Pdf Complications A Surgeon's Notes on an Imperfect Science

Trying to lose weight if no one is able to succesfully lose weight and keep it unless they are dangerous and intensive surgery I also to succesfully lose weight and keep it off unless they are dangerous and intensive surgery I also discouraged over the problems he presented that really have no attainable answersIn spite of my difficulty with his unanswerable uestions I appreciated Gawande s straightforward honesty about the medical profession and its weakness Ironically his admission of the fallibility of doctors and medicine makes me willing to approach a doctor It makes it asier for me to ask uestions if I don t Surgery for Cochlear and Other Auditory Implants expect the doctor to have all the right answersspecially if that doctor is willing to admit such a possibility I finished this book about a week ago and the next day my mom fell and f % broke her hip So this is NOT the type Of Book To Read Or Even Think book to read or Uncommon Leadership: How to Build Competitive Advantage by Thinking Differently even think when you have someone in the hospitalMost doctorsspecially surgeons are viewed as infallible but in reality they are just like us They have bad days they make mistakes and some of them should really change careersThe author writes Yoga Therapy for Insomnia and Sleep Recovery: Supporting People to Achieve Better Rest elouently with compassion and a clear love for surgery which made this a fascinating book to delve into Most of the stories felt anecdotal rather than a deep dive into the details which for a layman like me was perfectThe author also poses a lot ofthical uestions about the profession and how much patient autonomy should be allowed when making health decisionsIf you have any interest in medical memoirs you should try this author at least once Complications is a book of anecdotes about a surgical resident s xperiences and impressions of the current health care nvironment Gawande divides his stories into three sections fallibility mystery and uncertainty The fallibility section demonstrates that doctors can make mistakes Some fallibility arises from there being a learning curve For Extending Symfony 2 Web Application Framework example it is hard to do a central line correctly the first time But for a doctor to learn how to do a central line he must have a first patient to try it on The concern then arises as to which patients receive care from the inexperienced versus thexperienced Yet fallibility occurs in Angels Whiskey even the mostxperienced doctors Gawande reports on one doctor who became so careless that he was no longer allowed to practice The frightening part of that story is how long his colleagues let him continue when they had concerns The Doctor also brings up this issue It is understandable that doctors are reluctant to come down too hard on their colleagues They need Ritual Alliances of the Putian Plain: Volume Two: A Survey of Village Temples and Ritual Activities each other as a support system and thus need to maintain trusting relationships Further medicine is uncertain and it can take a long time to see a pattern of truly irresponsible behavior as opposed to just having complicated cases Gawande makes the point that discipline of doctors works best when it done by a group outside the doctors peer group ormployer because it is objective Then this outside group can propose a plan of action which the mployer can implement Unfortunately this model has been too xpensive to be much of a viable option The mystery section details stories of conditions that cannot be Wish You Were Here: An Essential Guide to Your Favorite Music Scenes—from Punk to Indie and Everything in Between explained by current medical science like blushing pain and nausea Inach of these cases the doctors could not The Day Christ Was Born explain why the patient had the condition Much of the time the patient just wanted the doctors to believe themven though there did not seem to be a physiological source of the problem It is interesting that the patient is willing to accept that there is no medical xplanation than the doctors Yet the doctors are the ones with the training and have probably seen many circumstances when they cannot make a diagnosis The uncertainty section deals with how to make the right diagnosis or judgment There are several points in this section that have come up in the other literature reviewed for this independent study First is the declining use of the autopsy The autopsy is how doctors can determine what was actually wrong with the patient It is the final way to get rid of uncertainty Its purpose is to help the doctors recognize such conditions in the future Yet autopsies are done less and less Although many times the family is opposed to the autopsy and will not allow it Another recurring point is the decision making power of the patient Patients have become pro active in their desire for decision making ability but they are much ambivalent about actually xercising it Especially in situations where there is uncertainty patients do not feel comfortable or motionally able to make the decision Some do not think they can handle the responsibility if it turns out to be the wrong decision Gawande notes that doctors also prefer to make the decision One of the things he had to learn as a resident is how to persuade patients to the decision he thinks is best As health care