Cover image for Complications : a surgeon's notes on an imperfect science
Complications : a surgeon's notes on an imperfect science
Gawande, Atul.
Personal Author:
First edition.
Publication Information:
New York : Metropolitan Books, 2002.
Physical Description:
x, 269 pages ; 22 cm
Fallibility -- Mystery -- Uncertainty.
Format :


Call Number
Material Type
Home Location
Item Holds
RD27.35.G39 A3 2002 Adult Non-Fiction Non-Fiction Area
RD27.35.G39 A3 2002 Adult Non-Fiction Open Shelf
RD27.35.G39 A3 2002 Adult Non-Fiction Open Shelf
RD27.35.G39 A3 2002 Adult Non-Fiction Open Shelf

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A brilliant and courageous doctor reveals, in gripping accounts of true cases, the power and limits of modern medicine.

Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is -- complicated, perplexing, and profoundly human.

Atul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur and why good surgeons go bad. He also shows us what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause; a young woman with nausea that won't go away; a television newscaster whose blushing is so severe that she cannot do her job. Gawande offers a richly detailed portrait of the people and the science, even as he tackles the paradoxes and imperfections inherent in caring for human lives.

At once tough-minded and humane, Complications is a new kind of medical writing, nuanced and lucid, unafraid to confront the conflicts and uncertainties that lie at the heart of modern medicine, yet always alive to the possibilities of wisdom in this extraordinary endeavor.

Complications is a 2002 National Book Award Finalist for Nonfiction.

Author Notes

Atul Gawande is a surgical resident in Boston and staff writer on medicine and science for The New Yorker. A former Rhodes scholar, he received his M.D. from Harvard Medical School. He lives with his wife and three children in Newton, Massachusetts.

(Publisher Fact Sheets) Atul Gawande is a surgeon at Brigham and Women's Hospital in Boston, a staff writer for The New Yorker, and a professor at Harvard Medical School and the Harvard School of Public Health. He is also the Executive Director of Ariadne Labs and chairman of Lifebox, a nonprofit organization making surgery safer globally.

He has written several books including Complications, Better, The Checklist Manifesto, and Being Mortal: Medicine and What Matters in the End. He has won the Lewis Thomas Prize for Writing about Science and two National Magazine Awards. He will be appearing at the 2015 Auckland Writers Festival in New Zealand. He won the prize for Adult Non-fiction in the Indies Choice Book Awards 2015 with Being Mortal: Medicine and What Matters in the End.

(Bowker Author Biography)

Reviews 2

Booklist Review

New Yorker readers will recognize writer-physician Gawande because of his article on the TV anchorwoman with an almost career-ending blushing problem. He exhibits the same smooth, engaging style and choice of unusual subjects in the 13 pieces in this collection, many of which amount to medical detective stories. Typical of those is the last piece, about a young woman who had, it seemed, a simple rash on her leg. But Gawande had earlier seen a patient with necrotizing fasciitis, the flesh-eating bacteria of tabloid fame, and had an uncomfortable hunch that he pursued with his fellow surgeons and a dermatologist. The rest of the tale illustrates the emotions and reactions of the patient and her father as well as the role of the hunch in science. Several entries deal with medical ethics, considering doctors who "go bad" and the long-time failure of doctors and their organizations to police the profession, and whenever Gawande depicts the regular morbidity and mortality conferences in hospitals, he is downright riveting. William Beatty

Publisher's Weekly Review

Medicine reveals itself as a fascinatingly complex and "fundamentally human endeavor" in this distinguished debut essay collection by a surgical resident and staff writer for the New Yorker. Gawande, a former Rhodes scholar and Harvard Medical School graduate, illuminates "the moments in which medicine actually happens," and describes his profession as an "enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line." Gawande's background in philosophy and ethics is evident throughout these pieces, which range from edgy accounts of medical traumas to sobering analyses of doctors' anxieties and burnout. With humor, sensitivity and critical intelligence, he explores the pros and cons of new technologies, including a controversial factory model for routine surgeries that delivers superior success rates while dramatically cutting costs. He also describes treatment of such challenging conditions as morbid obesity, chronic pain and necrotizing fasciitis the often-fatal condition caused by dreaded "flesh-eating bacteria" and probes the agonizing process by which physicians balance knowledge and intuition to make seemingly impossible decisions. What draws practitioners to this challenging profession, he concludes, is the promise of "the alterable moment the fragile but crystalline opportunity for one's know-how, ability or just gut instinct to change the course of another's life for the better." These exquisitely crafted essays, in which medical subjects segue into explorations of much larger themes, place Gawande among the best in the field. National author tour. (Apr. 4) (c) Copyright PWxyz, LLC. All rights reserved



When you are in the operating room for the first time and see the surgeon press his scalpel to someone's body, you either shudder in horror or gape in awe. I gaped. It wasn't the blood and guts that enthralled me. It was the idea that a mere person would ever have the confidence to wield that scalpel. I wondered how the surgeon knew that all the steps would go as planned, that bleeding would be controlled and organs would not be injured. He didn't, but still he cut.Later, I was allowed to make an incision myself. The surgeon drew a six-inch dotted line across the patient's abdomen and then, to my surprise, had the nurse hand me the knife. It was, I remember, still warm. I put the blade to the skin and cut. The experience was odd and addictive, mixing exhilaration, anxiety, a righteous faith that operating was somehow beneficial, and the slightly nauseating discovery that it took more force than I realized. The moment made me want to be a surgeon -- someone with the assurance to proceed as if cutting were routine. Excerpted from Complications: A Surgeon's Notes on an Imperfect Science by Atul Gawande All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.

Table of Contents

Author's Notep. 1
Introductionp. 3
Part I Fallibility
Education of a Knifep. 11
The Computer and the Hernia Factoryp. 35
When Doctors Make Mistakesp. 47
Nine Thousand Surgeonsp. 75
When Good Doctors Go Badp. 88
Part II Mystery
Full Moon Friday the Thirteenthp. 109
The Pain Perplexp. 115
A Queasy Feelingp. 130
Crimson Tidep. 146
The Man Who Couldn't Stop Eatingp. 162
Part III Uncertainty
Final Cutp. 187
The Dead Baby Mysteryp. 202
Whose Body Is It, Anyway?p. 208
The Case of the Red Legp. 228
Notes on Sourcesp. 253
Acknowledgmentsp. 265