This is a must read, important book. I had never heard of it until a week or so ago when it was given to me by a doctor who lives in our street. It is stunningly written – very clearly with the least medical jargon possible. And the subjects it deals with are just so important.
I probably can’t do it justice. But here goes. He examines how doctors fail and succeed – using some fascinating examples. He then suggests that major advances in health may be more in the area of diligence and ingenuity than in pure medical research. Now that all sound pretty blah but it is the issues he tackles that are riveting.
There is a chapter on the really tough issue of making sure health professionals take the time to thoroughly wash their hands between patient contacts. He makes it clear that most bugs people get in hospital come from the health professionals. And just how difficult it is when doctors and nurses are rushing to get things done to be sure that they are not spreading infection. Nailing a solution to this issue would prevent wide scale suffering.
There is a chapter on the crusade to eradicate polio from the world and why it is diligence in the small things that make the difference.
Another chapter deals with war casualties and explains why mortality rates are now so much lower in war. But also highlights how many people with horrific injuries are now surviving in circumstances where it is not known how to give them any real quality of life going forward.
But the chapter that grabbed me the most was about executions in the
. Apparently the medical ethics require doctors not to participate in any execution but prison officials nevertheless find doctors and other paramedicals who will get involved. He talks to a number of doctors and discusses why they do it. I had never thought about capital punishment from this angle before. I won’t spoil it for you by saying what his conclusion was. US
So all in all, a book that should be of interest to everyone not just those professionally involved with health. After all we are all affected by these issues.
This is Gawande’s second book, the first one is called Complications. I am going to find a copy to read soon.