Complications: A Surgeon’s Notes on an Imperfect Science

Atul Gawande’s Complications: A Surgeon’s Notes on an Imperfect Science is a collection of essays that weaves narratives from Gawande’s personal experience as a surgical resident together with research, philosophy, and case studies in medicine. Published in 2002, Complications became a 2002 National Book Award Finalist for Nonfiction. Gawande, a Rhodes Scholar and MacArthur Fellow, is a surgeon at Brigham and Women’s Hospital in Boston, a professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health, and a professor of surgery at Harvard Medical School. He’s also the author of three other books on medicine and a writer for The New Yorker and Slate.

Complications contains 14 essays divided into three sections: Part 1, “Fallibility”; Part 2, “Mystery”; and Part 3, “Uncertainty.” In Part 1, Gawande embarks on a candid discussion of errors and imperfections in medicine. In the first essay, “Education of a Knife,” Gawande tracks his ability over time to perform a specific procedure—installing a central line—and discusses the consequences and necessity of training doctors on the job.

“The Computer and the Hernia Factory” contains a debate about technology versus humans in the realm of diagnosis and looks at the successful example of a hospital streamlined for hernia operations, the results of a computer that reads EKGs better than people, and the inextricable role of humans in the diagnosis process.