Dr. Atul Gawande

Dr. Atul Gawande

Past Event: Monday, May 3, 2010

At Benaroya Hall — S. Mark Taper Foundation Auditorium

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SAL Presents

Atul Gawande’s talk at Seattle Arts & Lectures is entitled “Real Reform: What is Great Health Care?”

Rhodes Scholar, MacArthur Fellow, and staff member of Brigham and Women’s Hospital, the Dana Farber Cancer Institute, and The New Yorker, Dr. Atul Gawande has been known to operate while listening to a playlist of David Bowie, Arcade Fire, Regina Spektor, Aimee Mann, Bruce Springsteen, Elvis Costello, the Decemberists, and the Killers. Though, he explained to the New York Times of his selections, “It all depends on who’s in the room. You can’t play anything hard-hitting if there’s anyone over 45.” Gawande—or the reporter—didn’t specify whether or not that age limit included the patient.

The forty-four-year-old doctor/writer wanted to be a rock star in college. The son of Indian immigrants—a urologist and a pediatrician—medicine was his “default” career. But when he began his studies at Harvard Medical School (he was a terrible guitar player, he decided), he was surprised by how much he enjoyed it. He liked the blood and guts of the operating room, and the sense of urgency. He found he was good at making decisions, even though he knew that not every decision he would make would be the right one. “I’ve made so many terrible mistakes,” he said in a 2002 interview with The Atlantic for his book Complications: A Surgeon’s Notes on an Imperfect Science (2002). “I have no idea how I’d even begin to rank them. I mean, certainly my most vivid mistakes appear in the book, the ones that I’ve struggled with the most.”

Few doctors, let alone residents a year away from looking for a job, would think to publish a collection of their mistakes. But this candid collection of essays did exactly that, taking readers behind the surgical curtain and laying bare a hypochondriac’s nightmare of plain and simple medical truths. For starters, when the resident says she’ll be “assisting in surgery” it likely means she’ll be performing the surgery, perhaps for the first time. This is the only way she’ll learn, Gawande reminds us, and this is the only way that medicine survives.

Many of the essays in Complications began as columns for Slate, the online magazine started by Gawande’s Stanford friend Jacob Weisberg. Gawande didn’t feel fit for the job as he wasn’t confident in his skills as a writer, but offered plenty of editing help, Gawande accepted. The writing afforded him the luxury of reflection—on what he had done and what he could do better, how he could be a better doctor and perhaps, even, how the system of doctoring could be better. His columns were read regularly by editors at The New Yorker, and when Gawande got up the courage to pitch a piece there it was accepted. He became a staff writer a year later.

Writing makes Gawande a “happier surgeon” he says. His second book, Better, took a broader look at performance, with case studies including the last cases of polio in India, the treatment of battlefield wounds in Iraq, and the medical centers that treat children with cystic fibrosis. “I was trying to understand the moral dimensions of success in medicine,” he said in an interview with The Hindu, “and talking to medical consultants at executions or war doctors at Walter Reed Hospital was one way of trying to grasp that. Often, going out of the usual lets you see something in an entirely new way.”

This bigger picture engages the political and policy side of Gawande’s brain and is reflected in the Master of Public Health degree he earned from the Harvard School of Public Health and his experience working on the campaigns of Gary Hart and Al Gore, on the staff of Congressman Jim Cooper (D-TN), as Bill Clinton’s health care lieutenant during the 1992 campaign, and as senior advisor in the Department of Health and Human Services. In a June 2009 article for The New Yorker, Gawande made a case against revenue-driven medicine that has sparked more conversation in the past decade than perhaps any other single piece of writing on the subject. Combining the policy-wonk’s precise research, the doctor’s insider knowledge, and the writer’s clarity and convention, Gawande admits that his work on the page may be as lifesaving as his work in the OR.

“I now feel like writing is the most important thing I do,” he said in a New York Times interview in 2007. “In some ways, it’s harder than surgery. But I do think I’ve found a theme in trying to understand failure and what it means in the world we live in, and how we can improve at what we do.”

He lives with his wife Kathleen Hobson and their three children in Newton, MA.

