By Atul Gawande: Better: A Surgeon's Notes on Performance Paperback – January 1, 2007

I read this book for a course on disability ethics and couldn't put it down!

Perfect what I wanted?.

I listened to BETTER on CD, and was captivated by Gawande's message. As a surgeon he has learned that in many ways both he and the entire medical community have room for improvement. From the simple things we assume are well done, to the difficult care of the patient with Cystic Fibrosis, to the fight to eradicate just one disease in one country, there is more that could be done: better practices, more access, a simple attention to the humanity of each patient, as well as the care team for each patient, which should include the patient or the patient's caregiver as well.Early in BETTER, Gawande discusses something most of us take for granted: hand washing. He begins with the early understanding of the importance of washing (and the resounding refusal to wash by those in the profession for many years after) all the way to today, when we take for granted that no one skips this step. However, Gawande has seen that this is not the case, and although in some hospital situations much has been done to make washing easier, and teams work hard to implement the rules, hospital-related infections are still a frequent and preventable occurrence. Gawande follows two people who have worked to change the behavior of staff and through statistical studies of the results, the infection rate has dropped. He also shows how easy it is to forget in a moment, with a handshake, an exchange of an item, or simply by leaving a room to check something and returning without thinking.After his studies, Gawande went to India as a visiting doctor. A case of polio in a young child in a distant community had prompted a country-wide effort to vaccinate the children. He followed as people throughout India were trained, provided with vaccines, and sent to even the farthest distances to seek families and convince them of the need to allow them to vaccinate the children. You can imagine the difficulties they faced, but the numbers of children they reached were phenomenal. Later in the book there is a section doctors in India who often have little or nothing to work with yet still demonstrate phenomenal ingenuity and success.Gawande covers mistakes made, difficult medical decisions, and ways doctors can help themselves to overcome stress through positive behavior changes, and become better doctors.The chapters on centers dedicated to the treatment of Cystic Fibrosis were amazing. What a center in Cincinnati did to achieve better outcomes, using methods a center in Minnesota had adopted, were fascinating. He narrates how sharing information instead of keeping one center's successful methods or another's lack of success a secret results in better outcomes. Also demonstrated was the importance of involving the patient and the family in treatment decisions and best practices discussions.I was drawn to this title after reading his earlier book, BEING MORTAL. I do not hesitate to recommend either title, you will not be disappointed.