一位能够让我听着听着 流泪的作者。从每一本书中，你都能学到许许多多关于医学的知识。我们每个人都可能和医生打交道。看看这些书，让你知道医生到底是怎么治疗病人的。

维基百科（基于谷狗翻译）：

Gawande 于 2002 年出版了他的第一本书《并发症：外科医生关于不完美科学的笔记》，其中包含他在 《Slate》 和《纽约客》上发表的 14 篇文章的修订版。 它是国家图书奖决赛入围者。

Gawande published his first book, Complications: A Surgeon's Notes on an Imperfect Science, containing revised versions of 14 of his articles for Slate and The New Yorker, in 2002.[3] It was a National Book Award finalist.[3]

他的第二本书 Better：A Surgeon's Notes on Performance 于 2007 年 4 月出版。书中讨论了 Gawande 认为对医学成功最重要的三种美德：勤奋、正确行事和独创性。Gawande 在书中提供了体现这些美德的医生们的例子。 该书力求呈现有争议的医疗问题的多个方面，例如美国的医疗事故法、医生在死刑中的作用、以及医院之间的治疗差异。

His second book, Better: A Surgeon's Notes on Performance, was released in April 2007. It discusses three virtues that Gawande considers to be most important for success in medicine: diligence, doing right, and ingenuity. Gawande offers examples in the book of people who have embodied these virtues. The book strives to present multiple sides of contentious medical issues, such as malpractice law in the US, physicians' role in capital punishment, and treatment variation between hospitals.[22]

Gawande 于 2009 年出版了他的第三本书《清单宣言：如何把事情做好》。它讨论了组织和预先计划（例如全面的清单）在医学和更广阔的世界中的重要性。 《清单宣言》在 2010 年登上了《纽约时报》精装非小说类畅销书排行榜。

Gawande released his third book, The Checklist Manifesto: How to Get Things Right, in 2009. It discusses the importance of organization and preplanning (such as thorough checklists) in both medicine and the larger world. The Checklist Manifesto reached the New York Times hardcover nonfiction bestseller list in 2010.[23]

Being Mortal: Medicine and What Matters in End 发行于 2014 年 10 月，并成为《纽约时报》畅销书的第一名。 它讨论了有关辅助生活的临终选择以及医疗程序对绝症患者的影响。 这本书是 PBS 电视连续剧“前线”纪录片的基础，该纪录片于 2015 年 2 月 10 日首播。

Being Mortal: Medicine and What Matters in the End was released in October 2014 and became a #1 New York Times bestseller. It discusses end of life choices about assisted living and the effect of medical procedures on terminally ill people. The book was the basis of a documentary for the PBS television series "Frontline", which was first broadcast on February 10, 2015.[24][25]

1.《并发症》（Complications）

对阿图尔·加万德（Atul Gawande）的采访

An interview with Atul Gawande

七年前，Atul Gawande 面临医学培训的关键时刻。这名以前从未做过手术的学生，正在观察腹部手术；这时，需要他做第一个切口。 “病人被麻醉了，腹部暴露在外。然后，护士把刀递给了我，”他笑着回忆道，重温他当初的紧张快感。 “我把手术刀拿起来，在皮肤上划了一刀。皮肤比我想象的要坚韧得多，也更有弹性，所以我不得再次切割。

Seven years ago, Atul Gawande faced a crucial moment in his medical training. The student, who had never operated before, was observing an abdominal procedure when it came time to make the first incision. “The patient was put under, the belly exposed. And then, the nurse handed me the knife,” he recalls with a laugh, reliving the nervous thrill that went through him. “I picked it up and drew it across the skin. It was a lot tougher and springier than I thought it would be, so I had to cut twice.

“尽管如此，我还是很兴奋，”他说。 “你有种进入了别人看不到的世界的感觉——还有那种用刀刺入他人的轻微恶心的感觉。”

37 岁的 Gawande 在波士顿的布莱根妇女医院（Brigham and Women’s Hospital in Boston）接受电话采访，这是他外科住院医师实习的最后一年。虽然他最近克服了反胃的感觉，但他并没有失去对开刀的好奇心。

Still, I was exhilarated,” he said. “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.”

