Better by Atul Gawande
June 23rd, 2008Title: Better
Author: Atul Gawande
Publisher: Metropolitan Books (2007)
Atul Gawande is a really impressive person. He is a general and endocrine surgeon at Brigham and Women’s Hospital in Boston. He is an associate professor at Harvard Medical School and a writer for The New Yorker and Slate. Judging by his photographs he is about 22 years old. (Just kidding, he was born in 1965. But he looks really young.) All of this is really impressive stuff…with the life saving and all. But what I feel may be the most impressive thing about him is his thirst for knowledge (which, as we now know, is the treasure of Atlantis and Indiana Jones!) and his avoidance of the status quo. And that is what Better: A Surgeon’s Notes on Performance is all about.
In this book, Gawande takes you through a lot of different medical situations and how people have impacted that particular area of study. It is split into three sections: Diligence, Doing Right & Ingenuity. The Diligence section explains through three examples how a particular medical problem was solved (or at least improved upon). The opening story is about infectious diseases being spread throughout a hospital…by the doctors. Every year, 90,000 patients die of an infection they catch while in the hospital. What researchers found was that most doctors do not wash their hands in between patient exams and, therefore, easily spread bacteria and disease to other patients. A few years ago, a man named Peter Perreiah was put in charge of solving the problem of hospital infections. After finding out the problem was significantly caused by the lack of hand washing, he tried to figure out how to make doctors wash their hands. Apparently doctors don’t particularly like doing that because it takes too long. So Perreiah was diligent and came up with a system of supplies to keep patients and doctors as sterile as possible. This included supply stations – including a stethoscope – for each patient, anti-bacterial gels, and mandatory infection tests upon admission. The infection rate for MRSA (a super bug) dropped by 90 percent! The diligence of this man vastly improved the infection rate in his hospital.
Another really interesting story was in the ingenuity section. Historically, childbirth has been one of the most dangerous things a woman, and the child, could participate in. Of course, both are pretty much forced into taking part in it and even as late as the early 1950′s the mortality rate for both the mother and the child has been extraordinarily high. Then, in 1953, a doctor named Virginia Apgar did something very simple, yet used a lot of ingenuity in order to decrease the newborn death rate: she started keeping score. The Apgar score gives a scoring system for newborn babies on a scale from 0 to 10. Two for crying, two for moving all 4 limbs, etc… The score is taken immediately and after 5 minutes.
What this allowed the nurses to do was to have an objective manner of determining the health of an infant. It required careful observation of the baby. Appallingly, doctors and nurses used to give up on a baby pretty quickly if they didn’t look healthy. Not a good use of resources I guess. Once the Apgar score forced the hospital staff to document and observe the newborn, the mortality rate dropped dramatically. This was a very simple idea…but it revolutionized the obstetrics industry.
Every chapter in this book is a really interesting look at some way that people made the medical industry better. And while the book speaks only to medical situations, Gawande is really making the larger point that anyone can make any process they are involved with better. At the end of the book, Gawande even lists ways to become a “positive deviant”, which will theoretically help you make things better.
I really enjoyed this book and would recommend it to anyone interested in improving things in their lives and around the world. I think this book’s advice can be used on smaller levels than just what is shown here. Beyond all of that, Gawande is a really great writer…and even though he is a really smart guy, he writes at a level that even I can understand.
Rating: 5 out of 5
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August 14th, 2008 at 8:18 pm
I want this book. Mwaaaaa!!!
September 3rd, 2009 at 5:47 pm
This is a lame review, written for the 14 yr old reader. Gawande is brilliant. His first name is misspelled in the title. Who reviews these books?
Grr.
January 7th, 2010 at 11:27 pm
After reading the review I too want this book. It appears like guidlines to people management. Great sharing by A Gawande (Do not want to be wrong by spelling the first namebecause i know not.)
May 17th, 2010 at 7:04 am
[...] Books (2009) Hurray for Atul Gawande! I have already reviewed one of his earlier books (Better…almost 2 years ago!) and absolutely loved it. So I was expecting the same from this book, and [...]