Question

What are two key perspectives/themes (for example on medical training or diagnosis) you gained from reading Atul Gawande’s Perspective in Complications. Please discuss how they were presented in the book and what you learned from them.

Answer 1

1) The Making of a Surgeon

Gawande shows us that the dexterity so often associated with surgery is hard-won. Putting in a central line is one of the most basic techniques in medicine, but even this required several failed attempts before mastery came along. This rocky road to success prompted Gawande to question whether putting patients at risk is a justified means of training medical novices. No matter how talented you are, becoming a great doctor is about practice and is highly dependent on repeated assays, some of which end in failure and others in success, until successes outnumber failures and “[conscious] learning becomes unconscious knowledge”. No one is born with the skills to heal and operate; we all have to navigate a steep learning curve before we can become the accomplished doctors that patients wish to see.

2) Fallibility and Uncertainty

From the perplexing medical mysteries Gawande recounted, that medicine is more than just science—it is dependent as much on intuition and guesswork as it is on scientific facts and data. The vast array of diseases and possible diagnoses that doctors have to grapple with and rule out one by one seem to be one of the hardest parts of medicine. I realised that doctors often have to make decisions based on incomplete knowledge and ambiguous facts, while being burdened by the possibility of a mistaken diagnosis that could delay proper treatment.