Better: A Surgeon’s Notes on Performance

Atul Gawande, the author and narrator of Better, is a Harvard-educated surgeon who has published numerous books and is a well-known public-health researcher. Throughout the book, the deeply analytical Gawande meticulously explores ethical dilemmas faced by doctors in various situations both in first and third world countries. Gawande is also compassionate and always strives to humanize the face of medicine, which is often portrayed as a monolithic structure. As a narrator who is determined to remain an objective, outside observer, he never stops questioning what it means to be “better,” and he comes to a series of counterintuitive but innovative conclusions as a result.

As a Viennese obstetrician practicing medicine during the 19th century, Ignac Semmelweis was one of the first doctors to realize that there was a correlation between a lack of handwashing by medical personnel and the transmission of diseases to new mothers. He implemented a new handwashing policy, and it saved many lives. However, he was draconian about adherence to his policy, which made it difficult for his colleagues to accept. Gawande uses the cautionary tale of Semmelweis to show that new ideas must be accompanied with intelligent messages and accessible plans for implementation. Otherwise, such ideas will be difficult to enact because humans, especially doctors, are hesitant to change their methods without proof that a new one will work better.