Atul Gawande is a general and endocrine surgeon of Indian origin, practising in Boston. So what makes his latest book Better: A Surgeon's Notes on Performance relevant to us half the world away?
Well, it's a find for regular readers, almost as much as for all those idealistic medical students out there. And I have to say, I think fellow doctors could do worse than to flip through Better. Gawande, a Rhodes Scholar, writes seemingly common-sensical stuff, but with an edge. Take, for example, the importance of 'Washing Up' (Chapter 1), when it comes to doctors, nurses and other medical staff.
"Rising infection rates from superresistant bacteria have become the norm around the world" - this I've definitely read about. But what really hits home is Gawande's description of a team's effort to get all the medical staff to clean up and how even a SEVENTY per cent compliance rate isn't good enough...How hospital-acquired infections like MRSA aren't going away...How it could have been him, who first saved a 62-year-old man's life, and then quite possibly gave him MSRA. And if not him, then definitely someone on his team...A chilling thought - when our healers are the source of infection, and why? No time to remember the basics.
Gawande also tags along with a WHO paediatrician for a polio-mop up operation in Karnataka. And he witnesses some of the ignorance that fuels bias, as well as other challenges along the way. The questions he lists as coming from villagers, local doctors...'Why a polio drive when "diarrheal illness kills 500,000 indian children a year"? Why a polio drive given outbreaks of malaria, TB, cholera...Why a polio drive when there's a huge need for better nutrition.'
But as he's given to understand, eradicating polio in itself is a mammoth achievement, with the end perhaps in sight. And with India, the world.
But of course we know that since his 2003 trip, it's still very much an uphill struggle in the country...an uphill struggle costing billions of dollars.
But the book also addresses other issues, like male doctor/ female patient etiquette and the relevance of chaperones (I'm instantly in flashback mode, wishing one of my old Defence Colony-based doctors was more up to speed on stuff like this...)
And then Gawande gives some insight when he tracks down 'The Doctors of the Death Chamber' to find out doctors who perform the lethal injections when convicts are killed. Doctors as executioners, not as healers, and how that ties in with the Hippocratic Oath.
So what is it about the book? Well, it's well-written, which really does befit a series of essays that have appeared in The New Yorker...But it's not just the information, but also the real-life stories, the real-life patients. From 72-year old Thomas to the passing of his relative, the 12-year-old Callie...Gawande uses these stories powerfully.
There's trivia you might enjoy reading...from the most basic birthing manoeuvres, to the story of the forceps, to magical mini-stories of healing and learning...it's a regular pop-medical journey alright!
Non-fiction of a story-book sort and maybe the messages come in a little too pat at times, but there's no doubt about it, writing comes easily to this doctor.
Oh, and apart from being a Rhodes Scholar, Dr Gawande's received a Macarthur Grant, has written an earlier book Complications: Notes from the Life of a Young Surgeon and regularly writes for The New Yorker. Makes you feel like a regular little under-achiever!
Better - A Surgeon's Notes on Performance is a Penguin title, priced at Rs 250/-. Dr Gawande's earlier book Complications: Notes from the Life of a Young Surgeon is also available in paperback for Rs 250/-.
Read more about the man behind the title here.
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