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We have medicalized aging, and that experiment is failing us.

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
Failing
Experiment
Experiments
Aging

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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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Life is choices, and they are relentless. No sooner have you made one choice than another is upon you.
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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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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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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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We recruit for attitude and train for skill.
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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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Are doctors who make mistakes villains? No, because then we all are.
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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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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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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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We always hope for the easy fix: the one simple change that will erase a problem in a stroke. But few things in life work this way. Instead, success requires making a hundred small steps go right - one after the other, no slipups, no goofs, everyone pitching in.
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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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Having great components is not enough, and yet we've been obsessed in medicine with components. We want the best drugs, the best technologies, the best specialists, but we don't think too much about how it all comes together.
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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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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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We yearn for frictionless, technological solutions. But people talking to people is still the way norms and standards change.
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Expertise is the mantra of modern medicine.
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Man is fallible, but maybe men are less so.
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