BOOKS: Five Questions for Dr. Atul Gawande, author of "Better"

Growing up, Atul Gawande wanted to be a rock star. He told The New York Times: "I wanted to be a rock star. I played guitar and wrote songs and even had a couple of club shows. I was just terrible." The irony, of course, is that at 41, Atul Gawande is, indeed, a rock star - just not the musical kind.

Gawande, winner of a 2006 MacArthur "genius" grant, is both a star surgeon and a star writer, whose work at his Boston hospital and in The New Yorker has won rave reviews (his 2003 book, "Complications: A Surgeon's Notes on an Imperfect Science" was well received, not the least of all in my home, where my wife is a gushing fan). And his second book, a collection of New Yorker and New England Journal of Medicine essays - "Better: A Surgeon's Notes on Performance" (Amazon link) - is launching this week, with a big profile splashed over the front page of the NYT Arts section. Read the piece here and see a slideshow, called "Good Hands," of Gawande at work (curiously, none of the pictures of him in the print or online editions shows him without his mask - just like the cover of his book).

You can read more about "Better" at Gawande.com (his publicist is Sally McCartin, samccartin at aol - given the volume of requests she is getting, am sure she won't be able to reply to everyone).  See the full book tour schedule below (it's a 14-city tour). If you have never read a piece by him before, I suggest reading "Piecework: Medicine's Money Problem," a 4,000-word reported essay on the U.S. health system's fiscal underpinning that's classic Gawande).   

Earlier today, Gawande answered five quick questions from SAJAforum. Answers below. Post your thoughts in the comments section below.

FIVE QUESTIONS FOR ATUL GAWANDE, M.D.

SAJAforum: You are really showing up the rest of us who can barely keep one career going. How in the world do you manage to be both a successful surgeon and prolific writer?
Gawande: I don't honestly know. Everyday I just try to get a little something done.

SAJAforum: How did this new book come about? And tell us how it's different from "Complications."
Gawande: I found after I completed my surgery training that I was thinking about our imperfection. in medicine from a new perspective. Complications was written by
someone just out of medical schoool trying to understand why medicine is imperfect. Better is written from someone who has finally become competent but
is wondering, given our imperfection and the complexity that medicine now requires, how does one actually become great at what one does. The answer has both mechanical and moral dimensions to it. And a striking finding is how different and larger the lessons are from sports and business, where we usually turn for lessons about performance.

SAJAforum: You have a couple of South Asian characters in the book. Tell us about them.

Gawande: There are four I write about in this book. But the one I write about at greatest
length is Pankaj Bhatnagar, a physician and field director with the World Health
Organization that I travelled with as he responded to an outbreak of polio in
Karnataka. This was in many ways an ordinary man. But he had learned how to
succeed in doing an extraordinary thing: marshalling a seemingly impossible
effort to go door-to-door to vaccinate 4.2 million children in a 50,000-square-mile area in just 48 hours. Remarkable.

SAJAforum: How has the MacArthur changed your life?
Gawande: I'm still figuring it out. The biggest change so far, though, is in how my
colleagues in surgery regard the work I do. For a long time, they regard the
writing, I think, as something of a hobby--a neat hobby, to be sure, but a
hobby. The MacArthur foundation saw the research and writing and surgery the way
I do, though: as an integrated whole. There are answers of importance to be
found in each kind of work and the MacArthur may make it possible for me to make
writing a significant part of my day job rather than something I do just around
the edges.

SAJAforum: There seem to be a lot of doctors who are also writers, journalists,
etc. Any advice to physicians who are considering doing some writing?
Gawande: There does seem to be a sudden surge of physicians communicating in some way or
another --through television, fiction, journalism, book-writing. And the great
thing is to see the uncommonly high level of that work at present. It raises the
stakes for all of us. My advice for would-be physician-writers? It's the same as
for any would-be writer: write! And find somewhere to publish - whether it's a
newsletter, an internet blog, or a magazine. The key is to write, put it out,
and then learn from what went right or wrong in order to try again.

[SAJAforum note: Here's how the NYT captured Gawande's relationship with writing in today's story:

He began contributing little pieces to Slate about 10 years ago, while still a resident, he said, even though he thought he had no particular aptitude and had never written for publication before. He took one writing course in college, and the instructor told him that he could write a sentence but had nothing to say. “Slate was perfect for me,” he explained, “because it enabled me to fly under the radar. It was just like going through surgical residency. I did 30 columns for them, and it was like doing 30 gallbladders. Then I had to learn how to get comfortable with 4,000-word and then 8,000-word essays for The New Yorker.”

