Better by Atul Gawande


The stories in Better are engrossing, well written, entertaining and educational. The Doctor, looks at the medical establishment in America from the inside as a trained surgeon, and is able to keep it light and free of too much medical jargon, and therefore, readable to a non-medical audience.

Atul Gawande describes the need to be diligent, do the right thing and to stay ingenious at the same time. His chapter on the simple idea of washing hands was good. I also enjoyed his chapter on the score, about how childbirth had been made much safer, and the Apgar score that newborns were given 1 and 5 minutes after birth had significantly reduced infant mortality. For instance if a child at one minute after birth had a terrible Apgar score, they could often be resuscitated- with measures like oxygen and warming- to an excellent score in five minutes. This score also lead to the creation of neonatal intensive care units. The author suggested an Apgar type score be created after every operation for doctors to assess how they had done.

The chapter on Indian doctors using ingenious methods to bring health care to many people, at low costs and without too much specialization was very interesting. For instance Dr. Motewar in three hours had seen thirty six patients. With no time for a complete exam, a good history, or explanations, he relied mainly on a quick, finely honed clinical judgement. He sent a few patients out for X-rays and lab tests. The rest he diagnosed on the spot.

The Independent has a very positive review of this wonderful book.

This is a book about failure: how it happens, how we learn from it, how we can do better. Although its focus is medicine, its message is for everybody. Against expectations, that turns out to be hugely, enthrallingly optimistic. Atul Gawande is a surgeon at the Brigham and Women's hospital, Boston. He is also – and this could only happen in America - a staff writer on The New Yorker. He sees medicine from the inside, but with an outsider's perspective. His book is riveting: packed with insights, its luminous prose lifting effortlessly off the page.

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