Quotes from Atul Gawande

This is the consequence of a society that faces the final phase of the human life cycle by trying not to think about it. We end up with institutions that address any number of 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 anymore.

The three primary risk factors for falling are poor balance, taking more than four prescription medications, and muscle weakness.

Block has a list of questions that she aims to cover with sick patients in the time before decisions have to be made: 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? A decade

As people become aware of the finitude of their life, they do not ask for much. They do not seek more riches. They do not seek more power. They ask only to be permitted, insofar as possible, to keep shaping the story of their life in the world—to make choices and sustain connections to others according to their own priorities.

we need practice to get good at what we do. There is one difference in medicine, though: it is people we practice upon.

The possibilities and probabilities are all we have to work with in medicine, though. What we are drawn to in this imperfect science, what we in fact covet in our way, is the alterable moment-the fragile but crystalline opportunity for one's know-how, ability, or just gut instinct to change the course of another's life for the better.

the purpose of medical schooling was to teach how to save lives, not how to tend to their demise.

Endings matter, not just for the person but, perhaps even more, for the ones left behind.

assisted living isn't really built for the sake of older people so much as for the sake of their children.

sometime over the last several decades—and it is only over the last several decades—science has filled in enough knowledge to make ineptitude as much our struggle as ignorance.

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 everyone is able to answer such questions

Do what is right, and do it now.

not only do all human beings err, but they err frequently and in predictable, patterned ways.

need to understand how much you're willing to go through to have a shot at being alive and what level of being alive is tolerable to you.

ODTAA syndrome: the syndrome of One Damn Thing After Another.

Living is a kind of skill. The calm and wisdom of old age are achieved over time.

But as your horizons contract—when you see the future ahead of you as finite and uncertain—your focus shifts to the here and now, to everyday pleasures and the people closest to you.

Steps to become a positive deviant: 1. Ask unscripted questions 2. Don't complain 3. Count something that interests you 4. Write something... Anything 5. Change yourself. Change something

Old age is not a battle. Old age is a massacre.

Living is a kind of skill.

under conditions of complexity, not only are checklists a help, they are required for success.

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 seemingly easiest and most sensible rule for a doctor to follow is: Always Fight. Always look for what more you could do.

We're good at addressing specific, individual problems: colon cancer, high blood pressure, arthritic knees. Give us a disease, and we can do something about it. But give us an elderly woman with high blood pressure, arthritic knees, and various other ailments besides—an elderly woman at risk of losing the life she enjoys—and we hardly know what to do and often only make matters worse.