Top 100 Atul Gawande Quotes
#1. The companies' most effective tactic, however, was simply to put out the goods and let surgeons play.
Atul Gawande
#2. We are used to thinking of doctoring as a solitary, intellectual task. But making medicine go right is less often like making a difficult diagnosis than like making sure everyone washes their hands.
Atul Gawande
#3. The volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably.
Atul Gawande
#4. Courage is strength in the face of knowledge of what is to be feared or hoped. Wisdom is prudent strength.
Atul Gawande
#5. This is the reality of intensive care: at any point, we are as apt to harm as we are to heal.
Atul Gawande
#6. Whereas today people often understate their age to census takers, studies of past censuses have revealed that they used to overstate it.
Atul Gawande
#7. We want progress in medicine to be clear and unequivocal, but of course it rarely is. Every new treatment has gaping unknowns - for both patients and society - and it can be hard to decide what do do about them.
Atul Gawande
#8. The history of American agriculture suggests that you can have transformation without a master plan, without knowing all the answers up front.
Atul Gawande
#9. I chose surgery because I thought that perhaps this would make me more like the kind of person I wanted to be.
Atul Gawande
#10. So for any new checklist created from scratch, you have to pick the type that makes the most sense for the situation.
The checklist cannot be lengthy. A rule of thumb some use is to keep it to between five and nine items, which is the limit of working memory.
Atul Gawande
#11. 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
#12. Michael Jordan always had to wear University of North Carolina boxer shorts under his Chicago Bulls uniform.
Atul Gawande
#13. I was never born to write. I was taught to write. And I am still being taught to write.
Atul Gawande
#14. People spend years of sixty-, seventy-, eighty-hour weeks building their base of knowledge and experience before going out into practice on their own - whether they are doctors or professors or lawyers or engineers. They have sought to perfect themselves.
Atul Gawande
#15. We are not omniscient or all-powerful. Even enhanced by technology, our physical and mental powers are limited.
Atul Gawande
#16. Percent of medical students take no course in geriatrics,
Atul Gawande
#17. I said there are at least two kinds of satisfaction, however, and the other has nothing to do with skill. It comes from human connection. It comes from making others happy, understanding them, loving them.
Atul Gawande
#18. We Have Medicalized Aging, and That Experiment Is Failing Us
Atul Gawande
#19. The damage that the human body can survive these days is as awesome as it is horrible: crushing, burning, bombing, a burst blood vessel in the brain, a ruptured colon, a massive heart attack, rampaging infection. These conditions had once been uniformly fatal.
Atul Gawande
#20. 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
#21. We yearn for frictionless, technological solutions. But people talking to people is still the way norms and standards change.
Atul Gawande
#22. Under conditions of complexity, not only are checklists a help, they are required for success.
Atul Gawande
#23. And then a new question arises: If independence is what we live for, what do we do when it can no longer be sustained? In
Atul Gawande
#24. In a fire, the metal can plasticize - lose its stiffness and bend like spaghetti. This was why the World Trade Center buildings collapsed,
Atul Gawande
#25. Studies find that as people grow older they interact with fewer people and concentrate more on spending time with family and established friends. They focus on being rather than doing and on the present more than the future. Understanding
Atul Gawande
#26. Doctors quickly learn that how much they make has little to do with how good they are. It largely depends on how they handle the business side of their practice.
Atul Gawande
#27. Obstetrics went about improving the same way Toyota and General Electric went about improving: on the fly, but always paying attention to the results and trying to better them. And
Atul Gawande
#28. Health care confronts us with a difficult test. We have never corrected failure in something so deeply embedded in people's lives and in the economy without the pressure of an outright crisis.
Atul Gawande
#29. Before taxiing out to the runway, we paused again for five more checks: whether anti-icing was necessary and completed, the autobrakes were set, the flight controls were checked, the ground equipment was cleared, and no warning lights were on. The three checklists
Atul Gawande
#30. 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
#31. No matter what measures are taken, doctors will sometimes falter, and it isn't reasonable to ask that we achieve perfection. What is reasonable is to ask that we never cease to aim for it.
Atul Gawande
#32. Whatever the limits and travails we face, we want to retain the autonomy - the freedom - to be the authors of our lives.
Atul Gawande
#33. 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 don't have the physical skills but because they don't have the moral skills - to practise and admit failure.
