Quotes from Atul Gawande

We are not omniscient or all-powerful. Even enhanced by technology, our physical and mental powers are limited.

We could never bring ourselves to discuss the larger truth about his condition or the ultimate limits of our capabilities, let alone what might matter most to him as he neared the end of his life.

he was the one who had put in the most time caring for Walker.

We may have lumped several different diseases together in describing the syndrome.

Doctors with high confidence in a judgment they made proved no more accurate than doctors with low confidence.

But scientific advances have turned the processes of aging and dying into medical experiences, matters to be managed by health care professionals.

But somewhere along the way things started to go wrong.

People spend years of sixty-, seventy-, eighty-hour weeks building their base of knowledge and experience before going out into practice on their own—whether they are doctors or professors or lawyers or engineers. They have sought to perfect themselves.

The average doctor in a high-risk practice like surgery or obstetrics is sued about once every six years. Seventy percent of the time, the suit is either dropped by the plaintiff or won by the doctor in court. But the cost of defense is high, and when doctors lose, the average jury verdict is half a million dollars. General

He began to cut corners, became sloppy.

They all believed that you didn't need to sacrifice your autonomy just because you needed help in your life.

individual autonomy hardly seems the ideal we should aim for.

If offered the option to have someone more experienced, I certainly would have taken it. But that was simply how the system worked—no such choices were offered—and so I went along. What else could I do?

human beings are inconsistent: we are easily influenced by suggestion, the order in which we see things, recent experience, distractions, and the way information is framed.

that many decisions made by physicians appear to be arbitrary—highly variable, with no obvious explanation.

He knew our hospital was affiliated with Harvard, but he knew enough to realize that this did not necessarily mean we were anything special.

When I saw him three months later, he was still despondent. "I feel as if a part of my body is missing. I feel as if I have been dismembered," he told me. His voice cracked and his eyes were rimmed red. He had one great solace, however: that she hadn't suffered, that she'd got to spend her last few weeks in peace at home in the warmth of their long love, instead of up on a nursing floor, a lost and disoriented patient. *

Errors are too common and widespread to be explained so simply.

For Thomas, it was the perfect demonstration of his theory about what living things provide. In place of boredom, they offer spontaneity. In place of loneliness, they offer companionship. In place of helplessness, they offer a chance to take care of another being.

under conditions of complexity, not only are checklists a help, they are required for success. There must always be room for judgment, but judgment aided—and even enhanced—by procedure.

If learning is necessary but causes harm, then above all it ought to apply to everyone alike.

But Bratton was shocked at how young he appeared.

Given a choice, people wriggle out, and those choices are not offered equally.

We tend to give some variables too much weight and wrongly ignore others.