San Francisco’s Laguna Honda Hospital is the last almshouse in the country, a descendant of the Hôtel-Dieu (God’s hotel) that cared for the sick in the Middle Ages. Ballet dancers and rock musicians, professors and thieves—“anyone who had fallen, or, often, leapt, onto hard times” and needed extended medical care—ended up here. So did Victoria Sweet, who came for two months and stayed for twenty years.
Laguna Honda, relatively low-tech but human-paced, gave Sweet the opportunity to practice a kind of attentive medicine that has almost vanished. Gradually, the place transformed the way she understood her work. Alongside the modern view of the body as a machine to be fixed, her extraordinary patients evoked an older idea, of the body as a garden to be tended. God’s Hotel tells their story and the story of the hospital itself, which, as efficiency experts, politicians, and architects descended, determined to turn it into a modern “health care facility,” revealed its own surprising truths about the essence, cost, and value of caring for the body and the soul.
The struggle to perform well is universal: each one of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable.
Gawande's gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors' participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable.
At once unflinching and compassionate, Better is an exhilarating journey narrated by "arguably the best nonfiction doctor-writer around" (Salon). Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.
Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is -- complicated, perplexing, and profoundly human.
Atul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur and why good surgeons go bad. He also shows us what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause; a young woman with nausea that won't go away; a television newscaster whose blushing is so severe that she cannot do her job. Gawande offers a richly detailed portrait of the people and the science, even as he tackles the paradoxes and imperfections inherent in caring for human lives.
At once tough-minded and humane, Complications is a new kind of medical writing, nuanced and lucid, unafraid to confront the conflicts and uncertainties that lie at the heart of modern medicine, yet always alive to the possibilities of wisdom in this extraordinary endeavor.
Complications is a 2002 National Book Award Finalist for Nonfiction.
Thanks to advances in science and medicine, more of our parents are living longer than ever before. And though we are rewarded with more time with the people we love, we are also faced with new sets of complications—more diseases, more disability, more need for support and careful judgments. Yet while our health care system may help people live to an older age, it doesn't perform so well when decline eventually sets in. We want to do the best thing but are overwhelmed with the staggering choices we face.
Geriatrician Dennis McCullough has spent his life helping families to cope with their parents' aging and eventual final passage, experiences he faced with his own mother. In this comforting and much-needed book, he recommends a new approach, which he terms "Slow Medicine."
Shaped by common sense and kindness, grounded in traditional medicine yet receptive to alternative therapies, Slow Medicine advocates for careful anticipatory "attending" to an elder's changing needs rather than waiting for crises that force acute medical interventions—an approach that improves the quality of elders' extended late lives without bankrupting their families financially or emotionally. As Dr. McCullough argues, we need to learn that time and kindness are sometimes more important and humane at these late stages than state-of-the-art medical interventions.
My Mother, Your Mother will help you learn how to:
—form an early and strong partnership with your parents and siblings;
—strategize on connecting with doctors and other care providers;
—navigate medical crises;
—create a committed Advocacy Team;
—reach out with greater empathy and awareness; and
—face the end-of-life time with confidence and skill.
Although taking care of those who have always cared for us is not an easily navigated time of life, My Mother, Your Mother will help you and your family to prepare for this complex journey. This is not a plan for getting ready to die; it is a plan for understanding, for caring, and for helping those you love live well during their final years. And the time to start is now.
作家、精神科醫師／ 王浩威 家庭醫學科醫師／吳妮民 春禾劇團教學暨藝術總監／郎祖筠 NEWS98《財經起床號》節目主持人／陳鳳馨 天主教耕莘醫院總院長、天主教失智老人基金會執行長／鄧世雄 小說家／駱以軍