Recommendation: I mean sure, if you are into this sort of thing
Where to read: Not before entering a doctors office
Read with: Archie Rose Bone Dry Gin
In brief: Gawande is ridiculously overachieving – Rhodes Scholar, McArthur Fellowship winner, Masters of Public Health, Masters in PPE (classic Oxford), surgeon and professor. This is a sort of whistle-stop tour of some of his more interesting or poignant cases, written in gloriously effortless prose.
This sits in roughly the same genre as This is Going to Hurt or Unnatural Causes and is likely to appeal to similar audiences. Published in 2002, Complications brings together a series of essays and anecdotes written during Gawande’s surgical residency. Being an essay collection, it does feel like something of a mishmash at times however the broad organisation into three thematic sections – Fallibility, Mystery and Uncertainty – means it mostly hangs together. Some of these essays are still available online in their original form if you want to get a preview.
The individual case studies are interesting in their own right but the overarching point Gawande is trying to make is that doctors are fundamentally human and, as the title suggests, medicine is an imperfect science. It also fits into his more general work in public communication around medicine (see, for example, the Frontline episode based on his book Being Mortal).
I will say that it is, at times a slightly alarming read, particularly given I have recently binged Dr Death and the associated podcast (there is a fascinating chapter about the difficulties in dealing with impaired physicians). Even without malice or negligence, the idea, for example, that autopsies are becoming less common is alarming; this means doctors are getting less feedback about the actual cause of death (which may well be different from what the patient was diagnosed with) and are therefore less likely to learn about unusual presentations or their own knowledge gaps. Similarly, Gawande teases out the balance between the need to inexperienced doctors learn by treating patients and the very real risk to patients that entails.
Overall, the most impressive part of this is the prose – Gawande writes brilliantly and manages to communicate complex issues and ethical dilemmas with beautiful simplicity. If all science communication was done this well, the world would be a much better place.