walkitout (walkitout) wrote,

_Better_, Atul Gawande

I enjoyed Gawande's _Complications_ a few years ago, but I think I got it at the library and my opinion can be sensitive to how much I spent on a book. Also, I read some of these columns as they were published along the way (the pro-c-section article, which annoyed the hell out of me, and the cystic fibrosis article, which was interesting).

Gawande has a couple of themes. One is "making a difference", and he has some specific ideas about how to do this (pay attention, measure things, don't complain, be diligent and what that means). The other reflects a fairly narrow vision of what purpose doctors should serve, and this comes through quite clearly in the chapter on medical professionals in the context of executions. I thought his series of stories led quite clearly to an endorsement of medical professionals being present at and very limited participation in the sense that this is another area where doctors can ameliorate end-of-life. Yet the conclusion he came to was quite different and, I felt, asinine: better to have everyone boycott and hope that as a result, capital punishment would be ended as cruel and unusual punishment. I understand that capital punishment is a complex issue and people can land on a variety of sides of it. But I don't like to see the medical community opting out of ameliorating end-of-life ever. That kind of crap leads to people who refuse recommended treatment being refused any care at all.

He's intelligent. He's thoughtful. He's way too optimistic about what medicine can accomplish and should attempt. He's insufficiently skeptical about innovations in medicine. And he just seems to have a lot of trouble following the "don't just do something, stand there", which leads him to, at this late date, endorse regular mammograms without blinking.

YMMV, but I'd skip it. I'll donate it to the local library, in case someone here wants to give it a try. It wasn't worth the < $9.

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