(“I guess I always knew that I’d eventually come around to it,” he says.) Soon after, Slate editor Jacob Weisberg, a friend, approached him about writing a column on being a doctor. The son of two physicians, Gawande attended Oxford on a Rhodes scholarship, then worked in a research laboratory and as an adviser to the Clinton administration on health policy before earning his M.D. He asks: How much input should a patient have? How can young doctors gain hands-on experience without endangering lives? And how responsible are these doctors for their mistakes? In “Complications: A Surgeon’s Notes on an Imperfect Science” (Metropolitan Books, 288 pages, $24), a collection of 14 pieces, some of which were originally published in The New Yorker and Slate magazines, Gawande uses real-life scenarios – a burned-out doctor who refuses to quit a terminal patient who opts for risky surgery, with fatal results – to explore the larger ethical issues that underlie medicine. While he recently overcame his queasiness, he hasn’t lost his sense of wonder. Gawande, 37, who spoke by phone from Brigham and Women’s Hospital in Boston, is in his last year of surgical residency. “There is something about the feeling that you are entering a world that others don’t get to see – and that slightly sickening feeling of sticking a knife into somebody.” It was a lot tougher and springier than I thought it would be, so I had to cut twice. “I picked it up and drew it across the skin. And then, the nurse handed me the knife,” he recalls with a laugh, reliving the nervous thrill that went through him. “The patient was put under, the belly exposed. The student, who had never operated before, was observing an abdominal procedure when it came time to make the first incision. Seven years ago, Atul Gawande faced a crucial moment in his medical training.
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