Quotes from Atul Gawande

Some I am fortunate to still keep up with. Others I was never given the chance to know as well as I wish I could have. All of them have taught me more than any could know.

Do you want to be resuscitated if your heart stops? 2. Do you want aggressive treatments such as intubation and mechanical ventilation? 3. Do you want antibiotics? 4. Do you want tube or intravenous feeding if you can't eat on your own?

Even our brains shrink: at the age of thirty, the brain is a three-pound organ that barely fits inside the skull; by our seventies, gray-matter loss leaves almost an inch of spare room.

On another occasion

This book exists thanks to her love and dedication. So it is dedicated to her.

He stood mumbling for a moment

What do they understand their prognosis to be, what are their concerns about what lies ahead, what kinds of trade-offs are they willing to make, how do they want to spend their time if their health worsens, who do they want to make decisions if they can't?

LOU SANDERS WAS on his way to joining the infantilized and catatonic denizens belted into the wheelchairs of a North Andover nursing home

The earliest portions to shrink are generally the frontal lobes, which govern judgment and planning, and the hippocampus, where memory is organized. As a consequence, memory and the ability to gather and weigh multiple ideas—to multitask—peaks in midlife and then gradually declines.

These traits strike her as unusual

This is someone who makes his living studying disorders of the brain and the nerves. Yet he could not make sense of his own condition.

As Montaigne wrote, observing late-sixteenth-century life, "To die of age is a rare, singular, and extraordinary death, and so much less natural than others: it is the last and extremest kind of dying.

MODERN SCIENTIFIC CAPABILITY has profoundly altered the course of human life. People live longer and better than at any other time in history. But scientific advances have turned the processes of aging and dying into medical experiences, matters to be managed by health care professionals

When our time is limited and we are uncertain about how best to serve our priorities, we are forced to deal with the fact that both the experiencing self and the remembering self matter. We do not want to endure long pain and short pleasure. Yet certain pleasures can make enduring suffering worthwhile. The peaks are important, and so is the ending.

So today, with our average life span in much of the world climbing past eighty years, we are already oddities living well beyond our appointed time.

But that proved not to be the case.

The trouble is that we've built our medical system and culture around the long tail. We've created a multitrillion-dollar edifice for dispensing the medical equivalent of lottery tickets—and have only the rudiments of a system to prepare patients for the near certainty that those tickets will not win. Hope is not a plan, but hope is our plan. *

And this gap complicates everything we do.

With a DO-CONFIRM checklist, he said, team members perform their jobs from memory and experience, often separately. But then they stop. They pause to run the checklist and confirm that everything that was supposed to be done was done. With a READ-DO checklist, on the other hand, people carry out the tasks as they check them off--it's more like a recipe.

By December of 1998, her blushing had become intolerable

A seemingly happy life may be empty. A seemingly difficult life may be devoted to a great cause. We have purposes larger than ourselves.

Michael Jordan always had to wear University of North Carolina boxer shorts under his Chicago Bulls uniform.

There is almost always a long tail of possibility, however thin. What's wrong with looking for it? Nothing, it seems to me, unless it means we have failed to prepare for the outcome that's vastly more probable.

but the best surgeons retain a deep recognition of the limitations of both science and human skill.