You can't make a recipe for something as complicated as surgery. Instead, you can make a recipe for how to have a team that's prepared for the unexpected. Atul Gawande More Quotes by Atul Gawande More Quotes From Atul Gawande After readinf some essay on the nature of human fallibility, I was very aware that we are the recipients of a huge amount of discovery over the last century. Medicine exemplifies this. And that has transitioned us from a world in which people's lives were mostly governed by ignorance to one that's constrained by ineptitude. A century ago, we didn't know, for instance, what diseases afflicted us, what their nature really was, or what to do about them. And that has changed. Atul Gawande changed ignorance world These are folks that keep people out of hospitals, out of emergency rooms, out of nursing homes. And not only that, they help people achieve more fulfilling lives. Atul Gawande nursing home people In many ways, the effort to study philosophy was my rebellion away from medicine. I'm the son of two Indian immigrant physicians, so the natural path for me would have been to become a doctor. I ended up doing the master's degree at Oxford in politics, philosophy, and economics while already having a seat in medical school. I was keeping that as my escape hatch. But my hope was that I might become a philosopher or something else entirely. Atul Gawande philosophy school son And in stories, endings matter. Atul Gawande matter stories Good checklists, on the other hand are precise. They are efficient, to the point, and easy to use even in the most difficult situations. They do not try to spell out everything--a checklist cannot fly a plane. Instead, they provide reminders of only the most critical and important steps--the ones that even the highly skilled professional using them could miss. Good checklists are, above all, practical. Atul Gawande difficult-situations missing hands The big thing that's happened is, in the time since the Affordable Care Act has been going on, our medical science has been advancing. We have now genomic data. We have the power of big data about what your living patterns are, what's happening in your body. Even your smartphone can collect data about your walking or your pulse or other things that could be incredibly meaningful in being able to predict whether you have disease coming in the future and help avert those problems. Atul Gawande care helping meaningful Culture matters. Of course, if physicians are rewarded or penalized for their service and results, the culture will change. But the key values we doctors are being pressed to embrace are humility, teamwork, and discipline. Atul Gawande keys humility teamwork What is the alternative to understanding the complexity of the world? Atul Gawande alternatives understanding world In every industrialized nation, the movement to reform health care has begun with stories about cruelty. Atul Gawande reform movement stories Man is fallible, but maybe men are less so. Atul Gawande men The striking thing is that WHO doesn't really have the authority to do any of this. It can't tell governments what to do. It hires no vaccinators, distributes no vaccine. It is a small Geneva bureaucracy run by several hundred international delegates whose annual votes tell the organization what to do but not how to do it.…The only substantial resource that WHO has cultivated is information and expertise. Atul Gawande government organization running Our ideas of what our priorities are shift as we come face-to-face with some of the struggles. Atul Gawande priorities struggle ideas My own son has a congenital heart condition, where his life was saved by a cardiac surgeon stepping in at 11 days of life to save his life. But he is now 21 years old because of constant monitoring and working with him with a primary care physician. that's the only reason now that he's getting to live a long and healthy life. That's what we're not rewarding. They don't have the kind of resources and commitment that we are giving to people like me. I have millions of dollars of equipment available to me when I go to work every day in an operating room. Atul Gawande heart commitment son You want to ensure people can do it right 99 percent of time. When we have to fire one of our surgical trainees, it is never because they dont have the physical skills but because they dont have the moral skills - to practise and admit failure. Atul Gawande skills fire people I chose surgery because I thought that perhaps this would make me more like the kind of person I wanted to be. Atul Gawande surgery kind wanted This was not guilt: guilt is what you feel when you have done something wrong. What I felt was shame: I was what was wrong. Atul Gawande shame guilt done Having great components is not enough, and yet we've been obsessed in medicine with components. We want the best drugs, the best technologies, the best specialists, but we don't think too much about how it all comes together. Atul Gawande technology motivation inspiration In psychology, there's something called the broken-leg problem. A statistical formula may be highly successful in predicting whether or not a person will go to a movie in the next week. But someone who knows that this person is laid up with a broken leg will beat the formula. No formula can take into account the infinite range of such exceptional events. Atul Gawande broken successful next-week Making systems work is the great task of my generation of physicians and scientists. But I would go further and say that making systems work - whether in healthcare, education, climate change, making a pathway out of poverty - is the great task of our generation as a whole. Atul Gawande our-generation motivation inspiration Are doctors who make mistakes villains? No, because then we all are. Atul Gawande doctors villain mistake
