Writers of Color 50 Books Challenge

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.