Book Review - A Comparison of Complications & Singular Intimacies

By Ambreen Khalil

Gawande, Atul. Complications: A Surgeon’s Notes on an Imperfect Science. New York: Henry Holt and Company, 2002. 269 pp., paper, $24.00. ISBN 0-312-42170-2

Ofri, Danielle. Singular Intimacies: Becoming A Doctor At Bellevue. New York: Penguin Books, 2003. 246 pp., paper, $14.00. ISBN 0 14 20.0438

In the two non-fiction books, Complications, by Atul Gawande, and Singular Intimacies, by Danielle Ofri, we learn through the eyes of two resident physicians of their unique approaches used to tackle the difficult profession of medicine. Anyone that has ever been a patient in a hospital, interested or studying the science of medicine, working or planning on working in the healthcare industry will enjoy reading these two intriguing books about the practicality of real medicine. Dr. Gawande leads his readers through a descriptive and aggressive narration of the inexperienced resident doctors and further discusses the fallibility of residents and how medicine can be a disturbing business. On the other hand, Dr. Ofri depicts a more feminine view of the intimate relationships she builds and learns from, through her vulnerability and weak beginning stages as a resident physician.

In Complications, Atul Gawande, incorporates good humor and science in a witty sarcastic tone about the experiences as a surgical resident at an anonymous Boston Hospital. His book is divided into three sections, Fallibility, Mystery, and Uncertainty. Gwande tries to exemplify to the audience through recounting his mistakes as a resident physician, that all physicians are human consequently being imperfect individuals. He tells us about his several unsuccessful attempts to put in a central line. Turning one patient’s chest black and blue due to a dislodged needle from the vein. With some patients he says a physician needs to use their intuition, which according to him is a flawed approach to modern medicine. He recollects another more serious incident of performing an emergency tracheotomy, which goes terribly bad, consequently killing the patient.

Gawande makes his audience aware of the reality that medicine is not as orderly and dry cut as it seems. In order for a physician to learn he will make repeated mistakes and learn from them to become a skilled and confident physician, but through learned experience and practice on human life: "We look for medicine to be an orderly field of knowledge and procedure. It is an imperfect science, and enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line" [7].

Complications is written with a clear and concise style. As readers we don’t feel misplaced by the medical terminology. Gawande eloquently chooses his words to describe procedures keeping his reader in tuned and up-to pace with the medical jargon. We aren’t lost when he talks about complicated surgical procedures; rather I feel like I learned how to do a central line. At the end the audience feels sympathetic to his character and empathizes with the difficulties faced by physicians today.

In the book, Singular Intimacies, Danielle Ofri offers her readers a more holistic approach to modern medicine. This non-fiction book, which flows like a novel, shares Dr. Danielle Ofri's intimate and more personal experiences with patients as a resident physician. She depicts medicine as humanistic. She is a healer. She spends time with her patients and manages to create unique bonding experiences with them. The beginning of her book starts with a story of her comforting a French woman as she undergoes seven days of intubation and treatment. Immediately after the anesthesiologist discharges the succinylcholine into her muscles, Ofri wants to retract and revive the patient back to avoid any downfalls of the treatment. She goes on to tell similar stories of patients she cared for at Bellevue hospital and how she learned; she writes that " After you accompany someone through a life saving experience, just by being near him and touching him during a near death episode I felt I’d been privy to a singular intimacy" [11].

In her fifteen stories she critiques medicine and the education of doctors. In contrast to Gawande’s Complications, Ofri exposes a weaker side of physicians. She is not as aggressive and assertive as Gawande’s character. Perhaps this is due to her femininity? She is allowed to show her emotional responses openly. She hides in a broom closet when she cannot face the dirty old polish man who kisses her. She weeps at the loss of a friend, letting her personal life interfere while she was trying to insert a central IV into a patient. She uses her flaws and suffering to make herself stronger. She wants to abolish the boundary of doctors and patients; and is against the mockery of patients.

The two compelling yet different physicians are unique in their own experiences. Gawande is a man of confidence, integrity, and appears to be somewhat arrogant. He’s full of pride and prestige but fails to recognize other valid ethical concerns of patients under the knife. Ofri on the other hand is mundane and emotional. She’s charismatic and nurturing. She thinks about the patients needs and is concerned about making medical mistakes, and therefore steps back when she realizes that she’s unaware of certain protocols. Gawande, however, would rather take advantage of every opportunity to get practice to become the best surgeon.

Both books are an excellent read. I couldn’t put either one down. Complications is easy to read and follow, while Singular Intimacies is well written and nicely poised.

Contact Ellen Moody.
Pagemaster: Jim Moody.
Page Last Updated: 16 January 2006.