Summary Of Mystery, Uncertainty By Atul Gawande

Gawande (2002) writes: “As pervasive as medicine has become in modern life, it remains mostly hidden and often misunderstood. We have taken it to be both more perfect than it is and less extraordinary than it can be.” (p. 8) His book explains this idea, that medicine is both over and under-estimated, in three parts: “Fallibility,” “Mystery,” and “Uncertainty.” In each he gives personal stories, exhibiting medicine as an imperfect science.

Gawande’s writing shows that doctors are people, prone to mistakes just like everyone else. He writes that on occasion, doctors do not know what to do. They are faced with a case where the patient shows no troubling symptoms, yet they are unable to shake the feeling that something is seriously wrong. On these

The choice to treat appendicitis with antibiotics instead of removing the organ all together could very easily result in a patient’s passing. This idea alone is what troubles people when doctors work off of a hunch. Without concrete facts to back up their ideas, what would happen if they were wrong? Physicians are given access to some of the most modern technology in the world, so mistakes are not taken lightly; nonetheless, they still happen. Yet there are cases where a doctor’s intuition is wrong, but their plan works. Gawande speaks of a patient, Lee Tran, who had a tumor obstructing his airways and needed immediate aid. His team of doctors had only one idea: put in a catheter to drain the fluid from the tumor, in the hopes it would shift and open the airway to Tran’s left lung: a high-risk procedure. “It was little more than a guess about what to do - a stab in the dark, almost literally. We had no backup plan should disaster have occurred.” (p.7) The doctors were fortunate that day, and not only was the path to the left lung completely opened, so was the right’s. Lee survived. However, what would have happened had the outcome not been so favored? Gawande wrote that after he did research on similar cases, he found there was another option; a safer option. For the most part Gawande’s oversight is forgivable. Doctors are allowed to make mistakes; after all, humans are prone to error. But at what point does it turn from “following your gut” to actual negligence? There is a grey area between the two, and more often than not, a doctor’s unconscious choices are more at fault than their conscious ones. On this Gawande remarks: “In most cases it wasn’t technology that failed. Rather, the physicians did not consider the correct diagnosis in the first place. The perfect test or scan may have been available, but the physician never ordered it.” (p. 198) Humans are fallible, but in the healthcare