Best 104 of Atul Gawande quotes - MyQuotes

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Atul Gawande
By Anonym 13 Sep

Atul Gawande

At times, in medicine, you feel you are inside a colossal and impossibly complex machine whose gears will turn for you only according to their own arbitrary rhythm. The notion that human caring, the effort to do better for people, might make a difference can seem hopelessly naive. But it isn't.

By Anonym 18 Sep

Atul Gawande

Our reverence for independence takes no account of the reality of what happens in life: sooner or later, independence will become impossible. Serious illness or infirmity will strike. It is as inevitable as sunset. And then a new question arises: If independence is what we live for, what do we do when it can no longer be sustained?

By Anonym 13 Sep

Atul Gawande

If I became just a brain in a jar - as long as I can communicate back and forth with people, that would be okay with me.

By Anonym 13 Sep

Atul Gawande

Culture matters. Of course, if physicians are rewarded or penalized for their service and results, the culture will change. But the key values we doctors are being pressed to embrace are humility, teamwork, and discipline.

By Anonym 15 Sep

Atul Gawande

We've created a multitrillion-dollar edifice for dispensing the medical equivalent of lottery tickets - and have only the rudiments of a system to prepare patients for the near certainty that those tickets will not win. Hope is not a plan, but hope is our plan.

By Anonym 15 Sep

Atul Gawande

This is the reality of intensive care: at any point, we are as apt to harm as we are to heal.

By Anonym 13 Sep

Atul Gawande

Arriving at an acceptance of one's mortality is a process, not an epiphany.

By Anonym 14 Sep

Atul Gawande

Our reluctance to honestly examine the experience of aging and dying has increased the harm we inflict on people and denied them the basic comforts they most need.

By Anonym 13 Sep

Atul Gawande

Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.

By Anonym 13 Sep

Atul Gawande

After readinf some essay on the nature of human fallibility, I was very aware that we are the recipients of a huge amount of discovery over the last century. Medicine exemplifies this. And that has transitioned us from a world in which people's lives were mostly governed by ignorance to one that's constrained by ineptitude. A century ago, we didn't know, for instance, what diseases afflicted us, what their nature really was, or what to do about them. And that has changed.

By Anonym 14 Sep

Atul Gawande

No travel ban or quarantine will seal a country completely. Even if travel could be reduced by eighty per cent-itself a feat-models predict that new transmissions would be delayed only a few weeks. Worse, it would only drive an increase in the number of cases at the source. Health-care workers who have fallen ill would not be able to get out for treatment, and the international health personnel needed to quell the outbreak would no longer be able to go in.

By Anonym 19 Sep

Atul Gawande

We’ve divided the world into us versus them—an ever-shrinking population of good people against bad ones. But it’s not a dichotomy. People can be doers of good in many circumstances. And they can be doers of bad in others. It’s true of all of us. We are not sufficiently described by the best thing we have ever done, nor are we sufficiently described by the worst thing we have ever done. We are all of it.

By Anonym 18 Sep

Atul Gawande

The best way to convey meaning is to tell people what the information means to you yourself, he said. And he gave me three words to use to do that. "I am worried," I told Douglass.

By Anonym 15 Sep

Atul Gawande

The striking thing is that WHO doesn't really have the authority to do any of this. It can't tell governments what to do. It hires no vaccinators, distributes no vaccine. It is a small Geneva bureaucracy run by several hundred international delegates whose annual votes tell the organization what to do but not how to do it.…The only substantial resource that WHO has cultivated is information and expertise.

By Anonym 15 Sep

Atul Gawande

These are folks that keep people out of hospitals, out of emergency rooms, out of nursing homes. And not only that, they help people achieve more fulfilling lives.

By Anonym 14 Sep

Atul Gawande

Just using a checklist requires [doctors] to embrace different values from ones we've had, like humility, discipline, teamwork.

By Anonym 13 Sep

Atul Gawande

In every industrialized nation, the movement to reform health care has begun with stories about cruelty.

By Anonym 19 Sep

Atul Gawande

The simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And, in a war that you cannot win, you don't want a general who fights to the point of total annihilation. You don't want Custer. You want Robert E. Lee, someone who knew how to fight for territory when he could and how to surrender when he couldn't, someone who understood that the damage is greatest if all you do is fight to the bitter end.

