Atul Gawande on the Secrets of a Puzzle-Filled Career

; Atul Gawande, MD, MPH


December 06, 2013

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Editor's Note:
Atul Gawande, MD, MPH, wears many hats, including that of a surgeon, researcher, journalist, and author. In this segment of Medscape One-on-One, Dr. Gawande talks with Eric J. Topol, MD, about what inspires him, his plans for the future, and why he's secretly a frustrated rock singer.

Early Life

Eric J. Topol, MD: Hello. I'm Eric Topol, Editor-in-Chief of Medscape, and I'm really excited to have with me today on Medscape One-on-One Dr. Atul Gawande, who is my favorite medical writer. Happy birthday, by the way.

Atul Gawande, MD, MPH: Thank you. Do I have to confess how old I am?

Dr. Topol: No, we won't put you through that. We're here at Ariadne Labs, this remarkable innovation project here in Boston and with Harvard. I wanted to go back a little bit in your remarkable career. You were born in Brooklyn, New York. Is that right?

Dr. Gawande: That's right. My parents met in Brooklyn. They're both from India. They had come to the United States in the early 1960s. My mother is a pediatrician and my father was a urologist. He was in general surgery there and they met, married, and had me in Brooklyn.

Dr. Topol: And they took you to Ohio.

Dr. Gawande: Yes. They practiced in a college town in southeastern Ohio -- Athens, Ohio -- and that's where I grew up and did all my schooling.

Dr. Topol: And then you went from there to Stanford for college?

Dr. Gawande: Yes; that was a big shift for me. I had never been west of Chicago to that point. I arrived on the bus after taking an airplane. The bus brings you down the main street, Palm Drive as they call it, with palm trees and Memorial Church in front of you; I thought I'd arrived in paradise. It was a fantastic 4 years.

Dr. Topol: It's a pretty seductive place. And you went from there to being a Rhodes Scholar.

Dr. Gawande: I got very lucky there and got to go to Oxford and study philosophy and politics.

Dr. Topol: Was that a precursor to your very early involvement in politics? You worked with the Gore presidential campaign in your 20s, right?

Dr. Gawande: I had majored in biology as well as in political science, and I didn't know how I was going to put these things together. I knew I wanted to become a doctor but I was also very interested in public affairs, and it wasn't necessarily specifically around healthcare alone. I went to work as an intern on Gore's staff. I was originally going to work on his campaign. No one remembers this, but back in 1988 he had to drop out of his campaign because it was revealed that he had smoked pot in the past. So he dropped out and I worked on his Senate staff and learned a lot there. And then I went back, finished up my degree at Oxford, but continued onward working in politics for a little while.

Dr. Topol: And after a couple of years of med school, you then joined the Clinton administration?

Dr. Gawande: Yes. You should have seen my Indian parents' reaction to all of this. My dad was on the phone asking, "So when are you getting to medical school?" And Harvard Medical School was beautiful; they let me defer for a little while. So I was hopscotching around a little bit. I finished at Oxford. I then worked in a congressman's office, Jim Cooper of Tennessee, doing healthcare policy for him. One of the things I'm proudest of is that we helped revive the National Health Service Corps as a loan repayment program to help bring doctors into rural areas, especially to Indian reservations. But I knew I wanted to get back to medical school. So I started medical school, and then when Clinton ran for President, I was offered the chance to come head his healthcare and social policy unit.

Dr. Topol: Which is kind of amazing. You were, what -- 20-something?

Dr. Gawande: I was 26 and Clinton was only known for having given a really long, boring speech at the 1988 convention, and his campaign headquarters was in Little Rock, Arkansas. I suspect I was number 47 for the position because you got paid next to nothing, you had to move to Little Rock, and he's in the bottom of the polls with President Bush Sr., running with 70% favorability ratings at the time. For me, I had met Clinton and he was someone I admired greatly and thought I would learn a lot from seeing, and loved the chance to be able to support and figure out how to be effective.


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