Quotes from Atul Gawande

For more than half a century now, we have treated the trials of sickness, aging, and mortality as medical concerns. It's been and experiment in social engineering, putting our fate in the hands of people valued more for their technical prowess than for their understanding of human needs. That experiment has failed... we seek a life of worth and purpose, yet are routinely denied the conditions that might make it possible, there is no other way to see what modern society has done.

Ezekiel and Linda Emanuel

Her gratitude was immense and flattering

Other shoes aren't as comfortable

that doctors avoid them in order to cover up evidence of malpractice.

accepted stoically, without fear or self-pity or hope for anything

In surgery, as in anything else, skill and confidence are learned through experience

So it struck me as odd to find

Jessie F. Richardson Foundation

Kahneman termed the "Peak-End rule": an average of the pain experienced at just two moments—the single worst moment of the procedure and the very end. [...] Your remembering self is attempting to recognize not only the peaks of joy and valleys of misery but also how the story works out as a whole. That is profoundly affected by how things ultimately turn out.

we need practice to get good at what we do.

that no one was volunteering to take Friday the thirteenth.

feared that the autopsy would uncover an error.

When lipofuscin accumulates in sweat glands, the sweat glands cannot function, which helps explain why we become so susceptible to heat stroke and heat exhaustion in old age.

The risk of a fatal car crash with a driver who's eighty-five or older is more than three times higher than it is with a teenage driver. The very old are the highest-risk drivers on the road

Each year, about 350,000 Americans fall and break a hip. Of those, 40 percent end up in a nursing home, and 20 percent are never able to walk again. The three primary risk factors for falling are poor balance, taking more than four prescription medications, and muscle weakness. Elderly people without these risk factors have a 12 percent chance of falling in a year. Those with all three risk factors have almost a 100 percent chance.

But the dismal finances of geriatrics are only a symptom of a deeper reality: people have not insisted on a change in priorities.

To avoid fatigue and inattention, he did his work over the course of a week

We were taking turns making picks, and for the first few rounds, everything seemed normal.

People believed death should be accepted stoically, without fear or self-pity or hope for anything more than the forgiveness of God. Reaffirming one's faith, repenting one's sins, and letting go of one's worldly possessions and desires were crucial, and the guides provided families with prayers and questions for the dying in order to put them in the right frame of mind during their final hours. Last words came to hold a particular place of reverence.

I didn't see much likelihood that an error would be found. Today

Felix Silverstone, who for twenty-four years was the senior geriatrician at the Parker Jewish Institute

Cost is the spectre haunting health reform. For many decades, the great flaw in the American health-care system was its unconscionable gaps in coverage.

If I get hit by a bus tomorrow, my patients will not even be postponed. Another surgeon would step in and take over. The reason to do research and writing is that it at least makes me feel not entirely replaceable. If I didn't write, I don't know if I would do surgery.