The struggle to perform well is universal, but nowhere is this drive to do better more important than in medicine. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable. His vivid stories take us to battlefield surgical tents in Iraq, to a polio outbreak in India and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors' participation in lethal injections, examines the influence of money on modern medicine and recounts the astoundingly contentious history of hand-washing. Finally, he gives a brutally honest insight into life as a practising surgeon. Unflinching but compassionate, Gawande's investigation into medical professionals and their progression from good to great provides a detailed blueprint for success that can be used by everyone.

About the Author

One of the world's most distinguished doctors, he is a staff writer on the New Yorker, advised President Clinton on health policies, teaches surgery at Harvard Medical School and practises it in Boston. He has lectured in the UK and was a Rhodes Scholar at Oxford.

Prizes

The bestselling author of Complications reveals what you need to be a great surgeon - and shows how everyone can improve at what they do

Reviews

Surgeon and MacArthur fellow Gawande applies his gift for dulcet prose to medical and ethical dilemmas in this collection of 12 original and previously published essays adapted from the New England Journal of Medicine and the New Yorker. If his 2002 collection, Complications, addressed the unfathomable intractability of the body, this is largely about how we erect barriers to seamless and thorough care. Doctors know they should wash their hands more often to avoid bacterial transfer in the ward, but once a minute does seem extreme. Using chaperones for breast exams seems a fine idea, but it does make situations awkward. "The social dimension turns out to be as essential as the scientific," Gawande writes-a conclusion that could serve as a thumbnail summary of his entire output. The heart of the book are the chapters "What Doctors Owe," about the U.S.'s blinkered malpractice system, and "Piecework," about what doctors earn. Cheerier, paradoxically, are the chapters involving polio and cystic fibrosis, featuring Dr. Pankaj Bhatnagar and Dr. Warren Warwick, two remarkable men who have been able to catapult their humanity into their work rather than constantly stumble over it. Indeed, one suspects that once we cure the ills of the health care system, we'll look back and see that Gawande's writings were part of the story. (Apr.) Copyright 2007 Reed Business Information.

'I found I had been gripping the book so hard that my fingers hurt... it calls to mind one of the great classics of medical literature, Mikhail Bulgakov's A Country Doctor's Notebook. Few modern authors can stand that comparison, but Gawande can.' Sunday Times 'His book is riveting: packed with insights, its luminous prose lifting effortlessly off the page... It is essential reading for doctors and should be handed out with the antibiotics to all users of the NHS. It has already been described as a modern masterpiece - and so it is.' Independent 'It seems unfair that a surgeon should be able to write so beautifully... Better is perfect bedside reading - although it might keep you awake - for doctors as well as patients...All will learn something of value from this infinitely wise and humane surgeon' Daily MailSunday Times - '...this wise and often profound book should be an inspiration to doctors all over the world.'

Gawande, a Harvard-trained endocrine surgeon, contributor to The New Yorker, best-selling author (Complications: A Surgeon's Notes on an Imperfect Science), and 2006 MacArthur fellow, examines the nature of how success and excellence are achieved in medicine and how diligence, doing right, and ingenuity can combine to do better-in not only medicine but also all other human endeavors. In a narrative style reminiscent of Oliver Sacks, Sherwin B. Nuland, and Abraham Verghese, Gawande candidly weaves a tapestry of essays on topics as varied as hospital hand washing, polio in India, surgical tents in the Iraq war, physicians' salaries, malpractice insurance, and doctors' roles in lethal injections. The essays are united, as they highlight opportunities for improvement within the medical community, which serves as a successful framework for Gawande's study of a profession predicated on betterment. These revealing, humanistic essays are highly recommended for all libraries. Gawande's varied accomplishments have been publicized, and this book is certain to be a best seller [For a Q&A with Gawande, see LJ 3/15/07.-Ed.]-James Swanton, Harlem Hosp. Lib., New York Copyright 2007 Reed Business Information.