Excerpt from Better (2007)Stopping the epidemics spreading in our hospitals is not a problem of ignorance—of not having the know-how about what to do. It is a problem of compliance—a failure of an individual to apply that know-how correctly. But achieving compliance is hard. Why, after 140 years, the meticulousness of the operating room has not spread beyond its double doors is a mystery. But the people who are most careful in the surgical theater are frequently the very ones who are least careful on the hospital ward. I know because I have realized I am one of them. I generally try to be as scrupulous about washing my hands when I am outside the operating room as I am inside. And I do pretty well, if I say so myself. But then I blow it. It happens almost every day. I walk into a patient’s hospital room, and I’m thinking about what I have to tell him concerning his operation, or about his family, who might be standing there looking worried, or about the funny little joke a resident just told me, and I completely forget about getting a squirt of that gel into my palms, no matter how many laminated reminder signs have been hung on the walls. Sometimes I do remember, but before I can find the dispenser, the patient puts his hand out in greeting and I think it too strange not to go ahead and take it. On occasion I even think, Screw it—I’m late, I have to get a move on, and what difference does it really make what I do this one time?

Selected WorkBooksThe Checklist Manifesto (2009)Better: A Surgeon’s Notes on Performance (2007)Complications: A Surgeon’s Notes on an Imperfect Science (2002)Articles from The New Yorker“The Cost Conundrum,” June 1, 2009“Hellhole,” March 30, 2009“Getting There From Here,” January 26, 2009“The Checklist,” December 10, 2007“The Way We Age Now,” April 30, 2007“The Malpractice Mess,” November 14, 2005LinksThe author’s website The author’s research website Gawande’s widely read health care article in the June 1, 2009 New Yorker An article on Gawande in the September/October 2009 Harvard Magazine 

Event Details

Benaroya Hall — S. Mark Taper Foundation Auditorium

200 University Street
Seattle, WA 98101

View directions.

Transportation & Parking

This event will be held in the S. Mark Taper Foundation Auditorium, the largest event space at Benaroya Hall. 

Benaroya Hall is located at 200 University Street, directly across Second Avenue from the Seattle Art Museum. The public entrance to Benaroya Hall is along Third Avenue.

  • From Southbound I-5
    Take the Union Street exit (#165B). Continue onto Union Street and proceed approximately five blocks to Second Avenue. Turn left onto Second Avenue. The Benaroya Hall parking garage will be on your immediate left. The garage entrance is on Second Avenue, just south of Union Street.
  • From Northbound I-5
    Exit left onto Seneca Street (exit #165). Proceed two blocks and turn right onto Fourth Avenue. Continue two blocks. Turn left onto Union Street. Continue two blocks. Turn left onto Second Avenue. The Benaroya Hall parking garage will be on your immediate left. The garage entrance is on Second Avenue, just south of Union Street.
  • From Northbound Highway 99 (Aurora Avenue)
    Take the Seneca Street exit and move into the left lane. Turn left onto First Avenue and proceed one block. Take the next right (at the Hammering Man sculpture) onto University Street. Continue up the hill two blocks to Third Avenue. Turn left onto Third Avenue. Continue to the next block and turn left onto Union Street. Make the next left onto Second Avenue. The Benaroya Hall parking garage will be on your immediate left. The garage entrance is on Second Avenue, just south of Union Street.
  • From Southbound Highway 99 (Aurora Avenue)
    Take the Denny Way/Downtown exit. Keep right and cross over Denny Way onto Wall Street. Proceed approximately five blocks and turn left onto Second Avenue. Continue south on Second Avenue approximately eight blocks. The Benaroya Hall parking garage will be on your left. The garage entrance is on Second Avenue, just south of Union Street.

By Bus
Benaroya Hall is served by numerous bus routes. Digital reader boards along Third Avenue display real-time bus arrival information. For details and trip planning tools, call Metro Rider Information at 206.553.3000 (voice) or 206.684.1739 (TDD), or visit Metro online. The Downtown Seattle Transit Tunnel, served by bus and light rail, has a stop just below the Hall (University Street Station).

Parking
The 430-car underground garage at Benaroya Hall provides direct access from the enclosed parking area into the Hall via elevators leading to The Boeing Company Gallery. Enter the garage on Second Avenue, just south of Union Street. Maximum vehicle height is 6’8″. Blink charging stations are available for electric vehicles. The event rate is $16.

Parking is also available at:

  • The Cobb Building (enter on University Street between Third and Fourth avenues).
  • The Russell Investments Center (enter on Union Street between First and Second avenues).
  • There are many other garages within a one-block radius of Benaroya Hall, along with numerous on-street parking options.

Accessibility

All of our venues have accessible seating and listening devices available. Please contact us at sal@lectures.org or 206.621.2230 x10 for more details and to let us know you’re coming so we can better accommodate your needs.