Well, for those who may not understand the title (AKA most of the world), I just finished Atul Gawande’s book Better. And if I wasn’t already considering medicine as a possible profession, here he goes, both oddly convincing me and pushing me away from it simultaneously. Somehow. That’s just what happens with this book. Really great book in general. But I can’t tell if I’m encouraged or discouraged by it.
Let’s go back to the premise of this book. For those of you who can actually see my picture of this well enough, it’s a book about surgical performance and improving medicine. Atul Gawande is a surgeon, and this book is his reflection on medicine – as a business, an industry, a moral obligation, a way to save lives. It’s told through anecdotes supporting three main points, the three things that we need to be “better”: diligence, doing right (some or a lot of which involves having humanity), and ingenuity. These stories, mostly chronicles of others in medicine, or their experiences, are woven together by Gawande’s narrative, adding his opinions, sometimes going against the story that was just presented. Sometimes things are really clear – you work as hard as you possibly can to save someone’s life. As hard as you can. Harder than you think you possibly can. Harder than that. At other times the subject matter is more complex. Should doctors be involved in death sentences of criminals? Is it right to have the death sentence at all? No matter how apparently deep or shallow, Gawande brings together all of these tales and tries to make sense of the morally- and intellectually-complex world of medicine out there.
I was intrigued by this book right away. I found it at one of my favorite used bookstores, and knew that I wanted to read it, and pretty soon too. Granted, I was craving a good read-then-examine-your-life book. We completed self-reflections for class, and I wanted a book to put me in that mindset too. So I pulled this one off my shelf after I finished Fahrenheit 451 (review to come soon), and set to it.
It’s pretty well-written. Gawande makes some great points. I now know that if I ever go to med school, I will wash my hands about five hundred times a day, no doubt about it. I get obsessive-compulsive about these things sometimes. His advice at the end, the five points for how to be a positive deviant, are wonderful and useful, and slightly reminiscent of Adam Grant’s “how to implement being a giver” points at the end of Give and Take. Yet at times the book also seems a bit more crude than I would have thought – the stories he uses change really quickly at certain parts; one person one moment, then another the next, then he returns to one but it’s hard to remember which is which. Other times he sticks to one perspective, which is incredibly helpful as a reader, and strengthens his argument quite a lot. Plus, at points where the subject matter can be controversial, it sometimes seems like he’s thinking on the page. It doesn’t always seem like he has previously developed an opinion but is just now figuring out what he thinks in front of the reader. Not necessarily bad, not necessarily good.
What was hardest for me in reading this book was my personal shift back and forth during it. I have long been drawn to medicine as a career possibility. Gawande encourages that (mostly), but also somewhat discourages it in little ways. Medicine is hard. I get that. I will never understand it now as he does, given his experience in the industry. Some of the things he says, or just the tone attached, seem a bit discouraging to people looking to enter the industry. [I acknowledge I’m not giving specific examples here, and I apologize.] It just confused me that he switched between this almost “let’s go medicine, we save people!” tone and “this is hard and no one really wants to do these certain aspects so maybe it’s not the best idea to get involved.”
Mostly, what I took away from this book is that we can always get better. I will own up to my failings when working in groups, but in order to get better, we have to work together. Gawande mostly says, “Let’s get better together, on the little things. Not the big innovations, but the small practices. We’ll see what that brings, but I suspect it will have a much more profound impact than something huge in the first place.”
Better gets four stars from me. It’s overall an informative, interesting read (relatively quick), while generally saying that we can always improve, both as individuals and on a bigger scale. Writing is easy to understand, points get across clearly, and the stories used are strong (especially the lymphoma one – I was really emotional for that one). I feel it needs to clarify its tone, though, and maybe just say this: medicine is hard. If you don’t want to do it, and if you don’t want to tackle all of these challenges and consistently work to get better, then don’t start. But if you really want to, you can do magnificent things. (Perhaps this is me projecting what I want to hear, but I feel it’s an underlying current in this book already.)
Anyhow, I should read more of The Brothers Karamazov (or TBK or The Brothers K, whichever abbreviation our group uses that you’d prefer). We’re reading upwards of 65 pages per night. Philosophy and Dostoevksy and it’s a bit crazy but lots of fun. Plus, I have more hypars to fold for my other project. Will post pictures soon!
Have a great day! Read on! Give onions! (and kudos if you got that Karamazov reference)