He added: “I now feel like writing is the most important thing I do. In some ways, it’s harder than surgery. But I do think I’ve found a theme in trying to understand failure and what it means in the world we live in, and how we can improve at what we do.” ]

[ Book tour schedule - see updates at Gawande.com ]
(cover on right from March 2007 issue of The Indian American)

04/03/2007: U.S. and Canada Release Date for Better: A Surgeon's Notes on Performance (Metropolitan Books)

04/09: Boston     06:00 PM

HARVARD BOOK STORE sponsored event at THE BRATTLE THEATRE -- Discussion & Signing

40 Brattle Street

Cambridge, MA 02138       

04/10: New York     07:00 PM       

BARNES & NOBLE -- Discussion & Signing

1972 Broadway - Lincoln Center

New York, NY  10023

04/11: Chicago     06:00 PM       

SEMINARY COOP sponsored event at

INTERNATIONAL HOUSE -- Discussion & Signing

1414 East 59th Street

Chicago, IL  60637

04/12: St. Louis     12:00 PM       

WASHINGTON U SCH. OF MEDICINE -- Lecture/Signing

04/12: St. Louis     07:00 PM       

LEFT BANK BOOKS -- Discussion & Signing

399 North Euclid

St. Louis, MO  63108

04/13: Minneapolis     07:30 PM      

MAGERS & QUINN sponsored event at

LYNDALE UNITED CHURCH OF CHRIST -- Discussion & Signing

810 W. 31st St.

Minneapolis, MN

04/16: Taiwan Release Date for Better: A Surgeon's Notes on Performance (Commonwealth)

04/16: Houston     12:00 PM

UNIVERSITY OF TEXAS MEDICAL SCHOOL -- Lecture/signing            

04/17: Denver     07:30 PM       

TATTERED COVER BOOKSTORE -- Discussion & Signing

2526 East Colfax Avenue

Denver, Colorado 80206

04/18: Washington     07:00 PM       

POLITICS & PROSE -- Discussion/Signing

5015 Connecticut Ave. NW

Washington, DC  20008

04/23: Detroit     11:15 AM      

UNIVERSITY OF MICHIGAN/FLINT -- Lecture/signing

04/30: San Francisco     12:00 PM

UC SAN FRANCISCO -- Lecture/signing

04/30: San Francisco     07:30 PM       

KEPLER'S BOOKS -- Discussion & Signing

1010 El Camino Real

Menlo Park, CA  94025

05/01: San Francisco     06:00 PM      

COMMONWEALTH CLUB -- Lecture & Signing

595 Market Street

San Francisco, CA  94105

05/02: Portland   12:00 PM

OREGON HEALTH & SCIENCE UNIVERSITY -- Lecture & Signing

05/02: Portland     07:30 PM      

POWELL'S CITY OF BOOKS, BURNSIDE -- Discussion & Signing

1005 West Burnside

Portland, OR  97209

05/03: Seattle   12:00 PM

AMAZON.COM --Discussion & Signing

1200 12th Avenue, South/Pacific Medical Building

8th Floor AV Room

Seattle, WA  98108

05/03: Seattle     07:00 PM       

ELLIOTT BAY BOOK CO. sponsored event at

SEATTLE PUBLIC CENTRAL LIBRARY -- Discussion & Signing

Microsoft Auditorium

1000 Fourth Avenue

Seattle 98104

05/08: Newton, MA     7:30 PM

NEWTONVILLE BOOKS -- Books and Brews Event

296 Walnut Street

Newton, MA  02460

05/14: Philadelphia     06:00 PM       

UNIVERSITY OF PENNSYLVANIA MEDICAL SCHOOL

Commencement Address

05/17: Baltimore

JOHNS HOPKINS MEDICAL SCHOOL

Commencement Address

05/31: UK, Australia, and New Zealand Release Date

06/01: India Release Date for Better: A Surgeon's Notes on Performance (Penguin Books)

Post your thoughts in the comments section below.

 

 

Comments

[Louise Spencer]

I have read both books by Gawande now as well as How Doctors Think. They have given me terrific insight into the medical community--both the pluses and the minuses. I understand now why getting a diagnosis for anemia and fatigue took over two years. I also have better insight into how to work with my doctors in a more intelligent and efficient manner, I think. It is about time that medical people came out of the closet to help us all understand the whole process. Only then can both consumer and medical community work together toward improvement. Keep on keeping on!!