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	<title>code blog - tales of a nurse &#187; Book Report</title>
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		<title>Complications</title>
		<link>http://www.codeblog.com/archives/book_report/complications.html</link>
		<comments>http://www.codeblog.com/archives/book_report/complications.html#comments</comments>
		<pubDate>Tue, 02 Mar 2004 04:10:08 +0000</pubDate>
		<dc:creator>geena</dc:creator>
				<category><![CDATA[Book Report]]></category>

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			<content:encoded><![CDATA[<p>But first&#8230; 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&#8217;ll just have to live with reading comments on another page.  There there now&#8230; there are more difficult things to live with.</p>
<p>Oddly, the expandable &#8220;keep reading&#8230;&#8221; thing now works in Safari, with no intervention from us.  Weird.  But cool.</p>
<p>Anyway.  I&#8217;ve added a new category &#8211; Book Report!  I&#8217;m sure there&#8217;s a more elegant phrase, but I&#8217;ve never been one to be elegant.  For my first Book Report, I&#8217;ve chosen <a href="http://www.amazon.com/exec/obidos/ASIN/0312421702/ref%3Dnosim/tilegarden-20/103-1502348-1327852">&#8220;Complications: A Surgeon&#8217;s Notes on an Imperfect Science&#8221;</a> by Atul Gawande.  (Parts of this book have also been reflected upon by <a href="http://blogborygmi.blogspot.com/2004_02_01_blogborygmi_archive.html#107799658352714226">Blogborygmi</a>.)</p>
<p>I really enjoy reading medical books, especially nonfiction.  &#8220;Complications&#8221; was 100% brain candy as far as I was concerned, and I&#8217;m assuming you&#8217;d like for me to get to the point of why already.  First of all, it&#8217;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&#8217;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.</p>
<p>He goes on to describe the error-laden science of human beings treating other human beings.  Illnesses sometimes present &#8220;textbook,&#8221; but most don&#8217;t.  In trying to figure out what the heck is going on, doctors and surgeons sometimes&#8230; <i>make mistakes!</i>  He writes about several of his own mistakes as well as a few of his colleague&#8217;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.</p>
<p>As an example of this, I&#8217;ll tap out an excerpt: <i>If I had actually thought this far along, I would have recognized how ill-prepared I was to do an emergency &#8220;trache.&#8221;  As the one surgeon in the room, it&#8217;s true, I had the most experience doing tracheotomies, but that wasn&#8217;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.</i></p>
<p>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&#8217;s progress from surgery to how they&#8217;ve gotten on with their lives years later, for better or worse.  The very last chapter, &#8220;The Case Of The Red Leg&#8221; kept me up waaaaaaay past my bedtime.</p>
<p>And really, what better praise for a book is there??</p>
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