Better: A Surgeon’s Notes on Performance

Atul Gawande demonstrates his intuitive eye for captivating storytelling – the ability to spin a primarily scientific endeavour into an affecting narrative. Each description is sprinkled with the personal (perhaps unnecessary, from a medical viewpoint) details characteristic of a gripping novel, persuading even the least medically inclined readers that yes, it is pertinent, it is relatable, and it is certainly deserving of their attention. Above all, he has an extraordinary talent for making people care.

Better, his second book, is noticeably less personal that his first. Of course, Gawande still makes sure to thoughtfully contemplate, to paint the picture from his perspective. In fact, the most memorably section is the Afterword, which offers five concise suggestions for, very fittingly, becoming a better doctor or medical student. These suggestions were all drawn from his personal experiences. What do I mean by ‘less personal’ then? In Complications, like in Oliver Sacks’ renowned publications (see The Man Who Mistook His Wife for a Hat), many of the chapters focused on one or two cases that he was responsible for. The subsequent discussions were all anchored to these cases. In Better, however, many of the ‘cases’ were operations on a national, sometimes international, scale. Gawande travelled across states and continents to better understand these proceedings with unwavering determination, but the spotlight was no longer just illuminating his individual performance.

In my opinion, this made Better an even better read. It repeatedly reminded me that even if every doctor, nurse, pharmacist, technician, intern, government official relentlessly tried their very best to do better, the overall medical system is as at fault as these individuals in any room for improvement. The system in question can be a single hospital, a local healthcare plan, government policies or international NGOs. Furthermore, the victories are in the most mundane details – steady supplies of basic materials (a scalpel, a simple plastic tube), fundamental sanitary practices (washing hands)… Consistently establishing these as the routine can save significantly more lives than radical discoveries, but receives much less funding and attention than laboratory research.

To conclude, I highly recommend Better to anyone vaguely interested in the medical industry. It will pose questions, answer them, and make you want to ask even more. And it might even overturn how you think of medicine itself.

Rating: 4.5/5