not overlooking the details

Medicine and BBC Radio Four are not amongst my common interests but I was very pleased to have heard Dr. Atual Gawande on last week's Start the Week, promoting his book Better: A Surgeon’s Notes on Performance.

He began by observing that a patient's recovery depended on hundreds of people, from the engineer checking the oxygen pumps, to the cook monitoring allergies, 'all the way down to the doctor.' He talked about how introducing strategic systems for hand-washing could dramatically reduce the 90,000 deaths in the US per annum (10,000 in the UK) through hospital infections. Being great means not overlooking the basics.

Everyone, at every stage along the way, from the engineer and nurse all the way to the person running the hospital, saves lives…or loses lives.

The first point I'm still thinking about: Through simple, routine care and attention, we are life-givers or life-takers.

Dr. Gawande also spoke about interviewing doctors who were present to advise on the administration of lethal injections in US prisons. Some did so although against the death penalty, since they felt they should help the prisoner suffer as little as possible. But Gawande explained that last year in California, a group of anesthetists had refused to participate in administering lethal injections, the execution rate had dropped by over 60% since prisons had no choice but to stop killing people!

The second point I'm still thinking about: In seemingly unimportant ways, we can provoke great changes. In situations where we think we can only work to minimize harm, other possibilities can open up.

You may still be able to listen to the piece in full here.