Quotes from Atul Gawande

My wife used to say I was a loner, but I'm not. I just like my time alone," he told me. So when the tour guide said that the Florence Center had single rooms, "I said, 'You must be kidding!'" The tour had only begun and already he was sold.

Checklists seem to provide protection against such failures. They remind us of the minimum necessary steps and make them explicit. They not only offer the possibility of verification but also instill a kind of discipline of higher performance.

For human beings, life is meaningful because it is a story. A story has a sense of a whole, and its arc is determined by the significant moments. (...) And in stories, endings matter. (...) Endings matter, not just for the person but, perhaps even more, for the ones left behind.

But for whatever reasons—hubris, inattention, wishful thinking, hesitation, or the uncertainty of the moment—I let the opportunity pass.

Serious illness or infirmity will strike. It is as inevitable as sunset. And then a new question arises: If independence is what we live for, what do we do when it can no longer be sustained?

I tried to proceed deliberately, and not let panic take hold.

He found the work deeply satisfying, despite the gruelling hours.

she thought to herself.

Psychotropic drugs for agitation, like Haldol, decreased in particular. The total drug costs fell to just 38 percent of the comparison facility. Deaths fell 15 percent.

Four minutes without oxygen would lead to permanent brain damage, if not death.

Those were the four best years of my life

Such successes are not quite the result of logical thinking. But they are not the result of mere luck, either.

he had a wide range of choices for work.

Had they stayed just a few seconds longer, they would have plunged into the fire themselves.

doctors need to understand that we are businessmen—nothing less, nothing more—and the sooner we accept this the better.

An inherent tension exists between brevity and effectiveness. Cut too much and you won't have enough checks to improve care. Leave too much in and the list becomes too long to use.

How long has she been without an airway?

We end up with institutions that address societal goals-from freeing up hospital beds to taking burdens off families' hands to coping with poverty among the elderly-but never the goal that matters to the people who reside in them: how to make life worth living when we're weak and frail and can't fend for ourselves

After a while, though, it seemed that the only thing he thought about was getting through all his patients as quickly as possible.

Human beings have an ability to simply recognize the right thing to do sometimes. Judgment, Klein points out, is rarely a calculated weighing of all options, which we are not good at anyway, but instead an unconscious form of pattern recognition.

The fire had been difficult, but not to a degree that had ever made him flee before.

On average, in Boult's study, the geriatric services cost the hospital $1,350 more per person than the savings they produced, and Medicare, the insurer for the elderly, does not cover that cost. It's a strange double standard. No one insists that a $25,000 pacemaker or a coronary-artery stent save money for insurers. It just has to maybe do people some good.

All of this was odd, to say the least.

Studies find that as people grow older they interact with fewer people and concentrate more on spending time with family and established friends