Quotes from Atul Gawande

I had to wonder if we were right to operate on him.

Just ticking boxes is not the ultimate goal here. Embracing a culture of teamwork and discipline is.

What he found was unsurprising.

I felt disguised behind those glasses, less exposed, somehow freer.

The job of doctors is to supply up-to-date knowledge and skills. The job of patients is to supply the decisions.

In fact, he argued, human beings need loyalty. It does not necessarily produce happiness, and can even be painful, but we all require devotion to something more than ourselves for our lives to be endurable.

science has filled in enough knowledge to make ineptitude as much our struggle as ignorance.

The doctors were often not recognized to be dangerous until they had done considerable damage.

she and Felix had their own, private, decades-long conversation that had never stopped.

In other words, our decision making in medicine has failed so spectacularly that we have reached the point of actively inflicting harm on patients rather than confronting the subject of mortality.

In 2008, the national Coping with Cancer project published a study showing that terminally ill cancer patients who were put on a mechanical ventilator, given electrical defibrillation or chest compressions, or admitted, near death, to intensive care had a substantially worse quality of life in their last week than those who received no such interventions.

It's easy to hide in a statement. It's hard to hide between statements," Cook said.

At the M & M, the burden of responsibility falls on the attending.

when problems were identified, the follow-through was abysmal.

alone. His condition deteriorated rapidly.

They experienced trials, to be sure, and more moments of poignancy--that is, of positive and negative emotion mixed together. But overall, they found living to be a more emotionally satisfying and stable experience as time passed, even as old age narrowed the lives they led...The common view was that these lessons are hard to learn. Living is a kind of skill. The calm and wisdom of old age are achieved over time.

Once again, the salient risk factors seem to be social rather than physical.

His thirty-something son moved in to care for him.

In the past few decades, medical science has rendered obsolete centuries of experience, tradition, and language about our mortality and created a new difficulty for mankind: how to die.

The hospitals lobbied the government for help, and in 1954 lawmakers provided funding to enable them to build separate custodial units for patients needing an extended period of "recovery." That was the beginning of the modern nursing home. They were never created to help people facing dependency in old age. They were created to clear out hospital beds—which is why they were called "nursing" homes.

I asked Byrnes Shouldice, a son of the clinic's founder and a hernia surgeon himself, whether he ever got bored doing hernias all day long. "No," he said in a Spock-like voice. "Perfection is the excitement.

his own failure to be at her bedside when things got out of control.

The most striking aspect of the program, it seemed to me, was that

Again, none of this should be taken to mean that people are faking it.