“Complications”

“Complications: Notes from the Life of a Young Surgeon” is a book by Atul Gawande, a surgeon, and writer. The book talks about the challenges and uncertainties in the medical field, especially in surgery. It gives a feeling of reading a thriller where there are twists and unexpected endings. Some of the stories within the book are quite hair-raising. Atul Gawande has a talent for sharing true stories in a captivating way. His writing style is so engaging that it feels like you’re right there with him in the operating room. While the use of medical jargon is limited, it’s advisable for non-medical readers to have a dictionary handy for reference.

“Complications” is divided into three sections: “Fallibility,” “Mystery,” and “Uncertainty.” It comprises a collection of 14 essays that offer fascinating and jaw-dropping anecdotes of medical procedures.

In the first section, “Fallibility,” Atul Gawande shares his own experiences as a surgeon. In the first essay, “Education of a Knife,” Gawande talks about how doctors, specifically surgeons, learn and improve their skills over time. He writes, “We need practice to get good at what we do. There is one difference in medicine, though: it is people we practice upon.” In his essay, “The Computer and the Hernia Factory” Gawande stresses following set routines and repeating procedures in order to achieve flawless precision. Gawande talks about the Shouldice Hospital as a notable example. This hospital focuses exclusively on hernia surgeries and has achieved exceptional success rates. The surgeons at Shouldice have performed these surgeries many times, becoming highly skilled and efficient. The hospital’s setup is specifically designed for hernia surgeries. They purposefully avoid having distractions like TV and do not offer room service to patients. These measures encourage patients to move around and be active, which helps them recover faster.

The second section, “Mystery,” deals with the enigmatic nature of medicine. Gawande explores the complexities of diagnosing and treating patients, along with the mysteries that can arise during medical emergencies. He also writes about the problem of obesity in this section. In his essay titled “The Man Who Couldn’t Stop Eating,” Gawande explains a fascinating case of an individual who had an uncontrollable urge to eat. The man struggled with his weight, reaching a shocking 400 pounds, ultimately demanding gastric bypass surgery. Gawande writes, “We are a species that evolved to survive starvation, not resist abundance”. Research findings consistently indicate that humans are increasingly prone to overeating, which can be due to the abundance of readily available and highly tempting food options.

The third section, “Uncertainty,” is about the inherent uncertainties that occur in medical practice. Gawande discusses the unpredictable nature of the human body and the limitations of medical knowledge. In the essay “Final Cut,” Gawande writes that for doctors, autopsies can arouse both fear that their mistakes will be exposed and relief that the outcome was beyond human control. In the past, various religions had objections to autopsies, and even today, they are mainly done for legal purposes. There have been instances where bodies were stolen from graves in the past. In his exploration of the autopsy’s history, Gawande highlights the case of Julius Caesar back in 44 BC. Julius was killed during a senate meeting and had 23 stab wounds on his body. His body was brought to his residence where it was examined by a doctor named Antistius. In the early 20th century, doctors practiced autopsies for discovering new diseases like tuberculosis and improving medical knowledge.

Through these three sections, Gawande weaves together intriguing cases and challenges within the medical field. Overall, the book gives an honest and real look at the medical profession. A must-read for medical students and for those who are looking for a completely new genre of literature.