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Friday, November 21, 2008

Better

I recently read 'Better' by Dr. Atul Gawande. This is his second book after 'Complications', which I had read many years ago. Dr. Gawande is a staff member at the Brigham and Women's Hospital and Dana Farber Cancer Institute. He is also an Associate Professor of Surgery at the Harvard Medical School, Associate Professor in the Department of Health Policy and Management at the Harvard School of Public Health, and Associate Director for the BWH Center for Surgery and Public Health. Dr. Gawande is also a staffer at the NewYorker Magazine.

'Better' is a rare and a wonderful book and I thorughly enjoyed it. 'Better' brings forth a great understanding of issues facing the medical fraternity today, the constant quest to do better, to improve the delivery of medicine and care as we know it today. I discovered the importance of hand washing and how this simple act on the part of caregivers in a hospital can avoid infection and save lives. I mean I do know that handwashing is important but had never given a second thought, while I marched into a patient's room in any of the hospitals I worked in.

I was amazed to learn how the medical corps embedded with the American troops in Iraq, would save lives of soldiers seriously injured in terrible warfare. It is mindboggling to imagine soldiers being surgically treated in makeshift hospitals, stabilised and than being sent halfway around the world to Germany for the surgery to be completed and than if needed being sent to the US for more surgery and recuperation. Mortality Rates for those injured in battle have fallen significantly. We are doing better.

Another chapter focuses on the dilemmas of doctors, whose job is to supervise state sanctioned executions. Those condemned to death, must die with dignity and with the least amount of pain. Ironically, it is only doctors, trained in saving lives, who can ensure that a condemned man dies without suffering. Dr. Gawande brings out the issues facing the medical community and doctors with rare sensitivity.

The heroic fight against Cystic Fibrosis, a genetic disease, which limits the cells' ability to regulate the chlorides in the body, is captured in another poignant chapter. The painstaking effort, the diligence and the resolve to have better outcomes shines through Dr. Gawande's prose. Similar tales of WHO's unending battle against diseases such as Polio, takes the readers to rural India, where the logistics of reaching out to millions of illiterate and prejudiced people and convincing them about having their infants vaccinated against Polio comes across as a huge challange. Yet, their is tremendous hope as we know Polio has been on the verge of eradication for many years now.

Dr. Gawande writes with rare luminosity. His accounts are riveting. He documents failures and triumphs of his profession and his own journey as a surgeon, with candour and great understanding.

A must read for everyone and particularly those who have a stake in healthcare.

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