Complications - A Surgeon's Notes on an Imperfect Science (Hardcover, First)

Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is--complicated, perplexing, and profoundly human. Atul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made. He investigates such enduring mysteries as the nature of pain, the inability to cure nausea, even the little-understood biology of blushing. He explores how deadly mistakes happen, and why good doctors go bad. He also gives us privileged entry into the inspiring world of ambitious operations, remarkable experiments, and unexpected intuitions. And through it all, we find Gawande's deep concern with the actual experiences of patients and doctors as they negotiate the paradoxes and imperfections inherent in caring for human lives. At once unsentimental and humane, Complications is a new kind of medical writing, nuanced and lucid, unafraid to confront the conflicts and uncertainties that lie at the heart of modern medicine, yet always alive to the possibilities of wisdom in this extraordinary endeavor. From Complications: I had just finished examining someone in the ER when one of the physicians stopped me with yet another patient: twenty-three-year-old Eleanor Bratton had a red and swollen leg. "It's probably only a cellulitis" --a skin infection--"but it's bad," he said. He had prescribed intravenous antibiotics, but he wanted me to make sure there wasn't anything "surgical" going on. The patient looked fit and athletic. There did not seem anything seriously ill about her. I glanced at her chart--she had good vital signs, no fever, and no past medical problems. I asked Eleanor if she had had any pus or drainage from her leg. No. Any ulcers? No. A foul smell or blackening of her skin? No. I le