Wednesday, May 7, 2008

Blood, Guts, Infection - WOW!

Complications: A Surgeon's Notes on an Imperfect Science
by Atul Gawande

I've always been fascinated with the gross. I watch ER and Grey's Anatomy for the trauma and surgery scenes as much as the juicy story lines. When my friends had cuts or stitches when I was a kid, I always asked to see them. I certainly don't wish illness or injury on anyone, but must confess to a morbid curiosity about all things medical. This is a book that E. read several years ago and really liked. I had been intending to read it for a long time, and finally picked it up a few days ago.

Atul Gawande is a general surgeon, a staff writer for The New Yorker, a husband, and the father of three children. He must not need much sleep. Complications is about the uncertainty of medicine, how even the best doctors often have to rely on intuition rather than hard facts because even with all the advances in science and diagnostic technology, there is still so much that we do not know. He also acknowledges that doctors make mistakes, and goes into great detail about the efforts made to prevent and minimize error. Gawande is honest about his own mistakes, but his passion for the skill of surgery and his compassion for his patients is evident.

Gawande has several interesting chapters about various medical phenomena that are common but about which we still are woefully ignorant. He discusses the physiology of blushing at length, and how for a very small percentage of people, uncontrollable blushing can be a debilitating condition. His chapter on the causes of nausea and vomiting, and their relationship to one another, is enough to make you run for an emesis basin. Except for when the vomiter is one of my own kids, the sight or sound of someone vomiting has always been enough to get me started. Complications says that studies show that "sympathetic vomiting" is a real deal, and there are physiological causes for it! I always thought I was just a wimp.

Gawande's chapter on necrotizing fasciitis, a horrible lethal infection, is enough to scare anybody. I won't even go into it, or you'll be frightened to death with the slightest break of skin, even a paper cut. Let's just say that Gawande's way with words is so adept that just visualizing fasciitis is enough to generate some of the aforementioned sympathetic vomiting. Ugh.

This is a compelling read, and you will finish it with a greater appreciation for the work of physicians and a heightened sense of awe at the beautiful complexity of the human body.

Reverent Reader


At 5/7/08, 12:00 PM , Blogger Roy said...


Thanks for this review. I have read his essays in the New Yorker and now I want to read the book.

The artful practice of medicine is not far from the artful practice of ministry.

All the best

At 5/7/08, 12:53 PM , Blogger Reverent Reader said...

Hey Roy -

Yes, I saw several similarities between the two vocations. Intuition is often a better guide than dogma, and instincts are powerful. You will like the book. He also has a newer one out called "Better" that Ed read and liked. If you would like to borrow "Complications" I could send it to you via Leann.

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