Atul Gawande Takes the Pulse of the Medical Profession

True or false: More people go crazy when the moon is full.

If you said “true,” you probably haven’t read Atul Gawande’s Complications: A Surgeon’s Notes on an Imperfect Science (Picador, $14, paperback), a stylish collection of essays by a Boston surgeon and contributor to The New Yorker. Gawande reviewed more than a hundred studies of how lunar phases affect human behavior after his fellow doctors warned him to expect more hospital admissions when the moon was full. He found that researchers had pored over all kinds of evidence – police logs, homicide statistics, emergency room visits and consultations with psychiatrists. The result? There’s no relation at all between craziness and the full moon. Some studies have suggested the opposite – that full moon has a beneficial effect on human behavior.

This is the kind of fascinating material regularly dispensed by Gawande, who also wrote the new Better: A Surgeon’s Notes on Performance (Metropolitan, $24). The essays in Complications deal with subjects from doctors’ mistakes to patients with terrifying diseases like necrotizing fasciitis (known, somewhat misleadingly, “flesh-eating bacteria”). Gawande often takes controversial positions. He challenges the idea – cherished by many doctors – that surgeons need “good hands,” saying the continual practice of surgery matters more. (Doesn’t the quality of the practice matter? What about education? Can practice make you a great surgeon if you went to a medical school or work at a hospital that’s a step away from losing its accreditation?) But part of the appeal of Complications is that Gawande www.gawande.com has the courage to risk saying things other doctors won’t and the rhetorical skill to give his views force. He never hides behind a cardboard shield of medical omniscience. And he deals with a wider and more offbeat range of medical topics than physician-authors like Oliver Sacks and Sherwin Nuland. So you may enjoy Complications even if you couldn’t get through The Man Who Mistook His Wife for a Hat or How We Die.

© 2007 Janice Harayda. All rights reserved.

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