Complications

As I started reading Atul Gawande's Complications: A Surgeon's Notes on an Imperfect Science, my first reaction was Nooooo! Don't give away the secrets!

When relating his first attempts at an invasive procedure (central venous catheter insertion), Gawande is so frank about his uncertainty and shortcomings, that it made me squirm to recall my own similar experiences.

All physicians gain experience through practice - on real, live patients. This practice, during residency, is supervised by senior attending physicians. However, as Gawande points out, the degree and proximity of supervision varies according to circumstance.

How do we balance being honest about our level of expertise against wanting to spare patients unnecessary anxiety? How can residents learn a new procedure if they don't perform it on a patient?

Gawande explores these questions with astonishing openness. Plus, he's a great storyteller. His story of the failed tracheostomy (lost airway, anyone?) made me cringe.

Non-physicians read this book at your own peril. You may dispel the myth of the infallible surgeon.