Better

Starred review from February 12, 2007
Surgeon and MacArthur fellow Gawande applies his gift for dulcet prose to medical and ethical dilemmas in this collection of 12 original and previously published essays adapted from the New England Journal of Medicine
and the New Yorker
. If his 2002 collection, Complications
, addressed the unfathomable intractability of the body, this is largely about how we erect barriers to seamless and thorough care. Doctors know they should wash their hands more often to avoid bacterial transfer in the ward, but once a minute does seem extreme. Using chaperones for breast exams seems a fine idea, but it does make situations awkward. "The social dimension turns out to be as essential as the scientific," Gawande writes—a conclusion that could serve as a thumbnail summary of his entire output. The heart of the book are the chapters "What Doctors Owe," about the U.S.'s blinkered malpractice system, and "Piecework," about what doctors earn. Cheerier, paradoxically, are the chapters involving polio and cystic fibrosis, featuring Dr. Pankaj Bhatnagar and Dr. Warren Warwick, two remarkable men who have been able to catapult their humanity into their work rather than constantly stumble over it. Indeed, one suspects that once we cure the ills of the health care system, we'll look back and see that Gawande's writings were part of the story.

Starred review from March 1, 2007
Gawande, a Harvard-trained endocrine surgeon, contributor to "The New Yorker", best-selling author ("Complications: A Surgeon's Notes on an Imperfect Science"), and 2006 MacArthur fellow, examines the nature of how success and excellence are achieved in medicine and how diligence, doing right, and ingenuity can combine to do betterin not only medicine but also all other human endeavors. In a narrative style reminiscent of Oliver Sacks, Sherwin B. Nuland, and Abraham Verghese, Gawande candidly weaves a tapestry of essays on topics as varied as hospital hand washing, polio in India, surgical tents in the Iraq war, physicians' salaries, malpractice insurance, and doctors' roles in lethal injections. The essays are united, as they highlight opportunities for improvement within the medical community, which serves as a successful framework for Gawande's study of a profession predicated on betterment. These revealing, humanistic essays are highly recommended for all libraries. Gawande's varied accomplishments have been publicized, and this book is certain to be a best seller [For a Q& A with Gawande, see "LJ" 3/15/07.Ed.]James Swanton, Harlem Hosp. Lib., New York

Copyright 2007 Library Journal, LLC Used with permission.

March 1, 2007
Quick. What mundane practice, regularly propagated by generations of moms, could save the lives of thousands of hospital patients? To Brigham & Women's Hospital general surgeon and " New Yorker" staff writer Gawande, that question's answer is but one way to improve a profession where a "C+" performance rating just isn't good enough. The follow-up to Gawande's critically acclaimed " Complications" (2002) is a sparkling collection of essays about medical professionals and places where "better" either has or is becoming the norm, where excellence is a journey rather than a destination. While acknowledging that varying levels of achievement are inevitable in any human endeavor, Gawande believes the medical profession must assume the burden of constant diligence to do better because lives hang in the balance. Rather than preaching about improving performance, Gawande bears witness to the remarkable levels of care that can be achieved by describing some incredibly innovative, adaptive, and even mundane (e.g., conscientious hand washing) practices in hospitals from Boston to the rural Indian village of Uti, from Pittsburgh to Iraqi battlefields.(Reprinted with permission of Booklist, copyright 2007, American Library Association.)