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You know, 97 percent of the time, if you come into a hospital, everything goes well. But three percent of the time, we have major complications.
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
Everything
Hospital
Come
Hospitals
Well
Majors
Time
Major
Percent
Goes
Three
Complications
Wells
Complication
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Man is fallible, but maybe men are less so.
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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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We have medicalized aging, and that experiment is failing us.
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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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Expertise is the mantra of modern medicine.
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Are doctors who make mistakes villains? No, because then we all are.
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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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Coaching done well may be the most effective intervention designed for human performance.
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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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We yearn for frictionless, technological solutions. But people talking to people is still the way norms and standards change.
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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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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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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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I learned about a lot of things in medical school, but mortality wasn't one of them.
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We recruit for attitude and train for skill.
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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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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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What about regular professionals, who just want to do what they do as well as they can?
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Arriving at an acceptance of one's mortality is a process, not an epiphany.
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Checklists turn out...to be among the basic tools of the quality and productivity revolution in aviation, engineering, construction - in virtually every field combining high risk and complexity. Checklists seem lowly and simplistic, but they help fill in for the gaps in our brains and between our brains.
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