Complications: A Surgeon’s Notes on an Imperfect Science

The co-existence of fallibility amidst the quest for perfection is a defining trait of medicine and, consequently, of the book Complications. As Gawande weaves together disparate essays about individual mistakes, systemic flaws, and even bad behavior, he constantly keeps in view the ways doctors, researchers, and other medical professionals make these mistakes while striving for perfection. The life-and-death stakes of medicine turn a theme of fallibility amidst the quest for perfection into a suspenseful narrative tool.

In “When Good Doctors Go Bad,” Gawande zeroes in on the case of Dr. Hank Goodman to discuss one doctor’s egregious error but also to discuss surgeons’ relationships with their own fallibility, and with each other’s. Doctors are supposed to band together to confront and remove a troublesome doctor, but as Gawande says, this process rarely happens smoothly, if at all: “no tight-knit community can function that way” (94). In Goodman’s case, it took a third party, a facility dedicated to rehabilitating “bad doctors,” to step in and face his fallibility head-on.

Gawande includes several stories of patient care that involve errors or wrong calls by doctors, the sheer number of examples serving to normalize the fallibility of physicians who might be generally thought of as near-perfect.