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Arriving at an acceptance of one's mortality is a process, not an epiphany.

Atul Gawande

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Atul Gawande
Age: 59
Born: 1965
Born: May 11
Journalist
Medical Writer
Professor
Researcher
Surgeon
Brooklyn
New York
Atul A Gawande
Atul Gawande
Acceptance
Process
Epiphany
Arriving
Mortality

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This is the reality of intensive care: at any point, we are as apt to harm as we are to heal.
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No one teaches you how to think about money in medical school or residency. Yet, from the moment you start practicing, you must think about it. You must consider what is covered for a patient and what is not.
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If I became just a brain in a jar - as long as I can communicate back and forth with people, that would be okay with me.
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Making systems work is the great task of my generation of physicians and scientists. But I would go further and say that making systems work - whether in healthcare, education, climate change, making a pathway out of poverty - is the great task of our generation as a whole.
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As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients. Both practices have made for serious problems.
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You can't make a recipe for something as complicated as surgery. Instead, you can make a recipe for how to have a team that's prepared for the unexpected.
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Human interaction is the key force in overcoming resistance and speeding change.
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I think the extreme complexity of medicine has become more than an individual clinician can handle. But not more than teams of clinicians can handle.
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Writing lets you step back and think through a problem. Even the angriest rant forces the writer to achieve a degree of thoughtfulness.
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One of the consequences of if the Affordable Care Act is repealed, is that all of us now are at risk of being a preexisting - of having a preexisting condition waiting to happen. Life, increasingly, is a preexisting condition waiting to happen, now that we have more and more of this data available.
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A failure often does not have to be a failure at all. However, you have to be ready for it-will you admit when things go wrong? Will you take steps to set them right?-because the difference between triumph and defeat, you'll find, isn't about willingness to take risks. It's about mastery of rescue.
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The possibilities and probabilities are all we have to work with in medicine, though. What 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.
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Coaching done well may be the most effective intervention designed for human performance.
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When we, doctors, ask patients what their priorities are if time is short, what we do is we use what is available to us - whether it's geriatric care or palliative care or hospice care - to make sure they're living the kind of life that they want to live.
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Expertise is the mantra of modern medicine.
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People who reach certain levels of frailty, more important than getting their mammogram, more important than getting their blood pressure tweaked, they're at high risk of falling. If they fall and break their hip, they not only die sooner, they die miserably.
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Culture matters. Of course, if physicians are rewarded or penalized for their service and results, the culture will change. But the key values we doctors are being pressed to embrace are humility, teamwork, and discipline.
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Life is choices, and they are relentless. No sooner have you made one choice than another is upon you.
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I learned about a lot of things in medical school, but mortality wasn't one of them.
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Man is fallible, but maybe men are less so.
Atul Gawande