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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
Three
Complications
Wells
Complication
Everything
Hospital
Come
Hospitals
Well
Majors
Time
Major
Percent
Goes

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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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Expertise is the mantra of modern medicine.
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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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We have medicalized aging, and that experiment is failing us.
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Arriving at an acceptance of one's mortality is a process, not an epiphany.
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Human interaction is the key force in overcoming resistance and speeding change.
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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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I learned about a lot of things in medical school, but mortality wasn't one of them.
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Are doctors who make mistakes villains? No, because then we all are.
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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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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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Man is fallible, but maybe men are less so.
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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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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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This was not guilt: guilt is what you feel when you have done something wrong. What I felt was shame: I was what was wrong.
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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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