Atul Gawande
#34. But now the problem we face is ineptitude, or maybe it's "eptitude" - making sure we apply the knowledge we have consistently and correctly. Just making the right treatment choice among the many options for a heart attack patient can be difficult, even for expert clinicians.
Atul Gawande
#35. Instead they choose to accept their fallibilities. They recognised the simplicity and power of using a checklist.
Atul Gawande
#36. The only way death is not meaningless is to see yourself as part of something greater: a family, a community, a society.
Atul Gawande
#37. Their attitude seemed to result from incomprehension rather than cruelty, but as Tolstoy would have said, what's the difference in the end?
Atul Gawande
#38. In the past few decades, medical science has rendered obsolete centuries of experience, tradition, and language about our mortality and created a new difficulty for mankind: how to die.
Atul Gawande
#39. And the reason is increasingly evident: the volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably. Knowledge has both saved us and burdened us.
Atul Gawande
#40. But as your horizons contract - when you see the future ahead of you as finite and uncertain - your focus shifts to the here and now, to everyday pleasures and the people closest to you.
Atul Gawande
#41. human beings fail the way all complex systems fail: randomly and gradually.
Atul Gawande
#42. I learned about a lot of things in medical school, but mortality wasn't one of them.
Atul Gawande
#43. Culture has tremendous inertia," he said. "That's why it's culture. It works because it lasts. Culture strangles innovation in the crib.
Atul Gawande
#44. As Montaigne wrote, observing late-sixteenth-century life, To die of age is a rare, singular, and extraordinary death, and so much less natural than others: it is the last and extremest kind of dying.
Atul Gawande
#45. So Pabrai added the following checkpoint to his list: when analysing a company, stop and confirm that you've asked yourself whether the revenues might be overstated or understated due to boom or bust conditions.
Atul Gawande
#46. New technology also creates new occupations and requires new expertise, which further undermines the value of long experience and seasoned judgment.
Atul Gawande
#47. People die only once. They have no experience to draw on.
Atul Gawande
#48. Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of coordination.
Atul Gawande
#49. How we seek to spend our time may depend on how much time we perceive ourselves to have.
Atul Gawande
#51. The biggest cause of serious error in this business is a failure of communication,
Atul Gawande
#52. A young doctor is not so young nowadays; you typically don't start in independent practice until your midthirties. We
Atul Gawande
#53. In the United States, 25 percent of all Medicare spending is for the 5 percent of patients who are in their final year of life, and most of that money goes for care in their last couple of months that is of little apparent benefit.
Atul Gawande
#54. Neuroscientists have found that the prospect of making money stimulates the same primitive reward circuits in the brain that cocaine does.
Atul Gawande
#55. My vantage point on the world is the operating room where I see my patients.
Atul Gawande
#56. Death, of course, is not a failure. Death is normal. Death may be the enemy, but it is also the natural order of things.
Atul Gawande
#57. accepted stoically, without fear or self-pity or hope for anything
Atul Gawande
#58. George Orwell is a pinnacle writer, for his combination of moral insight and literary writing.
Atul Gawande
#59. You may not control life's circumstances, but getting to be the author of your life means getting to control what you do with them.
Atul Gawande
#60. We need practice to get good at what we do. There is one difference in medicine, though: it is people we practice upon.
Atul Gawande
#61. No one teaches you how to think about money in medical school or residency. Yet, from the moment you start practicing, you must think about it. You must consider what is covered for a patient and what is not.
Atul Gawande
#62. In the past, surviving into old age was uncommon, and those who did survive served a special purpose as guardians of tradition, knowledge, and history.
Atul Gawande
#63. need to understand how much you're willing to go through to have a shot at being alive and what level of being alive is tolerable to you.
Atul Gawande
#64. Our ideas of what our priorities are shift as we come face-to-face with some of the struggles.
Atul Gawande
#65. We recruit for attitude and train for skill,
Atul Gawande
#66. The third requirement for success is ingenuity - thinking
Atul Gawande
#67. I'm floating between multiple media. I really wish you could buy the hardcover book and it would come with the digital download and audible version. I spend stupid amounts of money because I'm usually buying my books in at least two formats.
Atul Gawande
#68. Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.
Atul Gawande
#69. Our great struggle in medicine these days is not just with ignorance and uncertainty. It's also with complexity: how much you have to make sure you have in your head and think about. There are a thousand ways things can go wrong.