becomes consumer driven the debate over the level of physician agency is likely to continue This book wss filled with about 25 anecdotes flimsily tied together by Gawan. Inching view from the scalpel’s dge Complications lays bare a science not in its idealized form but as it actual. Read these sentences and tell me that this writer isn t an unbearable idiot If choice of one s surgeon cannot go to veryone maybe it is better t an unbearable idiot If choice of one s surgeon cannot go to veryone maybe it is better it is not allowed at allTaking time to bond with patients is fine but Trickle Down Tyranny: Crushing Obama's Dream of the Socialist States of America every X ray must be tracked down andvery drug dose must be The Pocket Wife exactly right Hospital lawyers warn docto Let s play the who wants to be horrified game Complications made it hard to sleep Not because of gore necessarily but because it made clear to me that doctors are just people who were given a scalpel Yes they have a ton ofducation but at some point they must get xperienceIn one section Gawande discusses a procedure in which he must put in a central line which goes into a major vein in your chest which can which he must put in a central line which goes into a major vein in your chest which can kill you All he tells the patient is that he must put in a central line not that it is dangerous or that it is his first time doing this procedure I completely understand why he didn t tell the patient but that doesn t make it any less terrifying I have thought about how doctors have to start at some point but it was never so clear to me that there is a first patient for very procedure for very doctor For very surgeon there will be the first surgery There is a first time for cutting into the flesh of a still living personIt was published in 2002 so I m sure some things have changed but it s still current Obsession enough about how the training takes placeIt s an important realization of how much control doctors have over our bodies and how little they have oververything Cabaret: A Roman Riddle else in the hospital They don t get to chooseFor the full review please visit Practice is funny that way For days and days you make out only the fragments of what to do And then one day you ve got the thing whole Conscious learning becomes unconscious knowledge and you cannot say precisely how I have always been intrigued by medicine I know it s a scary thought but inevitably illness will impactach of us in one way or another Either we will get sick or somebody we love will get sick Which is why learning about medicine and healthcare is so important However a lot of books about medicine and healthcare can be pretty dry which is where Dr Gawande comes to the rescue His clear prose makes ven the most difficult medical concepts asy to understand In this book Gawande is just starting out his medical career Like most new graduates Gawande is xcited yet nervous about the new challenges that await him in the workplace But he soon re Not uite a 4 star read but close nough It s fairly short does make his major points fairly well They boil down to medicine isn t perfectDoctors are humans so need to learn will make mistakes All Roads Lead Home even with the best intentions Do I want a doctor to learn on me or mine Hell no Gawande admits that he doesn tither he makes sure they don t BUT we won t get any new ones if they don t start somewhere So what s the solution There isn t a good one Deal with itPatients are humans so they re complicated They do things that are bad for them all demand the highest level of care Since the mid 80 s they ve been getting say in what their treatment is often they re not well uipped to do so ither due to ignorance or just feeling like crap Balance between what the doctor recommends what the patient wants is toughMedicine has come a LONG way in a short time but they still don t know a lot As it becomes complicated it s tougher for doctors to stay on top of ven their specialty Unspoken but obvious in the subtext is that it takes people to do the job a lot depends on very one thing s availability doing their job properly Facilities are often stretchedOverall it was an interesting tour inside the field from a young surgeon s point of view I think this was his first book it suffered a bit from that It s also a bit dated in some respects having been written 15 years ago or so Still it s well worth reading 45 starsI had a great time reading this with Heidi from My Reading Life The book is broken up into three sections named for ideas that vex doctors Fallibility Mystery and Uncertainty He looks at the way surgeons are The Mephisto Threat (Paul Tallis educated advancements in medicine hard to pin down diagnoses and with a liberal sprinkling of fascinating casesThe pacing is perfect there aredge of your seat moments to see if a patient makes it and he brings up thical issues that appear in his later books such as medical rror and treatment decisio Although I am interested in the medical profession motivation to learn about it often lludes me Gawande was able to keep my attention and present points that I could understand in spite of my limited medical knowledgeAdmittedly some of his information scared me After reading some points about surgery I wondered how I ver allowed anyone to cut into me and place a plate and seven screws in my leg Also some of his writing made me sueemish I had to pause or skip places that became too graphic for my weak stomach Some of his writing discouraged me Why am In vivid accounts of true cases surgeon Atul Gawande xplores the power and the limits of medicine offering an unfl. ,