By Anonym 13 Sep

Atul Gawande

Having great components is not enough, and yet we've been obsessed in medicine with components. We want the best drugs, the best technologies, the best specialists, but we don't think too much about how it all comes together.

By Anonym 20 Sep

Atul Gawande

When our time is limited and we are uncertain about how best to serve our priorities, we are forced to deal with the fact that both the experiencing self and the remembering self matter. We do not want to endure long pain and short pleasure. Yet certain pleasures can make enduring suffering worthwhile. The peaks are important, and so is the ending.

By Anonym 15 Sep

Atul Gawande

We now have 30 percent, for example, of Medicare patients who are seeing doctors who are rewarded for doing this kind of work, like high blood pressure control. So, the Affordable Care Act has pushed this direction down the road.

By Anonym 16 Sep

Atul Gawande

In the end, people don't view their life as merely the average of all its moments—which, after all, is mostly nothing much plus some sleep. For human beings, life is meaningful because it is a story. A story has a sense of a whole, and its arc is determined by the significant moments, the ones where something happens. Measurements of people's minute-by-minute levels of pleasure and pain miss this fundamental aspect of human existence. A seemingly happy life maybe empty. A seemingly difficult life may be devoted to a great cause. We have purposes larger than ourselves.

By Anonym 15 Sep

Atul Gawande

All we ask is to be allowed to remain the writers of our own story.

By Anonym 14 Sep

Atul Gawande

People underestimate the importance of dilligence as a virtue. No doubt it has something to do with how supremely mundane it seems. It is defined as "the constant and earnest effort to accomplish what is undertaken."... Understood, however, as the prerequisite of great accomplishment, diligence stands as one of the most difficult challenges facing any group of people who take on tasks of risk and consequence. It sets a high, seemingly impossible, expectation for performance and human behavior.

By Anonym 13 Sep

Atul Gawande

In psychology, there's something called the broken-leg problem. A statistical formula may be highly successful in predicting whether or not a person will go to a movie in the next week. But someone who knows that this person is laid up with a broken leg will beat the formula. No formula can take into account the infinite range of such exceptional events.

By Anonym 19 Sep

Atul Gawande

We want autonomy for ourselves and safety for those we love. That remains the main problem and paradox for the frail. Many of the things that we want for those we care about are things that we would adamantly oppose for ourselves because they would infringe upon our sense of self.

By Anonym 14 Sep

Atul Gawande

Our ideas of what our priorities are shift as we come face-to-face with some of the struggles.

By Anonym 14 Sep

Atul Gawande

No one teaches you how to think about money in medical school or residency. Yet, from the moment you start practicing, you must think about it. You must consider what is covered for a patient and what is not.

By Anonym 19 Sep

Atul Gawande

The pressure remains all in one direction, toward doing more, because the only mistake clinicians seem to fear is doing too little. Most have no appreciation that equally terrible mistakes are possible in the other direction—that doing too much could be no less devastating to a person's life.

By Anonym 14 Sep

Atul Gawande

The big thing that's happened is, in the time since the Affordable Care Act has been going on, our medical science has been advancing. We have now genomic data. We have the power of big data about what your living patterns are, what's happening in your body. Even your smartphone can collect data about your walking or your pulse or other things that could be incredibly meaningful in being able to predict whether you have disease coming in the future and help avert those problems.

By Anonym 13 Sep

Atul Gawande

I learned about a lot of things in medical school, but mortality wasn't one of them.

By Anonym 14 Sep

Atul Gawande

Once you start to ask patients about their priorities, you discover what they're living for. Once you uncover that, it helps you, as a doctor, decide what to fight for. And when we do that, we often end up identifying limits to the kind of care that people want. One's assumption is that these people are going to live shorter lives, but what we're doing is protecting quality of life. In doing so, you sometimes end up helping people live longer. Certainly, you help people live better days and with more purpose in their lives.

By Anonym 13 Sep

Atul Gawande

Go back to the '30s, '40s, '50s, and it was the discovery of heroic interventions, the ability to cure people with penicillin or do an operation to stop disease that was what saved the day. Primary care physicians couldn't do all that much that really demonstrated a difference. The people who control and work with you to control your blood pressure, they're not rewarded for doing that or to be innovative about doing that. So, the result is half of Americans have uncontrolled high blood pressure, despite seeing clinicians.