Gawande, 37, who spoke by phone from Brigham and Women’s Hospital in Boston, is in his last year of surgical residency. While he recently overcame his queasiness, he hasn’t lost his sense of wonder.

“Complications: A Surgeon's Notes on an Imperfect Science”（Metropolitan Books，288 页，24 美元），包括 14 篇文章，其中一些最初发表在 The New Yorker 和 Slate 杂志上，Gawande 使用真实场景——一位拒绝辞职的精疲力尽的医生；一位选择冒险手术、但没有成功的绝症患者——探索构成医学基础的更大的伦理问题。他问：患者应该有多少“决定权”？年轻医生如何在不危及病人生命的情况下获得实践经验？医生对自己的错误应该负有多大责任？

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. 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?

作为两位医生的儿子，Gawande 获得了罗德奖学金（Rhodes scholarship）就读于牛津大学，然后在研究室工作，并在 1995 年获得医学博士学位之前担任克林顿政府卫生政策顾问（an adviser to the Clinton administration on health policy）。（“我想我一直都知道我最终会成为医生，”他说。）不久之后，Slate 编辑 Jacob Weisberg（一位朋友）找到他，希望他写一篇关于成为一名医生的专栏。 Gawande 以前从未尝试过新闻业，一开始也很挣扎，尽管他说他很享受这个过程。 “我最终写的很多主题，都来自我不理解或困扰我的经历。他们经常是病人问的问题，我没有答案，我想得到答案。”

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. in 1995. (“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. Gawande had never tried journalism before and struggled with it at first, though he says he enjoyed the process. “A lot of the topics I ended up writing about came from experiences that I didn’t understand or that bothered me. They were often things patients ask about and I don’t have answers for, and I wanted to get answers.”

许多读者会对 Gawande 描述的案例感到害怕，比如外科医生“切割”乳房活组织检查时，搞错了位置，将女病人的癌症诊断延迟了 18 个月。其他一些失败则是他自己的：他曾经被迫做了紧急气管切开术，这是他几乎没有经验的手术。他现在承认，他当时的犹豫几乎让女病人丧命。

Many readers will blanch at the cases Gawande describes, like the surgeon who biopsied the wrong part of a woman’s breast, delaying her cancer diagnosis by 18 months. Other failures are his own: He once needed to perform an emergency tracheotomy, a procedure he had little experience with, under time pressure. His hesitation, he admits now, nearly cost the patient her life.

虽然《并发症》充满了悲剧性的错误和差一点出事的个例，但书的本意并不是揭露这些。相反，Gawande 强调说，它旨在加深我们对医学复杂性的理解。 “在大多数医学著作中，医生要么是英雄，要么是恶棍，”他说，声音里带着“情绪”。 “我想做的是超越这一点，展示医生是多么普通——同时展示他们能做的事是非凡的。”

While “Complications” is full of tragic errors and near misses, the book is not intended to be an expose. Rather, Gawande asserts, it is meant to deepen our understanding of the intricacies of medicine. “In most medical writing, the doctor is either a hero or a villain,” he says, with an edge in his voice. “What I am trying to do is push beyond that and show how ordinary doctors are – and at the same time show that what they can do is extraordinary.”

在《谜团（Mystery）》（书的一章），作者回顾了一些一直困扰着他的案例，比如一位妇女最初并不明显的孕吐，一直持续到她分娩的那一天。在整本书中，Gawande 建议没有任何病痛或治疗是常规的。 “在外科医生的职业生涯中，对于究竟该做什么有很多不确定性，”Gawande 解释道。 “你希望对所有事情都有明确的指导方针，但事实并非如此。”

In a section called “Mystery,” the author revisits cases that continue to baffle him, such as a woman whose initially unremarkable morning sickness persisted until the day she gave birth. Throughout the book, Gawande suggests that no complaint or treatment is routine. “During a surgeon’s career, there is a lot of uncertainty about exactly what to do,” Gawande explains. “You’d love for there to be clear guidelines for everything, but that’s not the case.”

