another book review

Better: A Surgeon's Notes on Performance by Atul Gawande

My review

rating: 5 of 5 stars
This is a great book. From it's title, I thought it was about how doctors figure out how to make their patients better. But instead, it is about how the medical profession makes itself and its performance better. Gawande classifies the methods he sees in several ways. First, there is diligence, doing right, and ingenuity. He explores these ideals while discussing the campaign to get doctors and nurses to wash their hands in hospitals, improving the field of obstetrics, saving the lives of more and more wounded soldiers, and improving life expectancy for people with cystic fibrosis. He emphasizes that improvement is possible, even with the tools and techniques we already have. We have to use them diligently, every day. It's not easy. At the end of the book, he has 5 suggestions for improving performance and generally making a difference in one's career. His audience is typically medical students, but these suggestions work for everyone:



1. Ask an unscripted question. In other words, get to know the people you are working with. They will mean more to you, and you will work with them better. It's just good for society, too.



2. Don't complain. Complaining drags us all down. I love to complain, so this is a hard one for me. But I also know that negative energy is infectious, and kill energy and creativity. But positive energy is also infectious. Neither he nor I am encouraging people to be chipper and annoying - just don't drag everybody down. Change the subject if necessary.



3. Count something. That I can do! Gawande's point is, find a question that interests you in your profession, and observe it. In order to improve performance, you need information on current performance, and also information on why current performance is what it is. So count something. Then give me the data and I will analyze it for you.



4. Write something. Gawande says you should show your writing to other people, write for an audience. I think that you can learn a lot about yourself and your profession through writing, even if no one else sees it. It helps to clarify thoughts.



5. Change. Don't be afraid to make changes when they are necessary.



Here is a quote that I like from the book, the essence of the book in one paragraph:



"Arriving at meaningful solutions is an inevitably slow and difficult process. Nonetheless, what I saw was: better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try."



Gawande is a good writer, and his essays are interesting individually. Despite what I might have indicated here, he does not preach. He provides examples and offers up the lessons he learned from them. And he writes about really interesting topics. In addition to the ones mentioned above, he writes about doctors who participate in executions, trying to innoculate 4.2 million children in 3 days in India with a polio vaccine, the difficult question of patients' dress (or lack thereof) during medical examinations, doctors' income, and the extreme and pedestrian steps that some surgeons must take every day to treat patients in public medical clinics in India. Interesting stuff, well-written, reads quickly.


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