An informative and thought-provoking book about achieving excellence
Jan 9, 2009
In any human endeavor, variations of performance create a bell curve and most participants are average or below average. Dr. Atul Gawande explores the challenge of practicing medicine and striving to be a "positive deviant" on that curve. Better: A Surgeon's Notes on Performance explores the pursuit of perfection in several areas of medical practice. Athletes, he writes, teach us a lot about "the value of perseverance, of hard work and practice, of precision. But success in medicine has dimensions that cannot be found on a playing field. For one, lives are on the line." (p. 4)
Several chapters of this book appeared first as articles in periodicals. Though the book follows a fascinating theme, do not expect it to be as well-integrated as Complications: A Surgeon's Notes on an Imperfect Science. The overall message is the dialectic between strict adherence to practices known to work (hand-washing) and an inspired ingenuity. How to achieve both?
There is much interesting material here: the WHO campaign to eliminate polio, the history of Cesarian sections in obstetrics, the ethics of assisting in the death chamber, the story behind longer life span for cystic fibrosis patients. These and other chapters are tied together by the quest for improvement of outcomes.
The afterword encapsulates Dr. Gawande's advice to medical students on making a difference in people's lives, and it alone is worth the price of the book. "It often seems safest to do what everyone else is doing ..." he writes in closing. "But a doctor must not let that happen--nor should anyone who takes on risk and responsibility in society."
Altogether this is an informative and thought-provoking book with lessons that go beyond the specifics of medical practice.
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