De s less than inspiring reflections I HAVE THE BOOK IN FRONT the book in me at the moment and I am paging through rereading sections that I noted along the wayI had come into residency to learn how to be a surgeon I had thought that meant simply learning the repertoire of move and techniues involved in doing an operation or making a diagnosis In fact there was also the new and delicate matter of talking patients through their decisions something that sometimes ntailed its own repertoire of moves and techniues pg 217Next to this paragraph I had written NO SHITThe book is full of these minor pseudo piphianic moments that come off as weak aphorisms However given the audience of this book veryone he does well to treat people about how uncertain medicine really is and how it really comes down to the tricky is and how it really comes down to the tricky of making decisions and how they should be made in the medical settingBut the conundrum remains if both doctors and patients are fallible who should decide We want a rule And so we ve decided that the patients should be the ultimate arbiter But such hard and fast rule seems ill suited both to a caring relationships between docotr and patient and to the reality of medical care where a hunderred decisions have to be made uickly The doctor should not make all of these decisions and neither should the patient Something must be worked out between then one on one a personal modus operandi Where many thicits go wrong is in promoting patient autonomy as a kind of ultimate value in medicine rather than recognizing it as one value among othersAs the field grows ver complex and technological the real task isn t to banish paternalism the real task is to preserve kindness pg 223 4This simply makes sense nothing new hereThe best part of the book is the last two paragraphs and is all you really need to read have said that you have read the book in my opinionThe possibilities and probabilities are all we have to work on within medicineWhat we are drawn to in this imperfect science what we in fact covet in our way is the alterable moment the fragile but crystalline opportunity for one s know how ability or just gut instinct to change the course of another s life for the better In the actual situations that present themselves however we can never be sure whether we have such a moment or not Even less clear is whether the actions we choose will prove ither wise or helpful That our fforts succeed at all is still sometimes a chock to me But they do Not always but often nough pg 251 2In a way the whole thesis of this book which I think is summed up in the sentence in bold above is pretty remarkable There is so much talk about the fallibility and humanity in medicine right now fallibility is so hot right now However as is apparent in this book the medical community is only at the stage of recognizing this fallibility Gawande doesn t do what I thought he would suggest what we should do given the increase visibility of the fallibility of the practice of medicine He really doesn t have any good ideas In all his articles he seems to be advocating a technocratic answer using checklists tc The biggest problem I have with the book is the way Gawande seems to view the profession medical community of independently acting people who in the aggregate are not too of an impressive lot In this Gawande is ntirely old school He fails to recognize the possibility of alternative ways to approach patient care In a way I think that he is dangerously anecdotal Maybe it is just me being tired of reading anecdotal medical non fiction but it just seems like a lame format don t hold these words against me because I really don t know what I am looking for or what type of book I would write He treats them like data points I believe that the book could be reduced by about 80% for someone like you or I who are as far in the medical field as we are However I believe there to be value within this book I am really really happy that millions of people future patients are reading books like this and Groopman s How doctor s think as it really does ducate them to get real about what medical care is all about It will serve to mpower people and get them involved in their care and think about how they want it to go down But to me I really did xpect a lot from this guy The reviews that it got are ridiculous they are way over the top It is pretty incredible it goes to show how The Perfect Christmas Gift easy it is to be heard once you have written for the New Yorker and got a MD from Havard I will keep reading his books though for no other reason than that he is so hot right now millions are reading him I at least have to know other people are thinking about A year or ago I mistakenly placed a review for Gawande s book Better under this title I have fixed the mix up and I have now read ComplicationsGawande is pure pleasure to read His writing is fluid and full of germanexamples as he addresses big issues like rror and incompetence as well as Ly is uncertain perplexing and profoundly human  Complications is a 2002 National Book Award Finalist for Nonficti.

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Complications A Surgeon's Notes on an Imperfect Science