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Barring errors

india Updated: Sep 24, 2006 15:32 IST
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How often surgeons in India have earned notoriety for leaving scissors and scalpel inside patients and stitching them up? The fact is that this is not a typical Indian goof-up, but a ‘global problem’.

“Yes, it happens all over the world,” says Atul Gawande, the Indian-American surgeon from Harvard who chose to do something about it — bar-coding surgical instruments and tallying the supplies before and after surgery with the aid of a computer.

Operating on a code

Use of bar-coded surgical sponges, approved by the US Food and Drug Administration (FDA) last March, is now catching on in American hospitals. The institutions hope the new system will help eliminate the huge liability settlements made to patients filing malpractice lawsuits.

A Rhodes scholar with degrees from Stanford, Harvard and Oxford, Gawande is now among those handpicked by the Chicago-based MacArthur Foundation for its $500,000 (Rs 2.25 crore) ‘Genius’ award — a fellowship that offers limitless independence for the creative pursuits of its recipients.

For the 40-year-old Gawande, the announcement has been “a complete shock — a great surprise, a wonderful one”. The money, he adds, will allow him to do a little surgery and a little more writing.

His research agenda for the last eight years has focused on making advances in two areas: understanding and ultimately reducing injuries from error in surgery, and improving policies affecting surgical and medical care.  

Scalpel and pen

The New York-born, Ohio-raised Gawande’s popularity as a science writer is no less than his reputation as a surgeon. In fact, Gawande wears several hats. He is an assistant professor at the Harvard Medical School, a surgeon with Boston’s Brigham and Women’s Hospital, a staff writer for the New Yorker and a columnist for the New England Journal of Medicine.

His book in 2002, Complications: A Surgeon’s Notes on an Imperfect Science, was a New York Times bestseller. It was a finalist for the US National Book Award for non-fiction that year. It has since been published in 17 languages in more than 100 countries.

Gawande’s articles have also been repeatedly featured on the annual Best American Science Writing volumes. All this from a person who says he did not possess any worthwhile writing skills when he entered college. “I got a C on my first paper in freshman writing at Stanford. And if any of you know Stanford, you would know how hard it is to get a C there,” he once quipped. In college, he did take a fiction writing class once. “But it was mainly because I was keen on a girl in that class. We married a few years later,” he recalls.

A second-generation Indian-American, Gawande is currently working on Better, a book on performance in medicine to be published in spring 2007. A second book, Permission to Fail, examining the history of 20th century clinical experimentation, might take another two years to complete.

Gawande’s parents are also doctors. His Maharashtrian father, a urologist, and Gujarati mother, a paediatrician, had met in New York and are now settled in Ohio.

To politics and back

Back in 1992, Gawande, then barely 26, attracted attention for yet another reason. When Bill Clinton ran for his first White House term, Gawande was on the staff of his chief adviser for social policy. After Clinton won, Gawande joined the White House staff. However, after a year-and-a-half, he returned to Harvard and graduated in 1995.

Now, for the last three years, he is being asked to deliver commencement addresses at the Yale Medical School, Harvard Medical School and the Columbia College of Physicians and Surgeons. In fact, he has received over 200 invitations to speak and teach at medical schools across the US.

Gawande also heads a World Health Organisation taskforce to establish worldwide surgical standards. In 2003, he spent nearly three months in India as a visiting surgeon and produced a tome on surgical practices in the country.

Backed by a string of positions, honours and acclamations in the US, Gawande is surely not one to agree with anyone who says your ethnic background can still hold you back. “Never,” he says, chuckling that in his case, it has only been “a great advantage”.

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