'The experience was odd and addictive,' Gawande admits, 'mixing exhilaration from the calculated violence of the act, anxiety about getting it right, and a righteous faith that it was somehow good for the person.' Human skin, he discovers, is thick and springy and he has to make two attempts to get through. The first time Gawande is called on to make an incision, the senior surgeon draws a six-inch line on a sleeping patient's abdomen and hands him a knife. Mistakes are sometimes solved by surprisingly low-tech solutions, such as marking the patient's leg with felt-tip to ensure that the correct limb is operated on. There is the doctor who biopsied the wrong section of a woman's breast, delaying a diagnosis of cancer for months. There is the surgeon who left a large metal instrument in a patient's abdomen, where it tore through the bowel and the bladder wall. The book is also about split second decisions that could mean life or death and the limits - often unsuspected by the patient - of both doctors and medical science. One of the most striking features of Complications is the unsparing detail about what happens in the operating theatre.
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