Quotes from Atul Gawande

What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?

in my grandfather's premodern world, how he wanted to live was his choice, and the family's role was to make it possible.

Patients ask questions, look up information on the Internet, seek second opinions. And they decide.

they have priorities beyond merely being safe and living longer; that the chance to shape one's story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the last chapters of everyone's lives. Inevitably

to make sure that no physical illness could account for any dangerous behavior.

Sometimes, of course, the difference between one option and another isn't especially significant.

practice, however, matters aren't so straightforward.

Effort does matter; diligence and attention to the minutest details can save you.

I am in a profession that has succeeded because of its ability to fix. If your problem is fixable, we know just what to do. But if it's not? The fact that we have had no adequate answers to this question is troubling and has caused callousness, inhumanity, and extraordinary suffering.

He warned them at length about how terrible the risks were and how limited the potential benefit.

At home, you decide how you spend your time, how you share your space, and how you manage your possessions. Away from home, you don't. This

In contemporary societies, by contrast, old age and infirmity have gone from being a shared, multigenerational responsibility to a more or less private state—

The neurosurgeon had already gone over them in detail.

When someone has come to you for your expertise and your expertise has failed, what do you have left? You have only your character to fall back upon—and

The way we saw it, and the way our professors saw it, the purpose of medical schooling was to teach how to save lives, not how to tend to their demise.

our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one's story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the last chapters of everyone's lives.

I tried to sound firm without being harsh. "You

believe that the difference in death rates can be traced to the fundamental human need for a reason to live.

Nonetheless, as the defects in a complex system increase, the time comes when just one more defect is enough to impair the whole, resulting in the condition known as frailty. It happens to power plants, cars, and large organizations. And it happens to us: eventually, one too many joints are damaged, one too many arteries calcify. There are no more backups.

What were her biggest fears and concerns? What goals were most important to her? What trade-offs was she willing to make, and what ones was she not? Not

I froze, not knowing quite what to say.

what we aim for persists. And this gap complicates everything we do.

asked Thomas what his special technique for sales was as a kid. He said he didn't have any. It was simply that "I was willing to be rejected. That's what allows you to be a good salesperson. You have to be willing to be rejected.

I wouldn't be a surgeon if I thought otherwise.)