Gawande 不仅作为外科医生，也作为家长，感受了他的职业的局限性。在他成为住院医的第一个月，他刚出生的儿子Walker突然心力衰竭。 “我不得不放弃急诊室的协助工作，直接前往街对面的医院，那里的医生向我解释了我儿子为了生存，必须做些什么，”Gawande 回忆道。Walker康复了，虽然他马上还需要接受另一次手术，但这个男孩有希望过上健康人的生活。

Gawande has experienced the limitations of his profession not only as a surgeon, but as a parent. During the first month of his residency, his newborn son, Walker, suddenly went into heart failure. “I had to go straight from assisting in the ER to the hospital across the street, where doctors explained to me what my son had to do to survive,” Gawande remembers. Walker recovered, and while he will need another surgery soon, the boy is expected to live a full, healthy life.

因为每周在医院工作长达 110 小时，Gawande 不得不在晚上和周末挤时间写作。他说长时间的工作让他能够获取新的经验。正如他在《并发症》中所强调的那样，模棱两可和有问题的情况以惊人的频率出现：“上周，我为一位40多岁的妇女做了手术，她的腹部有一个肿瘤。我们打开后，发现那东西很大。肿瘤深入到周围的组织；我们弄不出来。所以我们把她缝好；我不得不坐下来向她解释，手术没法做。谈话结束时，她只是坐在那里看着自己的肚子；看着刀疤，一个没有带给她任何好处的手术。她问我，“你做的缝合吗？”我说，“是的，我做的。”她说，“做得很漂亮。”

Because he works at the hospital up to 110 hours a week, Gawande has to squeeze in his writing on nights and weekends. He says his long hours allows him to digest new experiences. And as he emphasizes in “Complications,” ambiguous and problematic situations arise with alarming frequency: “Last week, I operated on a woman in her forties who had a tumor in her abdomen. We opened her up and found the thing was huge. It had latched onto everything; we couldn’t get it out. So we sewed her back up, and I had to sit down and explain to her that this was, well, it was the end of the line. At the end of this conversation, she just sat there looking at her belly. There was our incision, which had been no good whatsoever. And she asked me, “Did you do that?’ And I said, “Yeah, I did.’ And she said, “It’s beautiful.’”

Gawande 在电话那头沉默了一会儿。最后，他说，“我没有能够为她做好手术。这种情况会发生，而且肯定会影响你的情绪。”

Gawande retreats into himself for a moment. Finally, he says, “While I hadn’t done any good for her, there are those moments. It certainly does affect you.”

约翰弗里曼，版权所有 (c) 2002 丹佛邮报。

John Freeman, Copyright (c) 2002 The Denver Post.

2.《更好一些》（Better）

Publishers Weekly采访 Atul Gawande

Publishers Weekly Talks with Atul Gawande

与你的第一本书《并发症》相比，现在这本书花去你不少精力。

《并发症》的基础是我自己作为外科医生的训练。在 《Better》 中，我试图检查我们所做工作中涉及的所有差距。我想展示风险情况是如何真正起作用的，处于不同情况下的医生是如何应对的。我不得不出去看看。这也意味着要去更不寻常的地方旅行。我想看看如何印度是如何应对小儿麻痹症爆发的。

You did a bit more legwork on this book than for your first Collection, Complications.

The skeleton of Complications was my own training as a surgeon. In Better, I’m trying to examine all the gaps involved in what we do. I wanted to show how situations of risk really work, how people in different situations grapple with that. I had to go out and see it. That also meant travelling to more unusual places. I wanted to see what it is like to respond to an outbreak of polio in India.

有多少病人知道你是作家？

How many of your patients know you have this other identity as a writer?

可能只是一小部分。我主要做癌症手术，所以当 [患者] 找到我时，他们很害怕，他们脑子里有其他事情。 [患者]在想，这家伙手术能做得多好？

Only a small minority, I think. I do cancer surgery primarily, so by the time [the patients] get to me, they’re scared, they have other things on their minds. [The patients] are thinking, how well can this guy operate?

你是在描述医学中的固有问题吗？

Are you describing inherent problems in medicine?

