Better Atul Gawande Quotes & Sayings

The possibilities and probabilities are all we have to work with in medicine, though. What we are drawn to in this imperfect science, what we in fact covet in our way, is the alterable moment-the fragile but crystalline opportunity for one's know-how, ability, or just gut instinct to change the course of another's life for the better. — Atul Gawande

A study led by the Harvard researcher Nicholas Christakis asked the doctors of almost five hundred terminally ill patients to estimate how long they thought their patient would survive, and then followed the patients. Sixty-three per cent of doctors overestimated survival time. Just seventeen per cent underestimated it. The average estimate was five hundred and thirty per cent too high. And, the better the doctors knew their patients, the more likely they were to err. — Atul Gawande

As people's capacities wane, whether through age or ill health, making their lives better often requires curbing our purely medical imperatives - resisting the urge to fiddle and fix and control. — Atul Gawande

MODERN SCIENTIFIC CAPABILITY has profoundly altered the course of human life. People live longer and better than at any other time in history. But scientific advances have turned the processes of aging and dying into medical experiences, matters to be managed by health care professionals. And we in the medical world have proved alarmingly unprepared for it. — Atul Gawande

A nurse has five seconds to make a patient like you and trust you. It's in the whole way you present yourself. I do not come in saying, 'I'm so sorry.' Instead, it's: 'I'm the hospice nurse, and here's what I have to offer you to make your life better. And I know we don't have a lot of time to waste. — Atul Gawande

I think we are faced in medicine with the reality that we have to be willing to talk about our failures and think hard about them, even despite the malpractice system. I mean, there are things that we can do to make that system better. — Atul Gawande

Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try. — Atul Gawande

I write because it's my way of finding cool ideas, thinking through hard problems and things I don't understand, and getting better at something. — Atul Gawande

Two-thirds of the terminal cancer patients in the Coping with Cancer study reported having had no discussion with their doctors about their goals for end-of-life care, despite being, on average, just four months from death. But the third who did have discussions were far less likely to undergo cardiopulmonary resuscitation or be put on a ventilator or end up in an intensive care unit. Most of them enrolled in hospice. They suffered less, were physically more capable, and were better able, for a longer period, to interact with others. In addition, six months after these patients died, their family members were markedly less likely to experience persistent major depression. In other words, people who had substantive discussions with their doctor about their end-of-life preferences were far more likely to die at peace and in control of their situation and to spare their family anguish. — Atul Gawande

There is a saying about surgeons, meant as a reproof: "Sometimes wrong; never in doubt." But this seemed to me their strength. Each day surgeons are faced with uncertainties. Information is inadequate; the science is ambiguous; one's knowledge and abilities are never perfect. Even with the simplest operation, it cannot be taken for granted that a patient will come through better off - or even alive. Standing at the table my first time, I wondered how the surgeon knew that he would do this patient good, that all the steps would go as planned, that the bleeding would be controlled and infection would not take hold and organs would not be injured. He didn't, of course. But still he cut. — Atul Gawande

Obstetrics went about improving the same way Toyota and General Electric went about improving: on the fly, but always paying attention to the results and trying to better them. And — Atul Gawande

Research has found that loss of bone density may be an even better predictor of death from atherosclerotic disease than cholesterol levels. — Atul Gawande

We now live in the era of the super-specialist - of clinicians who have taken the time to practice at one narrow thing until they can do it better than anyone who hasn't. — Atul Gawande

Equally worrying, and far less recognized, medicine has been slow to confront the very changes that it has been responsible for - or to apply the knowledge we have about how to make old age better. Although the elderly population is growing rapidly, the number of certified geriatricians the medical profession has put in practice has actually fallen in the United States by 25 percent between 1996 and 2010. Applications to training programs in adult primary care medicine have plummeted, while fields like plastic surgery and radiology receive applications in record numbers. Partly, this has to do with money - incomes in geriatrics and adult primary care are among the lowest in medicine. And partly, whether we admit it or not, a lot of doctors don't like taking care of the elderly. — Atul Gawande

When I was a child, the lessons my father taught me had been about perseverance, never to accept limitations that stood in my way. As an adult, watching him in his final years, I also saw how to come to terms with limits that couldn't simply be wished away. When to shift from pushing against limits to making the best of them is not often readily apparent. But it is clear that are times when the cost of pushing exceeds its value. Helping my father through the struggle to define that moment was simultaneously among the most painful and most privileged experiences of my life. Part of the way my father handled the limits he faced was by looking at them without illusion. Though his circumstances sometimes got him down, he never pretended they were better than they were. He always understood that life is short and one's place in the world is small. But he also saw himself as a link in a chain of history. — Atul Gawande