Friday, August 28, 2009

Sweet ice cream

Nobody's asked the question, so I haven't tested my answer, but if someone asked me what they should read after a cancer diagnosis, I would be strongly tempted to reply, "Atul Gawande."

Gawande is a surgeon and not an oncologist, and he is animated by health policy and procedure, which aren't usually the first concerns after diagnosis. But, as his editor at The New Yorker says, his pieces open like umbrellas, and the click of understanding that comes along with them has, for me at least, made the culture of physicians and hospitals more comprehensible. Understanding more about how doctors think (and how yours might frame crucial medical decisions for you) is a practical example of why Gawande is so useful to patients. But Gawande is a literary writer, and reducing his work into some sort of tool (even a tool so useful as an umbrella) cheapens it. The understanding and the pleasure he offers are the real rewards.

This month's Harvard Magazine has a profile of Gawande's life and work I wish I had written.

When Gawande began writing for the New Yorker, the Brigham’s public affairs department wanted to see each piece before it was submitted. “No way was the New Yorker going to allow that,” he says. “[Michael Zinner, Brighman and Women's chief of surgery] stepped in and said, ‘I’ll take responsibility.’ Then he said, ‘You don’t have to show it to me.’ ”
The two men share a fervent belief that pulling back the veil on medicine will do more good than harm, even if it means pushing transparency’s limits right up to the edge of lawsuit territory. “What is the alternative to understanding the complexity of the world?” Gawande asks. “It’s denying it. There’s no way that’s a successful strategy.”

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