Who is atul gawande

He is also author of more than scientific publications in medicine. We screen our comments for the criteria listed below. We maintain our patients confidentiality, and do not otherwise verify or edit the subjective comments for content.

Stay Informed. Connect with us. We use cookies and other tools to enhance your experience on our website and to analyze our web traffic. For more information about these cookies and the data collected, please refer to our Privacy Policy. Skip to contents. Previous Next. Cynthia and John F. Cancer - Surgical Oncology ,. My daughter had the most extraordinary piano lessons. And then there was a recital, and at the recital, they played Brahms and Chopin and Beethoven.

They were together only a couple years, but it made that impact. And that idea — that was beyond us. Tippett: Yeah, that collaboration. Tippett: I think a lot about how some of the ways we grow more wise and sophisticated in our thinking are about innovation and some of them are about rediscovering something we forgot.

You talk about your paternal grandfather in India. Way before people got sent away to nursing homes, people died surrounded by family and at home. But there, he was with family. He was at the head of the dinner table. People would come to him to bless their marriages, to get advice on business decisions — he was respected as the elder and could have that all the way to the very end.

But it came at a cost. That was possible because the younger generation, especially the women in the younger generation, were more or less enslaved to his needs, his physical needs. You get this complicated picture. There are many kinds of studies.

The most powerful one, for me, was the study that Jennifer Temel, a Massachusetts General Hospital physician, led, which took care of stage four lung cancer patients.

They lived only, on average, 11 months. And what she did was, half of the group were randomized to get the usual oncology care, and the other half were randomized to get the usual oncology care plus a palliative care clinician, physician, to see them early in the course of their illness. It was sort of a radical idea — see them from the very beginning. And the group who saw the palliative care clinicians from the very beginning did end up stopping their chemotherapy. They were 50 percent less likely to be on chemotherapy in their last three months of life.

They were 90 percent less likely to be on the chemotherapy in their last two weeks of life. They were less likely to get surgery towards the end. They had one-third lower costs. They started hospice sooner. They spent more time out of the hospital. They were less likely to die in the hospital or die in the ICU. And the kicker was that they not only had overall less suffering, they lived 25 percent longer. Tippett: Well, and physicians are authority figures. Physicians are some of the people in the world who we just hand over and believe that they know.

Gawande: This was what has been most transformative in my practice that I did not understand. What a clinician does, what we do with our authority has been a very tense issue over time.

Here are the options: option A, option B, option C. Here are the pros, the cons, the risks, the benefits. Now what do you want to do? And then what I found in the real world — that was the way I was taught to exercise my authority, was to give people knowledge and then ask what they want to do with it.

Tippett: What would you — yeah. Right, because you still know better. You still know better. This is not for me to decide; this is for you to decide. It never felt good. What the palliative care clinicians, when I watched them — or geriatricians — would do is they would go one step farther. What really matters to you?

And that idea is that you are a genuine counselor. The only way you can offer wisdom is by connecting what you know and have observed about what happens with various things to the goals that this individual person has.

The art of it is, can I extract, can I listen well enough, can I extract from this conversation enough to tell me what you really care about, to give you some guidance along the way here? That is hard. I had to learn from the palliative care folks. It takes as many of those family conversations, learned with deliberate practice, to be great at it as it takes for you to learn to do your cancer operations. And so think of it that way. Tippett: After a short break, more with Atul Gawande.

You can always listen again and hear the unedited version of every show we do on the On Being podcast feed, now with bite-sized extras wherever podcasts are found. Today, with Atul Gawande. And I was so impressed with the pledge that the students of the class of had written when they started. And then I think they also give the students the opportunity to rewrite that at the end, but they actually kept the one they had.

I was really stunned. We arrive at the threshold of our chosen profession, pledging to preserve our humility, integrity, and all the values which brought us to the practice of medicine. We will engage in honest self-reflection, striving for excellence but acknowledging our limitations, and caring for ourselves as we care for others. We will seek to heal the whole person, rather than merely treat disease, committing to a partnership with our patients that empowers them and demonstrates empathy and respect.

We will cure sometimes, treat often, and comfort always. And I have to say, it was the day of — there was all this drama going on in Congress about the health care bill and insurance.

This is it, this care. Gawande: I think the place we are coming to is, when you take that pledge seriously, it becomes a really interesting dialogue, because people often are not sure about their goals, or they have contradictory goals. I, for example, will badger my patients about quitting smoking and wearing a seatbelt, but their actions are telling me they want to not wear the seatbelt or want to keep smoking. Tippett: Right — [ laughs ] well, there you go. Did you know Sherwin Nuland, Shep Nuland?

Did you know him personally? Gawande: I did. That was the book that started me thinking hard about dying and what it means. But when I started writing for The New Yorker and then wrote my first book, Complications , during my surgical residency, he wrote the review in The New York Review of Books and then reached out to me.

It was this great, very special relationship. We met only once, actually, face-to-face, but we weirdly enough, on Talk of the Nation , we ended up doing a regular thing, where he was the senior eminence, and I was but the junior pup doctor, and we would talk about a topic of the day, every few months. It was now and again. But it became this dialogue that carried on.

I was such a huge admirer. And so he had a tough life and things he had to struggle through. So that was a very meaningful, influential relationship. Tippett: I love thinking about that cross-generational conversation between the two of you. I interviewed him years and years and years ago, and the conversation I had with him was about some of the things he started thinking about later.

Just with this awe of — because he went on, after he talked about how we die, about how — the miracle of how much works all the time. In addition, Dr. Gawande writes the Notes of a Surgeon column for the New England Journal of Medicine and has been a staff writer for the New Yorker magazine since Skip to content Faculty and Researcher Directory. Harvard T.