Complications ─ A Surgeon's Notes on an Imperfect Science

A brilliant and courageous doctor reveals, in gripping accounts of true cases, the power and limits of modern medicine.

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. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur and why good surgeons go bad. He also shows us what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause; a young woman with nausea that won't go away; a television newscaster whose blushing is so severe that she cannot do her job. Gawande offers a richly detailed portrait of the people and the science, even as he tackles the paradoxes and imperfections inherent in caring for human lives.

At once tough-minded 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.
Atul Gawande is a surgical resident in Boston and a staff writer on medicine and science for The New Yorker. A former Rhodes scholar, he received his M.D. from Harvard Medical School and an M.P.H. from the Harvard School of Public Health. His writing has also appeared in The Best American Science and Nature Writing 2000, the New Yorker essay collection In Sickness and In Health, and Slate. Gawande lives with his wife and three children in Newton, Massachusetts. This is his first book.
National Book Award Nominee
A New York Times Notable Book
A Discover magazine Best Science Book

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. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur, why good surgeons go bad. He shows what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause; a young woman with nausea that won't go away; a television newscaster whose blushing is so severe that she cannot do her job. Gawande also ponders the human factor that makes saving lives possible.

At once tough-minded 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.
"[Gawande] brings to modern high-tech medicine the same clinical watchfulness that writers such as [William Carlos] Williams and [Oliver] Sacks have brought to bear on the lives and emotions of often fragile patients . . . We get an honest sense of the complexities of twenty-first century healing."—Sherwin B. Nuland, The New York Review of Books
"Reading Complications we become aware of the emergence of a new medical voice, and a welcome one. Here we find clinical perception, a wide-ranging knowledge of the pertinent literature, and the precocious wisdom of a young physician confronting the realities of one of America's leading hospitals. He writes with directness and lucidity—and humility as well—that lift the veil of obscurity and obfuscation behind which so many of the most far-reaching dilemmas of today's medical care have been half-hidden. The writings of Atul Gawande convey the quiet assurance and tone of the doctor acting as both observer and participant. This is clinical watchfulness at its best [and Gawande] brings to modern high-tech medicine the same clinical watchfulness that writers such as [William Carlos] Williams and [Oliver] Sacks have brought to bear on the lives and emotions of often fragile patients . . . We get an honest sense of the complexities of twenty-first century healing."—Sherwin B. Nuland, The New York Review of Books

"None surpass Gawande in the ability to create a sense of immediacy, in his power to conjure the reality of the ward, the thrill of the moment-by-moment medical or surgical drama. Complications impresses for its truth and authenticity, virtues that it owes to its author being as much forceful writer as uncompromising character."—The New York Times Book Review

"Gawande's prose, much like the scalpel he wields, is precise, daring but never reckless. But it is after he exposes what lies beneath that we see the full measure of Gawande's gift: his compassion, his honesty, and a trademark hypervigilance paired with scholarship. Much like reading George Orwell, the reader emerges entertained, enlightened, transformed and immensely satisfied."—Abraham Verghese, author of My Own Country and The Tennis Partner

"Atul Gawande is a Harvard-trained surgeon and a former White House official, but he writes like a human being—and a born writer. Curiosity, wit, compassion, and humility are among the qualities he brings to these tales of modern medicine. The stories in Complications are gripping medical mysteries that always have something extra. He draws you in with the story 0but leaves you wiser about science, about health care issues, and even about the human condition."—Michael Kinsley

"Gawande is a writer with a scalpel pen and an X-ray eye . . . He turns every case—from gunshot wounds to morbid obesity to flesh-eating bacteria—into a thriller in miniature. Diagnosis: riveting."—Time

"Complications is a book about medicine that reads like a thriller. Every subject Atul Gawande touches is probed and dissected and turned inside out with such deftness and feeling and counterintuitive insight that the reader is left breathless."—Malcolm Gladwell, author of The Tipping Point

"No one writes about medicine as a human subject as well as Atul Gawande. His stories about becoming a surgeon are scary, funny, absorbing, and always touched with both a tender conscientiousness and an alert, hyper-intelligent skepticism. He captures, as no one else has, the doubleness of doctoring: what it feels like to see other people as fascinating, intricate, easily breakable machines and, at the same time, as mirror images of one's own self. Complications is a uniquely soulful book about the science of mending bodies."—Adam Gopnik, author of From Paris to the Moon

"Complications is a literary version of an informed consent form. It's refreshingly honest, if not always reassuring. Some people still prefer to think of surgeons as infallible gods. But Atul Gawande is a rare and wonderful storyteller who portrays his profession with bravery and humanity."—Ellen Goodman, author of Value Judgements

"Gawande is arguably the best nonfiction doctor-writer around . . . He's prescient and thoughtful