Atul Gawande
#70. Life is choices, and they are relentless. No sooner have you made one choice than another is upon you.
Atul Gawande
#71. An audience is a community. The published word is a declaration of membership in that community and also of a willingness to contribute something meaningful to it.
So choose your audience. Write something.
Atul Gawande
#72. Why would a football fan let a few flubbed minutes at the end of the game ruin three hours of bliss? Because a football game is a story. And in stories, endings matter.
Atul Gawande
#73. For all but our most recent history, death was a common, ever-present possibility. It didn't matter whether you were five or fifty. Every day was a roll of the dice.
Atul Gawande
#74. And there is such a strategy - though it will seem almost ridiculous in its simplicity, maybe even crazy to those of us who have spent years carefully developing ever more advanced skills and technologies. It is a checklist.
Atul Gawande
#75. I think the extreme complexity of medicine has become more than an individual clinician can handle. But not more than teams of clinicians can handle.
Atul Gawande
#76. Arriving at an acceptance of one's mortality is a process, not an epiphany.
Atul Gawande
#77. Mainstream doctors are turned off by geriatrics, and that's because they do not have the faculties to cope with the Old Crock," Felix Silverstone,
Atul Gawande
#78. The No. 2 pencils had been handed out. The timer had been started. But we had not even registered that the test had begun.
Atul Gawande
#79. Cost is the spectre haunting health reform. For many decades, the great flaw in the American health-care system was its unconscionable gaps in coverage.
Atul Gawande
#80. Courage, Laches responds, "is a certain endurance of the soul.
Atul Gawande
#81. Every country in the world is battling the rising cost of health care. No community anywhere has demonstrably lowered its health-care costs (not just slowed their rate of increase) by improving medical services. They've lowered costs only by cutting or rationing them.
Atul Gawande
#82. Coaching done well may be the most effective intervention designed for human performance.
Atul Gawande
#83. The purpose of medical schooling was to teach how to save lives, not how to tend to their demise.
Atul Gawande
#84. As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients. Both practices have made for serious problems.
Atul Gawande
#85. The job of doctors is to supply up-to-date knowledge and skills. The job of patients is to supply the decisions.
Atul Gawande
#86. But it's not only the breadth and quantity of knowledge that has made medicine complicated. It is also the execution - the practical matter of what knowledge requires clinicians to do.
Atul Gawande
#87. In every industrialized nation, the movement to reform health care has begun with stories about cruelty.
Atul Gawande
#88. The risk of a fatal car crash with a driver who's eighty-five or older is more than three times higher than it is with a teenage driver.
Atul Gawande
#89. If I became just a brain in a jar - as long as I can communicate back and forth with people, that would be okay with me.
Atul Gawande
#90. Our health-care morass is like the problems of global warming and the national debt - the kind of vast policy failure that is far easier to get into than to get out of. Americans say that they want leaders who will take on these problems.
Atul Gawande
#91. In the face of the unknown - the always nagging uncertainty about whether, under complex circumstances, things will really be okay -
Atul Gawande
#92. Your chances of avoiding the nursing home are directly related to the number of children you have,
Atul Gawande
#93. Effort does matter; diligence and attention to the minutest details can save you.
Atul Gawande
#94. Medicine was just another a tool you could try, no different from a healing ritual or a family remedy and no more effective.
Atul Gawande
#95. Even children are permitted to take more risks than the elderly.
Atul Gawande
#96. But we have at last entered an era in which an increasing number of them believe their job is not to confine people's choices, in the name of safety, but to expand them, in the name of living a worthwhile life.
Atul Gawande
#97. I tried not to seem like a kid who'd just been offered a chance to go up to the front of the plane and see the cockpit. Sure, I said. That sounds neat.
Atul Gawande
#98. As fewer of us are struck dead out of the blue, most of us will spend significant periods of our lives too reduced and debilitated to live independently.
Atul Gawande
#99. There was a succession of roommates, never chosen with her input and all with cognitive impairments. Some were quiet. One kept her up at night. She felt incarcerated, like she was in prison for being old. The
Atul Gawande
#100. When we lived in a society where we had large families that lived together, especially in agricultural societies like my grandfather and father grew up in, the result is you always had family around to take care of you.
Atul Gawande
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