Atul Gawande is a talented writer. Reading this book was not only enthralling, but effortless. I missed my train stop I was so involved in the book, and I nearly missed my bus stop later that same day for the same reason.
The most remarkable and enjoyable aspect of the book for me was the way in which he approaches the subject matter. He writes using several anecdotes to demonstrate how complex and unknown medical science is, and especially to show how utterly human an endeavor it is to be a doctor or a patient. Medical science is something that is relatively idealized in our society, and the ways in which we litigate and talk about medicine in many respects expects and demands a certain level of perfection that is simply inconsistent with who we are as beings - fallible, imperfect, working with knowledge of processes that are still rather mysterious, in situations that often require quick decisions based on a combination of knowledge and intuition.
Reading such a honest account of how things work, what struggles and worries present themselves in various situations was so refreshing. Not only that, but he was honest in a way that showed his acceptance of his accountability for his choices and actions. Rather than coming away with a wariness or fear of medical practice because of the honesty involved in the narrative, I came away with a deeper respect and admiration for doctors and their willingness to take on the responsibility of their choices that have such a tangible, physical, and often emotional impact on their patients. The chapter that talked about who should be making medical decisions was especially touching in that regard - that we push for patient autonomy (which is a good thing) and yet at some point we recognize that we may want doctors to make the decisions for us so that we don't have to live with the accountability for the outcome. What a human way to look at the kinds of choices doctors and patients make. I also really liked the chapter that talked about 'bad doctors' and rehabilitation - how to work with the acknowledgment that doctors suffer from the same kinds of issues we all do, and these issues can affect their performance just as they would affect any of us in our work performance. Obviously, the consequences may be more dire than for some other professions, and so how these doctors are dealt with matters, but how we treat them as human beings matters too. And sometimes choices are made that have lasting consequences that just have to be accepted. This is just a part of life in general, and it made the experiences of doctors and patients accessible. The point wasn't just the honesty of it all, but the responsibility and accountability of it all. I felt a more profound connection to and compassion for those who work in the medical profession after reading this book. Which, I think, happens more often than not when we are honest with others about our experiences, weaknesses, and mistakes.
I feel that so often people get caught up in not making mistakes in general, and so often try to crucify those who do make mistakes (of course, this tends to be amplified depending on what level of perfection we expect from someone, say, in a particular profession), that narratives of our honest experiences that come from an accountable perspective are sorely needed. We need to acknowledge and understand that none of us are alone in our imperfection. I only wish that there were more narratives like this - that relate our actual experiences as human beings in an honest light. A wonderful read.
