Quotes from Atul Gawande

Just ticking boxes is not the ultimate goal here. Embracing a culture of teamwork and discipline is. And if we recognised the opportunity, the two-minute WHO checklist is just a start.

It took her several minutes alone with her father before she could sign.

The brain gives us two ways to evaluate experiences like suffering—there is how we apprehend such experiences in the moment and how we look at them afterward—and the two ways are deeply contradictory.

The goal is to use explicit, logical, statistical thinking instead of just your gut.

We believe that having a longer duration of pain is worse than a shorter duration and that having a greater average level of pain is worse than having a lower average level. But this wasn't what the patients reported at all. Their final ratings largely ignored the duration of pain. Instead, the ratings were predicted by what Kahneman termed the "Peak-End rule": an average of the pain experienced at just two moments - the single worst moment of the procedure and the very end.

But it's not only the breadth and quantity of knowledge that has made medicine complicated. It is also the execution—the practical matter of what knowledge requires clinicians to do.

This has never been a problem before," people say. Until one day it is.

La gente quiere compartir sus recuerdos, transmitir su sabiduría y sus objetos personales, arreglar las relaciones, establecer sus legados, ponerse en paz con Dios y asegurarse de que las personas que deja atrás van a estar bien. Quieren finalizar su historia en sus propios términos.

The way that things go wrong in medicine is normally unseen and, consequently, often misunderstood.

So you want to keep the list short by focusing on what he called "the killer items" — the steps that are most dangerous to skip and sometimes overlooked nonetheless. The wording should be simple and exact, Boorman went on, and use the familiar language of the profession. Even the look of the checklist matters. Ideally, it should fit on one page. It should be free of clutter and unnecessary colors.

It's an opaque term, intensive care. Specialists in the field prefer to call what they do critical care, but that still doesn't exactly clarify matters.

and when we decide by instinct

People readily demonstrate a willingness to sacrifice their safety and survival for the sake of something beyond themselves, such as family, country, or justice.

Discussion had brought La Crosse's end-of-life costs down to half the national average. It was that simple—and that complicated.

So for any new checklist created from scratch, you have to pick the type that makes the most sense for the situation. The checklist cannot be lengthy. A rule of thumb some use is to keep it to between five and nine items, which is the limit of working memory.

The likelihood of my initial hunch being right was too low

life designed to be safe but empty of anything they care about.

Minutes passed in silence.

Our duties depend on our level of training, but we're never entirely on our own: there's always an attending, who oversees our decisions.

our frustration growing.

And partly, whether we admit it or not, a lot of doctors don't like taking care of the elderly.

The philosophy is that you push the power of decision making out to the periphery and away from the center. You give people the room to adapt, based on their experience and expertise. All you ask is that they talk to one another and take responsibility. That is what works.

he relied on me for surgical expertise.

The best way to convey meaning is to tell people what the information means to you yourself, he said. And he gave me three words to use to do that. I am worried, I told Douglass.