A must-read for medical professionals—and a discerning, humanizing portrait of doctors at work for the rest of us.
“What does it take to be good at something, when failure is so easy?” asks writer/physician Gawande in his follow-up to Complications (2002).
Diligence, ingenuity and “doing right,” he answers. Gawande illustrates each of these qualities with stories from his own experience, as well as his observations of and conversations with other physicians. Being diligent about the simple act of hand-washing dramatically reduces hospital infections, he demonstrates, and through diligence, army surgeons in Baghdad have greatly enhanced the survival rate among casualties in Iraq. The section on doing right tackles such troublesome moral issues as whether doctors should participate in executions and at what point treatment of a patient becomes mistreatment and should be stopped. Discussing ingenuity, Gawande shows how the rating scale devised by Virginia Apgar, neither an obstetrician nor a mother, transformed the practice of obstetrics. A similar rating scale for every medical encounter, he believes, would inform patients and improve the performance of doctors and hospitals. He lauds the innovative thinking of Don Berwick, head of the Institute for Health Care Improvement, who is challenging the medical profession to measure and compare the performance of doctors and hospitals and to give patients total access to that information. When such information is available, medical professionals can identify the best performance and learn from it, as Gawande illustrates with an account of exceptional results in treating cystic fibrosis at Babies and Children’s Hospital in Cleveland. Monitoring and improving clinical performance would do more to save lives than advances in laboratory knowledge, he contends. For young doctors wondering how they can make an individual difference, Gawande suggests five strategies: Ask unscripted questions, don’t complain, “count something” (be a scientist as well as a doctor), write something (to make yourself part of a larger world) and change in response to new ideas.
A must-read for medical professionals—and a discerning, humanizing portrait of doctors at work for the rest of us.Pub Date: April 3, 2007
ISBN: 0-8050-8211-5
Page Count: 288
Publisher: Metropolitan/Henry Holt
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Feb. 15, 2007
BOOK REVIEW
BOOK REVIEW
Naughty good fun from an impossibly sardonic rogue, quickly rising to Twainian stature.
The undisputed champion of the self-conscious and the self-deprecating returns with yet more autobiographical gems from his apparently inexhaustible cache (Naked, 1997, etc.).
Sedaris at first mines what may be the most idiosyncratic, if innocuous, childhood since the McCourt clan. Here is father Lou, who’s propositioned, via phone, by married family friend Mrs. Midland (“Oh, Lou. It just feels so good to . . . talk to someone who really . . . understands”). Only years later is it divulged that “Mrs. Midland” was impersonated by Lou’s 12-year-old daughter Amy. (Lou, to the prankster’s relief, always politely declined Mrs. Midland’s overtures.) Meanwhile, Mrs. Sedaris—soon after she’s put a beloved sick cat to sleep—is terrorized by bogus reports of a “miraculous new cure for feline leukemia,” all orchestrated by her bitter children. Brilliant evildoing in this family is not unique to the author. Sedaris (also an essayist on National Public Radio) approaches comic preeminence as he details his futile attempts, as an adult, to learn the French language. Having moved to Paris, he enrolls in French class and struggles endlessly with the logic in assigning inanimate objects a gender (“Why refer to Lady Flesh Wound or Good Sir Dishrag when these things could never live up to all that their sex implied?”). After months of this, Sedaris finds that the first French-spoken sentiment he’s fully understood has been directed to him by his sadistic teacher: “Every day spent with you is like having a cesarean section.” Among these misadventures, Sedaris catalogs his many bugaboos: the cigarette ban in New York restaurants (“I’m always searching the menu in hope that some courageous young chef has finally recognized tobacco as a vegetable”); the appending of company Web addresses to television commercials (“Who really wants to know more about Procter & Gamble?”); and a scatological dilemma that would likely remain taboo in most households.
Naughty good fun from an impossibly sardonic rogue, quickly rising to Twainian stature.Pub Date: June 1, 2000
ISBN: 0-316-77772-2
Page Count: 288
Publisher: Little, Brown
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: April 1, 2000
PERSPECTIVES
The memoir of George Dawson, who learned to read when he was 98, places his life in the context of the entire 20th century in this inspiring, yet ultimately blighted, biography. Dawson begins his story with an emotional bang: his account of witnessing the lynching of a young African-American man falsely accused of rape. America’s racial caste system and his illiteracy emerge as the two biggest obstacles in Dawson’s life, but a full view of the man overcoming the obstacles remains oddly hidden. Travels to Ohio, Canada, and Mexico reveal little beyond Dawson’s restlessness, since nothing much happens to him during these wanderings. Similarly, the diverse activities he finds himself engaging in—bootlegging in St. Louis, breaking horses, attending cockfights—never really advance the reader’s understanding of the man. He calls himself a “ladies’ man” and hints at a score of exciting stories, but then describes only his decorous marriage. Despite the personal nature of this memoir, Dawson remains a strangely aloof figure, never quite inviting the reader to enter his world. In contrast to Dawson’s diffidence, however, Glaubman’s overbearing presence, as he repeatedly parades himself out to converse with Dawson, stifles any momentum the memoir might develop. Almost every chapter begins with Glaubman presenting Dawson with a newspaper clipping or historical fact and asking him to comment on it, despite the fact that Dawson often does not remember or never knew about the event in question. Exasperated readers may wonder whether Dawson’s life and his accomplishments, his passion for learning despite daunting obstacles, is the tale at hand, or whether the real issue is his recollections of Archduke Ferdinand. Dawson’s achievements are impressive and potentially exalting, but the gee-whiz nature of the tale degrades it to the status of yet another bowl of chicken soup for the soul, with a narrative frame as clunky as an old bone.
Pub Date: Feb. 1, 2000
ISBN: 0-375-50396-X
Page Count: 288
Publisher: Random House
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Dec. 15, 1999
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