What Not to Read When You’ve Got a Rash

What Not to Read When You’ve Got a Rash June 14, 2015

I don’t have a rash, so I can read this book:

Complications: A Surgeon’s Notes on an Imperfect Science by Atul Guwande.

What it is: Published in 2003, so technically it’s sort of old, in medical-technology years, but no, not really I don’t think so, the book is a discussion of the imprecisions and hazards of practicing medicine, told from the point of view of a freshly-minted surgeon.

You get a combination of riveting stories (including a time Dr. Guwande really screwed up), statistics, and a pile of frank discussion about just how freaky it is to be a doctor.  Includes a tour of what hospitals do to try to prevent errors, what seems to work best, what doesn’t, and why you don’t always get the best but sometimes you do.

The writing is superb – vivid, fast-paced, and transparent, so if you’re a writer it’s worth reading just for that, and if this is your topic, it’s a page-turner.  (It is not “literary.”  When I say superb what I mean is that the man can tell a story.  If you like strained, opaque analogies to impress your friends at the poetry reading, look elsewhere.)

Why it’s worth reading:  It won’t make you a more patient patient, but it will make you a better one.

Reading Level: Educated layman.  If you have a working knowledge of medical things as gleaned from the newspaper and Google MD and cable TV and sometimes maybe arguing with your doctor about stuff, you’re good.

Because there are stories about so many different types of surgeries and health problems and administrative decisions, I think this is probably a stretch for someone like my 13-year-old, who reads family medical guides for fun, but  doesn’t yet have the breadth of knowledge needed to easily follow the narrative.  Guwande honed his craft writing for The New Yorker, so that gives you an idea of the target audience.

Ethics Level: Not bad for a heretic.  Other than a passing anecdote referencing his father’s urology practice (see: vasectomies) everything else was, to my eye, 100% consistent with Catholic moral teaching.

To review on vasectomies and the like, we can summarize the moral life this way: When it comes to that part of your body designed for the procreation of human beings with eternal souls, if it ain’t broke, don’t break it.   Just post-it note that little correction in your copy of the book, and consider the thing edited.

In contrast, there were some great stories touching on end-of-life issues and treatment decisions that could have been straight from a Catholic moral theology textbook, except of course then it would have been boring and used long words.

Why you shouldn’t read this book when you have a rash:  Necrotizing fascitis.  Okay, so maybe you should read the book if you have a rash.  Just don’t read those last chapters late at night.


Photo by Tim Llewellyn, courtesy of http://atulgawande.com/media/images/

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