Complications (36 page)

Dr. Michael Zinner, my hospital’s chairman of surgery, has likewise given me his backing and protection. I remember approaching him after I had written my story trying to explain what happens when doctors make mistakes, intending to publish it in
The New Yorker
. I knew it was something I could not publish without permission from him. So I gave him the manuscript and then, a few days later, walked into his office braced for the worst. As it turned out, he didn’t love it. How could he? No hospital public relations department in the world would have let an essay like that go out. But he did a remarkable thing: he supported me anyway. The article could easily backfire, he warned me, with the public or with other doctors. But if there was flak he would help me, he promised. And he let me go ahead.

In the end, there never was any flak. Even when my colleagues from work have disagreed with what I’ve written, they have been constructive and engaged and have held nothing against me. We are all, I’ve found, in the process of trying to understand how much of what we do is good, how much of it can be better.

To the patients and families who go named and unnamed in this book, I wish to extend a great and special thanks. Some I am fortunate to still keep up with. Others I was never given the chance to know as well as I wish I could have. All of them have taught me more than any could know.

There is just one person, however, who has been involved in all the parts of what is here—the writing, the doctoring, and the struggling to succeed at both: my wife, Kathleen. She’s stuck with me through the long hours and turmoil of surgical training and bolstered me when my confidence and resilience have failed me. Then, when I’ve come home, she’s helped me to talk through the ideas I’ve had for writing and stayed up late with me to help hammer them into words. A magnificent editor herself, she has red-penciled this
entire manuscript and, though I’ve sometimes not wanted to admit it, made everything better. She has also, most critically, kept our sweet and demented children in my life—even bringing them to the hospital to see me when I’ve missed them and been away for too long. This book exists thanks to her love and dedication. So it is dedicated to her.

A
TUL
G
AWANDE
is a resident in surgery in Boston and a staff writer on medicine and science for
The New Yorker
. He received his M.D. from Harvard Medical School as well as an M.P.H. from the Harvard School of Public Health. His writing has appeared in
The Best American Science and Nature Writing 2000
and the
New Yorker
essay collection
In Sickness and In Health
. Gawande lives with his wife and three children in Newton, Massachusetts.