Dr. Atul Gawande
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SAL Presents

Dr. Atul Gawande

Past Event: Monday, May 3, 2010

At Benaroya Hall — S. Mark Taper Foundation Auditorium

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.

By Car

  • 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 I-5 via Westbound I-90
    Take the 2C exit for I-5 North. Follow signs for Madison Street/Convention Place and merge right onto Seventh Avenue. Turn left onto Madison Street. Proceed three blocks and turn right onto Fourth Avenue. Continue four 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.

By Public Transit (Bus & Light Rail)

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 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″. ChargePoint charging stations are available for electric vehicles. Visit the Benaroya Hall website for event pricing.

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

Open Captioning is an option for people who have hearing loss, where a captioning screen displaying the words that are spoken or sung is placed on stage. This option is present at every event at Benaroya Hall in our 2021/22 Season.

Closed Captioning is an option for people who have hearing loss, where captioning displays the words that are spoken or sung at the bottom of the video during an online event. Captioning is available for all online events; click the “CC” button to view captions during the event.

Assistive Listening Devices (ALDs) are devices that people with hearing loss use in conjunction with their hearing device (hearing aids or cochlear implants). Benaroya Hall has an infrared hearing system, which transmits sound by light beams. Headsets are available in The Boeing Company Gallery coat check and the Head Usher stations in both lobbies.

Sign Language Interpretation is available upon request for Deaf, DeafBlind, and hard of hearing individuals for both in-person and online events. To make a request for interpretation, please contact us at [email protected] or 206.621.2230×10, or select “Sign Language Interpretation” from the Accessibility section during your ticket checkout process and we will contact you to confirm details. Please note: we appreciate a two-week advance notice to allow us time to secure interpretation.

Wheelchair Accessible Seating and Accessible Restrooms are available in all sections at our venues, and our venues are fully accessible to ticket holders with physical mobility concerns. Among other features, Benaroya Hall has designated parking spaces adjacent to elevators in their parking garage. Elevators with Braille signage go to all levels within the Hall. To reserve seating for a specific mobility concern, you may select “Wheelchair Accessible or Alternative Seating Options” during ticket checkout, and we will contact you to confirm details. For more details on their accessibility features, click here.

Guide and service dogs are welcome.

Gender neutral restrooms are available.

We are pleased to offer these accessibility services at our venues, and they are provided at no additional cost to ticket holders. Please contact us with any questions and feedback about how we can be more accessible and inclusive. Our Patron Services Manager is available at [email protected], or Monday-Friday from 10:00am – 5:00pm at 206.621.2230×10.

For more accessibility information, please head to lectures.org/accessibility. If you would like to make accessibility arrangements you do not see listed here, please contact our box office or select “Other Accommodations” from the Accessibility section during your ticket checkout process, and we will contact you to confirm details.