Quotes from Atul Gawande

this claim makes little sense.

Medical care is about our life and death, and we've always needed doctors to help us understand what is happening and why, and what is possible and what is not. In the increasingly tangled web of experts and expert systems, a doctor has an even greater obligation to serve as a knowledgeable guide and

Surgery itself is a kind of autopsy. "Autopsy" literally means "to see for oneself," and, despite our knowledge and technology, when we look we're often unprepared for what we find.

even on the shuttle bus to and from the convention center.

Sometimes it turns out that we had missed a clue along the way, made a genuine mistake. Sometimes we turn out wrong despite doing everything right.

We've been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way.

Equally troubling, people seem happy to let us off the hook.

At least two kinds of courage are required in aging and sickness. The first is the courage to confront the reality of mortality—the courage to seek out the truth of what is to be feared and what is to be hoped.

I never made it to the other side.

which was an unheard-of accomplishment.

Culture has tremendous inertia," he said. "That's why it's culture. It works because it lasts. Culture strangles innovation in the crib." To combat the inertia, he decided they should go up against the resistance directly—"hit it hard," Thomas said.

Nothing that takes off becomes quite what the creator wants it to be. Like a child, it grows, not always in the expected direction.

Doctors lined up for the bags, even when they had to give away their phone numbers and addresses, just to get something to hold all the free merchandise they were collecting.

Two professors who study the science of complexity—Brenda Zimmerman of York University and Sholom Glouberman of the University of Toronto—have proposed a distinction among three different kinds of problems in the world: the simple, the complicated, and the complex.

All we ask is to be allowed to remain writers of our own story. That story is ever changing. Over the course of our lives, we may encounter unimaginable difficulties. Our concerns and desires may shift. But whatever happens, we want to retrain the freedom to shape our lives in ways consistent with our character and loyalties.

The choices don't stop, however. Life is choices, and they are relentless. No sooner have you made a choice than another is upon you.

Thinking about averting plane crashes in 1935, or stopping infections of central lines in 2003, or rescuing drowning victims today, I realized that the key problem in each instance was essentially a simple one, despite the number of contributing factors.

was once on trauma duty when a young man about twenty years old was rolled in, shot in the buttock.

The No. 2 pencils had been handed out. The timer had been started. But we had not even registered that the test had begun.

They too devoted a full day to research presentations.

we pay doctors to give chemotherapy and to do surgery but not to take the time required to sort out when to do so is unwise. This certainly is a factor. But the issue isn't merely a matter of financing. It arises from a still unresolved argument about what the function of medicine really is—what, in other words, we should and should not be paying for doctors to do.

Wilson spent several days camped out in one government office after another until she had secured an exemption. Unbelievably, she and her husband cleared every obstacle. And in 1983, their new "living center with assistance" for the elderly—named Park Place—opened in Portland.

Reality is more complex, though. People readily demonstrate a willingness to sacrifice their safety and survival for the sake of something beyond themselves, such as family, country, or justice. And this is regardless of age.

Having given up totally on making it to anything else that day, I spotted a