科学给我们带来了成千上万件我们可以做的事情——每件事情都非常复杂，而且其中大部分存在于许多不同的人的头脑中。我们现在面临着社会的复杂性，实际应对这些的经历是痛苦的。我们在（一个大）机器里。我们所能做的就是尝试以道德上清晰的方式思考我们的目标，并尝试发挥创造力。

Science has brought us thousands of things we can do–and each is very complicated, and most of it resides in the heads of many different people. We’re confronted with the complexity of society now, and the experience of actually dealing with it is painful. We’re in the machine. All we can do is try to think in morally clear terms about our goals and try to be creative.

告诉我们一些人们不知道的关于医疗系统的事。

Tell us something about the medical system that people don’t know.

有很多例子可以说明我们是如何改变我们的生活的。一个很好的例子是 [Dr.] Virginia Apgar。这是一位妇女面临的情况，在分娩时失去孩子是一种常见的经历。仅仅因为她在[1952 年]发明了一个简单的记分方法；她激发了数百个产生巨大变化的小变化。

There are huge examples of how we’ve been able to change our lives. A good example is [Dr.] Virginia Apgar. Here’s a woman confronting a situation where losing a child in childbirth was a common experience. And just by inventing a simple score [in 1952], she spurred hundreds of little changes that made a huge difference.

我们的标准已经改变；我们现在可以做很多事情，以至于我们将增加医疗保健视为一场大危机。

Our standards have changed, and we’re able to do so much that we look at increased health care for all as a big crisis.

是的。你也需要（这台大）机器。但是每天的经历都感觉像是一场灾难。我在拥有10,000 名员工的官僚机构工作。在这样的环境中工作并不是那么令人愉快。但是有些事情只有在这样的组织中才能做。所以你只需要找到有效的模式。就像明尼苏达州Fairview 大学儿童医院的 Warren Warwick 一样，他就是一个很好的例子。他生活在（这个大）机器里。凭借纯粹的意志力和创造力，他成功了——他诊所的患者比国内任何其他囊性纤维化诊所的患者都活得更长。太棒了。这很鼓舞人心。

Yes. And you need the machine, too. But the experience of it feels like a disaster every day. I work in a bureaucracy with 10,000 employees. Functioning in such a world is not all that pleasant. But there are things that you can do only if you are in such an organization. So you just need to find the patterns of what has worked. Like Warren Warwick, of Fairview University Children’s Hospital in Minnesota–he’s a great example. He lives in the machine. Through sheer force of will and creativity, he makes it work–and the patients in his clinic live longer than in any other cystic fibrosis clinic in the country. It’s stunning. It’s inspiring.

3.《清单宣言》（The Checklist Manifesto）

马尔科姆·格拉德威尔 (Malcolm Gladwell) 对《清单宣言》的书评

Malcolm Gladwell’s review of The Checklist Manifesto

在过去的十年里，因为他在期刊《纽约客》上发表的一些文章和他的两本书《并发症》 、《Better》，阿图尔·加万德 (Atul Gawande) 成为名作家；他的写作体现了他对现代医学的问题和挑战的精心思考。他的新书《清单宣言》（The Checklist Manifesto）以读者熟悉的背景开始，讲述了他作为一名外科医生的经历。但很快，读者就清楚Gawande真正感兴趣的是一个几乎困扰现代世界方方面面的问题，即专业人士如何处理他们日益复杂的职责。多年以来，我一直没有读到一本如此有影响力和发人深省的书。

Over the past decade, through his writing in The New Yorker magazine and his books Complications and Better, Atul Gawande has made a name for himself as a writer of exquisitely crafted meditations on the problems and challenges of modern medicine. His latest book, The Checklist Manifesto, begins on familiar ground, with his experiences as a surgeon. But before long it becomes clear that he is really interested in a problem that afflicts virtually every aspect of the modern world–and that is how professionals deal with the increasing complexity of their responsibilities. It has been years since I read a book so powerful and so thought-provoking.