By Anonym 13 Sep

Atul Gawande

In one study, old people assigned to a geriatrics team stayed independent for far longer, and were admitted to the hospital less.

By Anonym 15 Sep

Atul Gawande

What is the alternative to understanding the complexity of the world?

By Anonym 14 Sep

Atul Gawande

My own son has a congenital heart condition, where his life was saved by a cardiac surgeon stepping in at 11 days of life to save his life. But he is now 21 years old because of constant monitoring and working with him with a primary care physician. that's the only reason now that he's getting to live a long and healthy life. That's what we're not rewarding. They don't have the kind of resources and commitment that we are giving to people like me. I have millions of dollars of equipment available to me when I go to work every day in an operating room.

By Anonym 19 Sep

Atul Gawande

The seemingly easiest and most sensible rule for a doctor to follow is: Always Fight. Always look for what more you could do. (...) But our fight is not always to do more. It is to do right by our patients, even though what is right is not always clear.

By Anonym 15 Sep

Atul Gawande

When we, doctors, ask patients what their priorities are if time is short, what we do is we use what is available to us - whether it's geriatric care or palliative care or hospice care - to make sure they're living the kind of life that they want to live.

By Anonym 13 Sep

Atul Gawande

As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients. Both practices have made for serious problems.

By Anonym 15 Sep

Atul Gawande

All the same I fear what happens when we expand the terrain of medical practice to include actively assisting people with speeding their death. I am less worried about the abuse of these powers than I am about dependence on them.

By Anonym 16 Sep

Atul Gawande

In 2008, the national Coping with Cancer project published a study showing that terminally ill cancer patients who were put on a mechanical ventilator, given electrical defibrillation or chest compressions, or admitted, near death, to intensive care had a substantially worse quality of life in their last week than those who received no such interventions. And, six months after their death, their caregivers were three times as likely to suffer major depression. Spending one’s final days in an I.C.U. because of terminal illness is for most people a kind of failure. You lie on a ventilator, your every organ shutting down, your mind teetering on delirium and permanently beyond realizing that you will never leave this borrowed, fluorescent place. The end comes with no chance for you to have said goodbye or “It’s O.K.” or “I’m sorry” or “I love you.” People have concerns besides simply prolonging their lives. Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The hard question we face, then, is not how we can afford this system’s expense. It is how we can build a health-care system that will actually help dying patients achieve what’s most important to them at the end of their lives.

By Anonym 19 Sep

Atul Gawande

There is a saying about surgeons, meant as a reproof: "Sometimes wrong; never in doubt." But this seemed to me their strength. Each day surgeons are faced with uncertainties. Information is inadequate; the science is ambiguous; one's knowledge and abilities are never perfect. Even with the simplest operation, it cannot be taken for granted that a patient will come through better off - or even alive. Standing at the table my first time, I wondered how the surgeon knew that he would do this patient good, that all the steps would go as planned, that the bleeding would be controlled and infection would not take hold and organs would not be injured. He didn't, of course. But still he cut.

By Anonym 19 Sep

Atul Gawande

[We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way. Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?

By Anonym 14 Sep

Atul Gawande

The definition of what it means to be dying has changed radically. We are able to extend people's lives considerably, including sometimes, good days.

By Anonym 14 Sep

Atul Gawande

No matter what measures are taken, doctors will sometimes falter, and it isn't reasonable to ask that we achieve perfection. What is reasonable is to ask that we never cease to aim for it.

By Anonym 15 Sep

Atul Gawande

You want to ensure people can do it right 99 percent of time. When we have to fire one of our surgical trainees, it is never because they dont have the physical skills but because they dont have the moral skills - to practise and admit failure.

By Anonym 13 Sep

Atul Gawande

Expertise is the mantra of modern medicine.

By Anonym 14 Sep

Atul Gawande

Sometimes we can offer a cure, sometimes only a salve, sometimes not even that. But whatever we can offer, our interventions, and the risks and sacrifices they entail, are justified only if they serve the larger aims of a person's life. When we forget that, the suffering we inflict can be barbaric. When we remember it the good we do can be breathtaking.

By Anonym 19 Sep

Atul Gawande

The seemingly easiest and most sensible rule for a doctor to follow is: Always Fight. Always look for what more you could do.

By Anonym 15 Sep

Atul Gawande

We yearn for frictionless, technological solutions. But people talking to people is still the way norms and standards change.