Lady Mendl was an incredible person,- self-made in proper American tradition on the one hand, for she had been haunted by the poverty of her childhood, and the years of struggle up from its ugliness,- until she became synonymous with the exotic, exquisite, worshipper at beauty's whrine. And his hostess was Lady Mendl (Elsie de Wolfe), arbiter of American decorating taste over a generation. For Bemelmans was "the man who came to cocktails". For young doctors wondering how they can make an individual difference, Gawande suggests five strategies: Ask unscripted questions, don’t complain, “count something” (be a scientist as well as a doctor), write something (to make yourself part of a larger world) and change in response to new ideas.Ī must-read for medical professionals-and a discerning, humanizing portrait of doctors at work for the rest of us.Īn extravaganza in Bemelmans' inimitable vein, but written almost dead pan, with sly, amusing, sometimes biting undertones, breaking through. Monitoring and improving clinical performance would do more to save lives than advances in laboratory knowledge, he contends. When such information is available, medical professionals can identify the best performance and learn from it, as Gawande illustrates with an account of exceptional results in treating cystic fibrosis at Babies and Children’s Hospital in Cleveland. He lauds the innovative thinking of Don Berwick, head of the Institute for Health Care Improvement, who is challenging the medical profession to measure and compare the performance of doctors and hospitals and to give patients total access to that information. A similar rating scale for every medical encounter, he believes, would inform patients and improve the performance of doctors and hospitals. Discussing ingenuity, Gawande shows how the rating scale devised by Virginia Apgar, neither an obstetrician nor a mother, transformed the practice of obstetrics. The section on doing right tackles such troublesome moral issues as whether doctors should participate in executions and at what point treatment of a patient becomes mistreatment and should be stopped.
Being diligent about the simple act of hand-washing dramatically reduces hospital infections, he demonstrates, and through diligence, army surgeons in Baghdad have greatly enhanced the survival rate among casualties in Iraq. Gawande illustrates each of these qualities with stories from his own experience, as well as his observations of and conversations with other physicians.
“What does it take to be good at something, when failure is so easy?” asks writer/physician Gawande in his follow-up to Complications (2002).ĭiligence, ingenuity and “doing right,” he answers.
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