Surgeons can sometimes be at a loss and find it difficult to make decisions when the factors that need to be considered are too complex to make a choice. This is the exact essence of medical exploration: surgeons have to transcend various complexities and pursue perfection.

This is a meditative book on medicine written by a surgeon, who is an insider on the matter. However, the author, Atul Gawande, is not an ordinary insider. He is a professor at the Harvard Medical School, the youngest advisor in the Department of Health and Human Services, a key figure in Obama's Medical Reform Policy, and a MacArthur Fellow. What is even more praiseworthy is that he is not only good at medicine, but also at writing. He is said to be the best writer among surgeons, as seen in the column that he writes for the New Yorker. Three of his four published books are New York Times Best Sellers.

This book is both the first of Atul Gawande’s famous medical trilogy, and is his masterpiece. In this book, Atul Gawande shares the unforgettable stories he experienced during his eight-year surgical training. He demonstrates the complexities that doctors face from all sides and documents their mental developments as they struggle with these complexities.

Next, we will explore what these complexities are using three categories: diseases, patients, and surgeons, and show you how surgeons transcend complexity and strive for perfection in the midst of imperfection.

First, we will give an overview of the complexity of diseases. You will learn that medicine is not omnipotent and that there are still many unsolved medical problems. Treatments for some diseases are still imperfect;

Second, we will look at the particularities and complexities of individual patients. We will learn why surgeons may sometimes make a misdiagnosis, why there is no universal solution for the same diseases, and what surgeons should do when patients make medical decisions that can be harmful to themselves;

Finally, we need to understand the complexity of surgeons’ decision-making and see the major challenges that every surgeon faces.

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