In the summer months, we find that we gravitate to a different type of book. Perhaps one that fits in a beach bag, boat tote, or into a woven bike basket. It is a time to relax and enjoy the cadence of longer days and warm lingering evenings.
Pick up the book, listen to a pod cast, or download the audio or e-book version to enjoy on a drive or as you relax on the beach. Here are a few of my favorites by Dr Atul Gawande: renowned surgeon, author, and champion of healthcare improvements.
Better: A Surgeon's Notes on Performance
Gawande A. New York: Picador/Holt; 2007
Dr Gawande's insightful observations from the center of healthcare today-what it is and what could be-are expressed in a book every patient and healthcare professional should read.
Gawande's essays articulate his passion about the complexity of medicine, and the simplicity of our challenges. He examines 3 core principles: diligence, doing things right, and ingenuity.
These themes are woven into stories, with insights into the healthcare system and the individuals who are working to make it better... some challenges, some solutions, all thought provoking and inspiring. His message is personal as he inspires us to do better.... He reminds us that success is hundreds of small steps... in the right direction. Perhaps, that the secret to doing "better" isn't more research, or new technology. It's simply doing many things, even the small things like hand washing, better. Download this link to hear Dr Gawande read from Better: http://www.npr.org/2007/06/12/10952407/atul-gawande-reads-from-better. This reading of Better took place in April 2007 at the Politics & Prose bookstore in Washington, DC.
Complications: A Surgeon's Notes on an Imperfect Science
Gawande A. New York: Metropolitan Books/Holt; 2002
Dr Gawande's first collection of essays poises important questions, such as how much input should a patient have, how can a young doctor gain experience safely, and how do we handle our mistakes? Complications is not just a book about doubt and error; it is an honest view, from a healthcare professional who informs and inspires us by creating a deeper understanding of the challenges we face as we care for patients in a dangerous system. This publication was released just as the public and providers were beginning to struggle with the reality of medical errors and the fragility of safe medical care. It is as timely today as it was at the time of initial publication. Gawande raises questions that patients and caregivers must never stop asking.
The Checklist Manifesto: How to Get Things Right
Gawande A. New York: Metropolitan Books/Holt; 2009
This book has changed the way I think about the world, healthcare, and my own practice. The main theme is again quite simple; no matter how expert you may be, a checklist can improve your outcomes.
Dr Gawande tells stories that illustrate the complexity of our system. Within a complex system, errors occur... things get left out... stuff happens. Searching for methods to operate within this complexity, healthcare leaders have adapted techniques used by the aviation industry for years, including the pilot checklist. Gawande brings us inside a world where professionals are committed to error prevention and are dedicated to checklist. Checklists are not unique to aviation, as we appreciate when Gawande ascends to the top of a new building under construction, where he describes his experience looking over the Boston skyline. He listens as the engineers, architects, and constructions managers describe the many checklists that cascade together to ensure a safe structure. The conclusions are obvious; we can and should do this in our daily work, in all areas of healthcare. He reflects on the work of Dr Peter Pronovost, who engineered the checklist for central line insertion. Gawande takes this opportunity to introduce us to the World Health Organization's Safe Surgical Program.
Dr Gawande published his first book while he was still a resident. He was recognized as a National Book Award finalist in 2002 and earned a MacArthur "genius" fellowship in 2006. Dr Gawande writes for The New Yorker and is a frequent contributor to The New England Journal of Medicine.
Many nonfiction books give us insights into the patient experience and allow us to reflect on extraordinary roles we play in the lives of our patients. Authors Joan Didion and Anne Fadiman write with clarity and elegance about the patient and family experience.
The Year of Magical Thinking
Didion J. New York: Vintage Book; 2006
One of America's most brilliant writers, Joan Didion, shares her experience after the sudden death of her husband and the critical illness of her daughter. Didion writes about an intensely personal yet universal experience: a portrait of family illness and death, a journey of vulnerability, despair, and grief.
On Christmas day 2003, Joan's only daughter, Quintana, went to an emergency room in New York City with flulike symptoms. She was admitted with possible septic shock and immediately moved to the intensive care unit. Five days later, Joan and John Didion sat down to dinner. In midsentence, John suddenly slumped over and fell to the floor. Joan called 911. Later that evening, he was pronounced dead.
As nurses, we know this vulnerability; we feel it when we hold the hands of family members, care for them at the bedside, and stand vigil with them. Didion gives us a visceral account of what we do not see. She takes us home with her, carrying the hospital bag of belongings, to the living room that was transformed into an emergency room after her 911 call. Her words tell us about grief; "it is nothing we expect it to be," she writes. "Life changes in an instant. You sit down to dinner, and life as you know it ends."
Ms Didion writes about the year she spent trying to come to terms with what happened, her thoughts, feelings, writing she "cut loose any fixed idea I had ever had about death, about illness... about grief... about the ways in which people do and do not deal with the fact that life ends...."
Her only child is critically ill, unconscious in an intensive care unit, and her husband suddenly dead. It is an honest view into the lives of many families we care for. There is much we can learn about compassion and family needs through this personal story of loss, grief, and sorrow.
The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures
Fadiman A. New York: Farrar, Straus, and Giroux; 1997
Anne Fadiman relates the true story of Lia Lee, a Hmong child whose family came from Laos in 1980, when the refugee family settled in California. Lia was only 3 months old when she suffered a seizure, the first of many. She was brought to the local community medical center in Merced, California. The family described her symptoms as "qaug dab peg," translated to mean "The spirit catches you and you fall down." The Hmong-English translation is epilepsy. The book follows the child's complicated medical course and the devastating effects of cultural dissonance between healthcare providers and families. The book explores the tremendous harm that results when spiritual healing and cultural beliefs are ignored by Western medicine. The misunderstandings were described as "collisions," resulting in tragedy and unimaginable suffering. Highly competent doctors and nurses saw the best treatment as a confusing combination of pills, while her parents wanted to use a combination of Western medicine and folk remedies designed to coax her wandering soul back into her body. Years of linguistic confusion and cultural differences between a loving family and dedicated providers led to a devastating outcome. The book is disturbing and enlightening; it gives voice to patients and providers, as the two cultures collide inside-out healthcare system. The book includes a discussion guide that would be an excellent resource for a cultural seminar.