Gawande 首先区分了无知错误（errors of ignorance；我们犯这种错误，因为我们知识不够）和无能错误（errors of ineptitude；我们犯这种错误，因为我们没有正确使用我们学过的知识）。他写道，现代世界的失败实际上与这些错误中的第二个有关，他通过一系列医学示例向我们展示了外科医生的日常任务现在如何变得如此复杂，以致于犯下这样或那样的错误几乎是不可避免的：对于一个原本称职的医生来说，很容易漏掉一个步骤，或者忘记问一个关键问题，或者在当下的压力山大（stress）和压力（pressure）下，无法为每一种可能发生的情况做好适当的计划。 Gawande 拜访了飞行员和建造摩天大楼的人员，并带回一个解决方案。专家需要清单——字面意义上的书面指南，引导他们完成任何复杂程序中的关键步骤。在本书的最后一部分，Gawande 展示了他的研究团队如何采纳这一想法，开发出安全手术检查表，并在世界范围内应用，并取得了惊人的成功。

Gawande begins by making a distinction between errors of ignorance (mistakes we make because we don’t know enough), and errors of ineptitude (mistakes we made because we don’t make proper use of what we know). Failure in the modern world, he writes, is really about the second of these errors, and he walks us through a series of examples from medicine showing how the routine tasks of surgeons have now become so incredibly complicated that mistakes of one kind or another are virtually inevitable: it’s just too easy for an otherwise competent doctor to miss a step, or forget to ask a key question or, in the stress and pressure of the moment, to fail to plan properly for every eventuality. Gawande then visits with pilots and the people who build skyscrapers and comes back with a solution. Experts need checklists–literally–written guides that walk them through the key steps in any complex procedure. In the last section of the book, Gawande shows how his research team has taken this idea, developed a safe surgery checklist, and applied it around the world, with staggering success.

给出这样简短的“结论”的危险在于，它使 Gawande 的书看起来焦点狭窄或结论平淡无奇。其实不是。 Gawande 是一位出色的作家， 也很会讲故事。本书的目标其实雄心勃勃。 Gawande 认为，现代世界要求我们重新审视专业知识的含义：专家需要帮助，而进步取决于专家谦逊地承认他们需要帮助。

The danger, in a review as short as this, is that it makes Gawande’s book seem narrow in focus or prosaic in its conclusions. It is neither. Gawande is a gorgeous writer and storyteller, and the aims of this book are ambitious. Gawande thinks that the modern world requires us to revisit what we mean by expertise: that experts need help, and that progress depends on experts having the humility to concede that they need help.

4. 《凡人终有一死》（Being Mortal）

http://atulgawande.com/book/being-mortal/

书的简介

作者 Atul Gawande，一本可能改变医学的书；也可能改变“生与死”。

Book Description

From Atul Gawande, a book that has the potential to change medicine – and lives. 

医学在现代取得了胜利，将分娩、受伤和疾病的危险从痛苦变为可控。但当涉及到现实中不可避免的衰老、死亡时，医学能做的往往与它应该做的背道而驰。

Medicine has triumphed in modern times, transforming the dangers of childbirth, injury, and disease from harrowing to manageable. But when it comes to the inescapable realities of aging and death, what medicine can do often runs counter to what it should.

通过令人大开眼界的研究和他自己的病人和家人的扣人心弦的故事，Gawande 揭示了这种动态所产生的痛苦。养老院，首先当然是致力于老人的安全，常常需要与老人们进行“战斗”： 什么可以吃、什么选择是允许的。医生在讨论患者对死亡的焦虑时感到不自在，转而寄希望于虚假的希望和实际上缩短生命而不是改善生命的治疗方法。家人也不提出异议。

Through eye-opening research and gripping stories of his own patients and family, Gawande reveals the suffering this dynamic has produced. Nursing homes, devoted above all to safety, battle with residents over the food they are allowed to eat and the choices they are allowed to make. Doctors, uncomfortable discussing patients’ anxieties about death, fall back on false hopes and treatments that are actually shortening lives instead of improving them. And families go along with all of it.

在他的畅销书中，外科医生阿图尔·加万德 (Atul Gawande) 无畏地揭示了他职业中的挣扎。现在，随着年龄增长，他审视了医学最终的局限性和失败——在他自己和其他人的实践中。他分享我们如何才能做得更好。他跟随一位临终关怀护士巡视，随访一位在自己诊所里的老年病学家，也看到改革者将养老院搞得天翻地覆。他采访一些人；这些人向我们展示如何进行艰难对话、以及如何确保我们永远不会牺牲（老）人真正关心的东西。