Atul Gawande, Better

[sanguinity]

19. Atul Gawande, Better.

Let me be up front about this: the way folks talk about Malcolm Gladwell is the way I feel about Atul Gawande. Gladwell is a bit too pop and shiny for me, and his "look at this in a new way" perspectives often seem a bit of a stretch. Sure, I learned some neat stuff, but it's mostly shiny factoids -- his framework ideas seldom reach my personal threshold of whoah.

Atul Gawande, though-- Well, I've got a great, big, sciencey crush on Gawande.

Part of my crush, of course, is that our interests match up astonishingly well. We both think of the world in terms of systems, we both are constantly poking at the structural, meta- causes of why things fail. We also both wrestle with personal responsibility, both what it means to do right, and what actually doing right (in the real world, non-theoretically) requires. When I read Gawande, it's clear that we've both been thinking about, and wrestling with, the same things. And it's clear that Gawande has been thinking about them better.

Gawande's most recent book, Better, is a natural follow-up to Complications -- not simply an elucidation of how and why systems fail (the main topical theme of Complications) -- but a discussion of what success looks like, and what is required to bring that within practical reach. (Or rather, what improvement looks like. Gawande, like me, believes that any practical notion of success is best defined as improvement.) Gawande's essays are drawn from his experiences as a surgeon, but the specific topics are diverse: medicalization of state executions; the success (and its unanticipated non-monetary costs) of the new improvements in battlefield medicine; changing global medical demographics and the struggle of local medicine to keep up; the reason that the C-section has become ubiquitous in modern medicine while less-traumatic birth techniques have become all but forgotten. And through it all, Gawande twines his questioning about the world. It is difficult to say whether Better is a work about science, about philosophy, about the structure of reality, or simply the struggle to live a meaningful life.

Yum. Those of you who know me, you can see why I have a crush on this man, yes?

In his afterword, he highlights a recurring theme of the book: that groundbreaking advances in science often don't come from institutional researchers, but from folks in the field trying to get through the actual, practical work that needs doing. (I concur: my greatest science heroes are folks who "simply" noticed things that had not been previously noticed, and who then made them noticeable to others.) Gawande obviously feels that a good portion of fulfillment in life comes from the ability to make things better, and to not feel like a cog in a machine. He makes five suggestions that he has found useful -- suggestions that could almost as easily be retitled "A Layman's Guide to Fulfillment Through Doing In Situ Science":

1. Ask an unscripted question.
   
2. Don't complain.
   
3. Count something.
   
4. Write something.
   
5. Change.

I could write essays on most of those -- especially the first and third. And I could draw great parallels between that list and why I participate in this group. But I won't. Let me just say that I find this book crazy-inspiring, and not in the flash-and-charisma way, but in the quiet, deep, this-is-life-the-universe-and-everything sort of way.

So. Yeah. I'm a crushity-happy science geek. Who, fresh out of Gawande books, is comforting herself with his New Yorker archives.

Comments

[oyceter]

Ooo, thanks! I love pop science-y books, and Gladwell's a little too shiny for me as well.

[sanguinity]

You're welcome. And I'll be interested to hear your take on them, if/when you get there. :-)

[nebulist.livejournal.com]

Thanks for the link - I am enjoying reading some of the articles.

[sanguinity]

Oh, yay! You may have already noticed that there's a big difference between the NYT and the New Yorker articles -- the essays in his books are drawn from the latter.

[nebulist.livejournal.com]

I read a couple of the NYT articles so far. If you have any specific recommendations on which articles to read, BTW, I am all ears. :)

[sanguinity]

It's more that he's writing different kinds of pieces for the different venues -- if his writing for one isn't clicking for you, it's worth sampling some of the others. If you want to know what the books are like, have a look at the New Yorker essays -- most or all of the essays in the books started as New Yorker articles.

Hm... On inspection, most of the New Yorker essays are under lock. Of what is available here, I thought "The Score" was particularly fascinating, as was "The Bell Curve". Both are quite a bit longer than the NYT op-eds.

[nebulist.livejournal.com]

Oh, "The Bell Curve" is the one I had started reading, heh. I will also check out the other one. I like his writing in both NYT and NY from what I've read. Thanks again!

[rydra_wong]

Linkage yay! I didn't know he had a website, so thank you so much for that. I loved Complications, and Better is on my to-read pile.

[sanguinity]

Didja notice that he edited the Best Science Writing 2006? His criteria was anything that he thought was cool. Which, given how much I groove on Gawande's thoughts, makes me feel optimistic that the 2006 anthology will be pretty groovy itself.

[hhw]

thanks for posting about Gawande's work -- I would probably have overlooked the books as being surgeon-specific, but I just picked up the copy of Better at the library where I work, and I was immediately sucked in.

[sanguinity]

Yay! I hope you continue to enjoy.

And he's definitely not surgeon-specific. You could make the argument that he's medicine-specific, but I'm not sure I'm wiling to go that far. Some of the essays are definitely about medicine, but others simply use medicine as an example-set for discussing something else.

[bibliofile.livejournal.com]

I would probably have overlooked the books as being surgeon-specific

Yes, me too. [Inserts mild rant about why they probably included that in the title.] Now I'm wondering if the other hold on Complications in my local library is someone else in this community . . .

[jinian.livejournal.com]

I read this last week! I liked it too, very good thinking. (Will definitely look for that Best Science Writing, too, if I can figure out where they're hiding the recent ones in the bookstore.)