code blog: tales of a nurse

But first... some housekeeping issues. My enormously patient and talented husband has decided against expandable comments, with the explanation that loading them will take too long. So until I can nag him sufficiently and bend him to my will, or he succeeds in keeping my nagging at bay, we'll just have to live with reading comments on another page. There there now... there are more difficult things to live with.

Oddly, the expandable "keep reading..." thing now works in Safari, with no intervention from us. Weird. But cool.

Anyway. I've added a new category - Book Report! I'm sure there's a more elegant phrase, but I've never been one to be elegant. For my first Book Report, I've chosen "Complications: A Surgeon's Notes on an Imperfect Science" by Atul Gawande. (Parts of this book have also been reflected upon by Blogborygmi.)

I really enjoy reading medical books, especially nonfiction. "Complications" was 100% brain candy as far as I was concerned, and I'm assuming you'd like for me to get to the point of why already. First of all, it's written very candidly. Dr. Gawande has a very easy-to-read writing style. He gets your attention within the first few sentences and doesn't let go. He has numerous anecdotes and stories woven in with his own personal take on several different topics, including medical malpractice suits, surgeon burn-out and even the Friday The 13th Curse.

He goes on to describe the error-laden science of human beings treating other human beings. Illnesses sometimes present "textbook," but most don't. In trying to figure out what the heck is going on, doctors and surgeons sometimes... make mistakes! He writes about several of his own mistakes as well as a few of his colleague's. Even though I work in the medical world, I was surprised at how in-depth his writing is concerning something that is usually a taboo subject; how willingly he opens the doors into the mind of a person who is In Charge Of Saving Your Life Right Now But Is Scared Witless NoneTheLess.

As an example of this, I'll tap out an excerpt: If I had actually thought this far along, I would have recognized how ill-prepared I was to do an emergency "trache." As the one surgeon in the room, it's true, I had the most experience doing tracheotomies, but that wasn't saying much. I had been the assistant surgeon in only about half a dozen, and all but one of them had been non-emergency cases, employing techniques that were not designed for speed. The exception was a practice emergency trache I had done on a goat. I should have immediately called Dr. Ball for backup. I should have got the trache equipment out-lighting, suction, sterile instruments-just in case. Instead of hurrying the effort to get the patient intubated because of a mild drop in saturation, I should have asked Johns to wait until I had help nearby. I might even have recognized that she was already losing her airway. Then I could have grabbed a knife and done a tracheotomy while things were still relatively stable and I had time to proceed slowly. But for whatever reasons-hubris, inattention, wishful thinking, hesitation, or the uncertainty of the moment-I let the opportunity pass.

Being a surgeon, he writes about some of his own patients (gastric bypass, a futile spinal surgery, among others) and interestingly, he actually follows up! We get to find out the patient's progress from surgery to how they've gotten on with their lives years later, for better or worse. The very last chapter, "The Case Of The Red Leg" kept me up waaaaaaay past my bedtime.

And really, what better praise for a book is there??