Tuesday, 4 April 2017

Complications: A Surgeon's Notes on an Imperfect Science

Medicine is, I have found, a strange and in many ways disturbing business.

Complications does seem a bit all over the place in the terms of theme, more like a collection of pieces, musings over the ins and outs of being a surgeon, than a book that was written with a purpose in mind. The complications of the title, are a tenuous link. Yes, there are some bits about when procedures go wrong but it's also about the everyday complications of being a doctor.

One of my favourite pieces was about nausea. It's not often talked about but it's certainly something we've all experienced at some point. Whilst the memory of pain fades, the memory of sickness is much stronger. We'll often try again if something hurts us, maybe with a bit more caution, but how often do we stay away from a certain food or drink forever? Because the smell or thought of it, still turns our stomachs years later.

As patients, we want both expertise and progress. What nobody wants to face is that these are contradictory desires.

In a few cases, it touches on the connections between physical and psychological; how we often need to treat both. And does the physical determine the psychological? I liked the case of the newsreader who suffered from extreme blushing. It also tries to explore the reasons we blush, like how maybe the blush triggers feelings of embarrassment rather than the other way round.

In parts beautifully written and also very honest. Yes doctors are fallible, mistakes are made. The only way for them to learn is to practice on people. One chapter focuses on how good doctors go bad, another on the need for autopsies. Some stories reminded me of House and the M&M sessions are something that exist in many professions, just not usually dealing with death. I would certainly try and read one of Atul's more recent books.

We’d all like to think of “problem doctors” as aberrations. The aberration may be a doctor who makes it through a forty-year career without at least a troubled year or two.

Most the books of this type I've read have been from surgeons at the end of their careers, so it's interesting having a resident level doctor write about their profession. It also makes a change reading about medicine from a US perspective, where there's not the shadow of an overworked and underfunded NHS in the background.

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Book Source: Purchased

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