Book and Media Reviews

Book Review

Kathleen Ahern Gould, PhD, RN

In the summer months, we find that we gravitate to a dif- search, or new technology. It’s simply doing many things, ferent type of book. Perhaps one that fits in a beach bag, even the small things like hand washing, better.Download boat tote, or into a woven bike basket. It is a time to relax this link to hear Dr Gawande read from Better: http:// and enjoy the cadence of longer days and warm lingering www.npr.org/2007/06/12/10952407/atul-gawande- evenings. reads-from-better. This reading of Better took place in Pick up the book, listen to a pod cast, or download the April 2007 at the Politics & Prose bookstore in audio or e-book version to enjoy on a drive or as you relax Washington, DC. on the beach. Here are a few of my favorites by Dr Atul Gawande: renowned surgeon, author, and champion of Complications: A Surgeon’s Notes on healthcare improvements. an Imperfect Science Gawande A. New York: Metropolitan Books/Holt; 2002 Dr Gawande’s first collection of essays poises impor- tant questions, such as how much input should a patient have, how can a young doctor gain experience safely, and how do we handle our mistakes? Complications is not just a book about doubt and error; it is an honest view, from a healthcare professional who informs and inspires us by creating a deeper understanding of the challenges we face as we care for patients in a dangerous system. This publication was released just as the public and providers were beginning to struggle with the reality of medical errors and Complications Better The Checklist the fragility of safe medical care. It is as timely today as it Manifesto was at the time of initial publication. Gawande raises questions that patients and caregivers must never stop asking. Better: A Surgeon’s Notes on Performance The Checklist Manifesto: How to Get Gawande A. New York: Picador/Holt; 2007 Things Right Dr Gawande’s insightful observations from the cen- Gawande A. New York: Metropolitan Books/Holt; 2009 ter of healthcare todayVwhat it is and what could This book has changed the way I think about the world, beVare expressed in a book every patient and healthcare healthcare, and my own practice. The main theme is again professional should read. quite simple; no matter how expert you may be, a checklist Gawande’s essays articulate his passion about the com- can improve your outcomes. plexity of medicine, and the simplicity of our challenges. Dr Gawande tells stories that illustrate the complex- He examines 3 core principles: diligence, doing things right, ity of our system. Within a complex system, errors occurI and ingenuity. things get left outI stuff happens. Searching for methods These themes are woven into stories, with insights into to operate within this complexity, healthcare leaders have the healthcare system and the individuals who are work- adapted techniques used by the aviation industry for years, ing to make it betterI some challenges, some solutions, all including the pilot checklist. Gawande brings us inside a thought provoking and inspiring. His message is personal world where professionals are committed to error pre- as he inspires us to do betterI. He reminds us that suc- vention and are dedicated to checklist. Checklists are not cess is hundreds of small stepsI in the right direction. unique to aviation, as we appreciate when Gawande as- Perhaps, that the secret to doing ‘‘better’’ isn’t more re- cends to the top of a new building under construction,

178 Dimensions of Critical Care Nursing Vol. 32 / No. 4 DOI: 10.1097/DCC.0b013e318299813e

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Book Review where he describes his experience looking over the Boston Ms Didion writes about the year she spent trying to skyline. He listens as the engineers, architects, and con- come to terms with what happened, her thoughts, feelings, structions managers describe the many checklists that cas- writing she ‘‘cut loose any fixed idea I had ever had about cade together to ensure a safe structure. The conclusions death, about illnessI about griefI about the ways in are obvious; we can and should do this in our daily work, which people do and do not deal with the fact that life in all areas of healthcare. He reflects on the work of Dr endsI.’’ Peter Pronovost, who engineered the checklist for central Her only child is critically ill, unconscious in an in- line insertion. Gawande takes this opportunity to intro- tensive care unit, and her husband suddenly dead. It is an duce us to the World Health Organization’s Safe Surgical honest view into the lives of many families we care for. Program. There is much we can learn about compassion and family Dr Gawande published his first book while he was still needs through this personal story of loss, grief, and sorrow. a resident. He was recognized as a National Book Award finalist in 2002 and earned a MacArthur ‘‘genius’’ fel- lowship in 2006. Dr Gawande writes for The New Yorker The Spirit Catches You and You Fall and is a frequent contributor to The New England Down: A Hmong Child, Her American Journal of Medicine. Doctors, and the Collision of Two Cultures Many nonfiction books give us insights into the pa- Fadiman A. New York: Farrar, Straus, and Giroux; 1997 tient experience and allow us to reflect on extraordinary roles we play in the lives of our patients. Authors Joan Anne Fadiman relates the true Didion and Anne Fadiman write with clarity and elegance story of Lia Lee, a Hmong child about the patient and family experience. whose family came from Laos in 1980, when the refugee family set- tled in California. Lia was only 3 months old when she suffered a The Year of Magical Thinking seizure, the first of many. She was Didion J. New York: Vintage Book; 2006 brought to the local community medical center in Merced, California. The One of America’s most brilliant family described her symptoms as writers, Joan Didion, shares her ‘‘qaug dab peg,’’ translated to mean ‘‘The spirit catches you experience after the sudden death and you fall down.’’ The Hmong-English translation is of her husband and the critical ill- epilepsy. The book follows the child’s complicated medi- ness of her daughter. Didion writes cal course and the devastating effects of cultural dissonance about an intensely personal yet between healthcare providers and families. The book ex- universal experience: a portrait of plores the tremendous harm that results when spiritual family illness and death, a journey healing and cultural beliefs are ignored by Western medi- of vulnerability, despair, and grief. cine. The misunderstandings were described as ‘‘collisions,’’ On Christmas day 2003, Joan’s resulting in tragedy and unimaginable suffering. Highly only daughter, Quintana, went to an emergency room in competent doctors and nurses saw the best treatment as New York City with flulike symptoms. She was admitted a confusing combination of pills, while her parents wanted with possible septic shock and immediately moved to the to use a combination of Western medicine and folk rem- intensive care unit. Five days later, Joan and John Didion edies designed to coax her wandering soul back into her sat down to dinner. In midsentence, John suddenly slumped body. Years of linguistic confusion and cultural differences over and fell to the floor. Joan called 911. Later that eve- between a loving family and dedicated providers led to a ning, he was pronounced dead. devastating outcome. The book is disturbing and enlight- As nurses, we know this vulnerability; we feel it when ening; it gives voice to patients and providers, as the two we hold the hands of family members, care for them at cultures collide inside-out healthcare system. The book the bedside, and stand vigil with them. Didion gives us a includes a discussion guide that would be an excellent re- visceral account of what we do not see. She takes us home source for a cultural seminar. with her, carrying the hospital bag of belongings, to the living room that was transformed into an emergency room ABOUT THE AUTHOR after her 911 call. Her words tell us about grief; ‘‘it is noth- Kathleen Ahern Gould, PhD, RN, is an adjunct faculty at Boston ing we expect it to be,’’ she writes. ‘‘Life changes in an in- College, Chestnut Hill, Massachusetts, and lecturer at Curry College, stant. You sit down to dinner, and life as you know it ends.’’ Milton, Massachusetts.

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