Wednesday, September 12, 2007


Being in the medical field, I found myself pretty engrossed in Atul Gawande’s COMPLICATIONS. But even if you’re not in medicine, there’s no reason you shouldn’t pick up the book. Focusing on both sides of the scalpel (those that get cut as well as those that do the cutting), the vignettes sketched out here are hit upon with compassion, thoughtfulness, and razor-sharp telling ("We have taken [medicine] to be both more perfect than it is and less extraordinary than it can be.")

Gawande holds back nothing in his narrative. One chapter will discuss the evolution of a surgeon and how perilous and dangerous it can be ("Everyone wants a surgeon with experience, but how does a new surgeon become the veteran?"), while the next will look at how effective specialized medicine is (a hospital that does ONLY hernia operations and how incredibly successful those surgeons are).

The most frightening portion of the book — for me — was the discussion on dangerous doctors (chapter 5: When Good Doctors Go Bad). When MD’s get older and can’t function as well, or get burned out, or simply can’t keep up with new medical technology, there’s no system in place to remove them. The AMA, local affiliate groups, none have the sole power to remove a doctor until it is often too late for the patients (Gawande’s examples are horrifying, showing us an orthopedist who had more law suits pending against him than patients in his practice, and still he practiced and operated).

The big flaw with this "novel" is that it isn’t novel at all. It is a compilation of short stories without a core. Whipping back and forth between medical superstitions in one chapter to the study of subjective pain the next, there’s no rhyme or reason to the placement of chapters within the book. This isn’t all bad, though, just something the reader should be aware of before digging in.

Regardless, it is an eye-opener to those in the medical profession and those who are patients within it. Gawande is as sharp with his pen as he is with his scalpel. And he spares no one; from the physicians within his own cadre, to the misconceptions patients hold for their care givers.

Complications should be required reading by all physicians, past, present and, especially, future simply because it is brutally honest and keeps its perspective tightly woven toward patient care.


Dan Simmons is a phenom. Being able to write aptly in just about any genre of his choosing, this proficient author continues to surprise and amaze readers.

I was first introduced to Mr. Simmons’ novels via his excellent HYPERION series (science fiction). I then ventured to SONG OF KALI and CARRION COMFORT (horror) and then touched his JOE KURTZ series (Mystery, PI). Enjoying all of them, I finally found THE TERROR sitting on my local bookstore shelf and promptly snatched it up.

Certainly Simmons has a way with prose. It is this that keep most readers reading his stuff. Without this ability, though, I fear I might not have been able to finish The Terror. And what I mean by that is that the story sags in the middle (heavily) but then picks up nicely in the end. If Mr. Simmons didn’t write so well, I feel confident this book would’ve gone unfinished.

The story is that of the fatal search for the Northwest Passage by the infamous Sir John Franklin expedition. This portion of the novel is certainly relegated to nonfiction, but mixed with fiction via Simmons’ own imagination. Sir John takes two large ships with him on his quest, The Erebus (Franklin’s own vessel) and The Terror (captained by Francis Crozier, whom takes up 3/4 of the book’s story). Trapped in the ice for far too long, we get to read about the slow demise of the crew via deadly scurvy, near mutinies (that eventually flower into a full-blown one of sorts), and the stalking and killing of the expeditioners by a powerful creature nick-named The Terror also.

If this sounds depressing, it is. As a reader you often get in tight with certain characters (if the author does his job right) and certainly some of them must die. But all of them (this is not a spoiler; you can find out about The Franklin Expedition by looking at any encyclopedia)? I became somewhat close to one of the medical personnel. Reading about him was fascinating but his death seemed harsh and unnecessary. Then to read about the other deaths was almost too much; the entire book seemed to be spiraling into a dark pit. Again, had it not been for Mr. Simmons’ able writing skills, I might have put The Terror down and moved on. But I persevered.

The ending was surprising and a bit uplifting (if unreal). There is one particular item that is left up to the reader’s interpretation (I won’t spoil it here, but I will say that I felt Captain Crozier and The Terror — both monster and ship — had to move on).

This isn’t Simmons’ best work but it is a valuable read, both historically and fictionally. The Washington Post called it a "Patrick O’Brien meets Edgar Allen Poe.." story, and I would most certainly agree with that summation. But I would’ve liked to have seen more O’Brien and a bit less Poe.