Quotes from Atul Gawande

There's one looming danger, though: the stalk of the gallbladder is a branch off the liver's only conduit for sending bile to the intestines for the digestion of fats. And if you accidentally injure this main bile duct, the bile backs up and starts to destroy the liver. Between 10 and 20 percent of the patients to whom this happens will die. Those who survive often have permanent liver damage and can go on to require liver transplantation.

En la vejez y la enfermedad se requieren dos tipos de valor. El primero es el valor para afrontar la realidad de la mortalidad –el valor de querer saber la verdad de lo que cabe temer y lo que cabe esperar–

Medical professionals concentrate on repair of health, not sustenance of the soul. Yet

Before taxiing out to the runway, we paused again for five more checks: whether anti-icing was necessary and completed, the autobrakes were set, the flight controls were checked, the ground equipment was cleared, and no warning lights were on. The three checklists

Embracing a culture of teamwork and discipline is.

And the insight was that as people's capacities wane, whether through age or ill health, making their lives better often requires curbing our purely medical imperatives—resisting the urge to fiddle and fix and control. It was not hard to see how important this idea could be for the patients I encountered in my daily practice—people facing mortal circumstances at every phase of life.

litigation has proved to be a singularly unsatisfactory solution. It is expensive, drawn out, and painfully adversarial. It helps very few people.

Just ticking boxes is not the ultimate goal here.

This is normal. Although the processes can be slowed—diet and physical activity can make a difference—they cannot be stopped.

I had seen the procedure done. Now it was my turn to try.

the team decided whether the doctor was fit to return to practice. Neff

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.

We always hope for the easy fix: the one simple change that will erase a problem in a stroke. But few things in life work this way. Instead, success requires making a hundred small steps go right--one after the other, no slipups, no goofs, everyone pitching in. We are used to thinking of doctoring as a solitary, intellectual task. But making medicine go right is less often like making a difficult diagnosis than like making sure everyone washes their hands.

The aged did not lose status and control so much as share it. Modernization did not demote the elderly. It demoted the family. It

Whereas today people often understate their age to census takers, studies of past censuses have revealed that they used to overstate it. The dignity of old age was something to which everyone aspired.

If to be human is to be limited, then the role of caring professions and institutions—from surgeons to nursing homes—ought to be aiding people in their struggle with those limits.

Medicine's focus is narrow. Medical professionals concentrate on repair of health, not sustenance of the soul.

A study led by the sociologist Nicholas Christakis asked the doctors of almost five hundred terminally ill patients to estimate how long they thought their patient would survive and then followed the patients. Sixty-three percent of doctors overestimated their patient's survival time. Just 17 percent underestimated it. The average estimate was 530 percent too high. And the better the doctors knew their patients, the more likely they were to err.

Several months passed before I saw Vince Caselli again.

and I called him to see how he was doing.

In many the entry point is never found at all.)

If independence is what we live for, what do we do when it can no longer be sustained?

Ronald Dworkin

You must decide whether you want a DO-CONFIRM checklist or a READ-DO checklist. 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.