I had the fortune of seeing Dr Atul Gawande speak last week in Seattle. Truth be told, I entirely invited myself. I heard there was a group from the hospital going and I begged my way in. I sat in the corner. Flashbacks to finding a seat in the junior high cafeteria. I made it through and forgot all about the awkward act of my self-inviting and seat-finding by the end. Despite my disrespect for Ms Manners and my loud mouth, my pushy ways afforded me the opportunity to witness a leader in medicine.
I enjoyed what Dr Gawande said about his work in using checklists to ultimately decrease complications and death in the surgical setting. I have read Dr Gawande’s books (or parts of them, I admit) and many of his articles in the New Yorker (whole thing, thank you). I marvel at his skill and ease of writing, his ability to translate complicated problems and make you feel like you thought of them yourself due to their apparent simplicity. His assertions, however, are not simple. It’s just that his skill in expressing his position, explaining the breakdowns in the system and offering opinion wed with solution puts us all at ease. His article, The Cost Conundrum, remains one of my favorite articles of all time. I have read it numerous times and think about it when caring for children on a weekly basis. He has affirmed the way I feel about over-testing in medicine. As I have said previously, in pediatrics so often less is more.
When he spoke in Seattle last week he used a metaphor that delighted me. When he said it, a grin appeared on my face. One of those grins you have when you know you belong or feel included in an elite group. In this case, the group is parents. I was reminded of my good luck and good fortune in being a mom. His mention of it demonstrates the simple brilliance I have seen in Dr Gawande’s words before. After his talk he took questions from the audience which was a mix of physicians, business and health care workers, and administrators. In discussing some differences in medical problems he categorized:
There are simple problems: Making a cake and following the directions on the box.
There are complicated problems: Launching and preparing a rocket ship for a trip to the moon.
And then there are complex problems: Raising a child.
Enough said, Dr Gawande. Thanks for the affirmation.
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