Gawande and Topol on the Thrill of the Operating Room

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Editor's Note:
The following video and transcript were excerpted from an interview between Medscape Editor-in-Chief Eric J. Topol, MD, and surgeon and author Atul Gawande, MD, MPH, which posted on Medscape in November. In the full interview, Dr. Gawande discussed his concurrent career as a physician and journalist, his plans for the future, and many other aspects of his life and work. It is available as part of Dr. Topol's One-on-One series.

"I never thought surgery was going to be what I was going to do," said Dr. Gawande, who worked on Bill Clinton's first presidential campaign and on public policy initiatives with Rep. Jim Cooper (D-Tenn) before finishing his studies at Harvard Medical School.

"I went through medical school thinking that I would so something like internal medicine, combine a career where I have a clinic on the side but mostly do public policy, trying to understand how you make health systems better," he told Dr. Topol. "Then I got into an operating room and I fell in love with it, and it was a real problem."

"You were mesmerized by the operating room," replied Dr. Topol.

"Weirdly enough, I thought surgeons were like politicians. Surgeons are grappling with having limited information and knowledge, imperfect science, but they have a necessity to have to act in the face of both imperfection in their own abilities and imperfect knowledge in the world," Dr. Gawande continued. "And I saw a lot of the same incredible range of characters and people [in politics and the operating room]. I have sometimes said that my favorite New Yorker cartoon, because it described me, was a picture of a headstone in which the inscription read, 'He kept his options open.' I was the guy who kept his options open."

Dr. Gawande added, "I wanted to be more like surgeons and more like the politicians I admired, who could make decisions, live with the consequences, and learn from the consequences."

Authors and Disclosures

Authors

Eric J. Topol, MD

Director, Scripps Translational Science Institute; Chief Academic Officer, Scripps Health; Professor of Genomics, The Scripps Research Institute, La Jolla, California; Editor-in-Chief, Medscape

Disclosure: Eric J. Topol, MD, has disclosed the following relevant financial relationships:
Serve[d] as a director, officer, partner, employee, advisor, consultant, or trustee for: AltheaDX; Biological Dynamics; Cypher Genomics (Co-founder); Dexcom; Genapsys; Gilead Sciences, Inc.; Portola Pharmaceuticals; Quest Diagnostics; Sotera Wireless; Volcano
Received research grant from: National Institutes of Health; Qualcomm Foundation

Atul Gawande, MD, MPH

Director, Ariadne Labs; Professor, Department of Health Policy and Management, Harvard School of Public Health; General and Endocrine Surgeon, Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts

Disclosure: Atul A. Gawande, MD, MPH, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Brigham and Women’s Hospital; Harvard School of Public Health; Lifebox Foundation
Serve(d) as a speaker or a member of a speakers bureau for: National Hospice & Palliative Care Organization; PeaceHealth; Intermountain Health Care; ABT Assoc; Partners Healthcare; Amer Soc of Anesthesiologists; American College of Surgeons; Leading Age; Carolinas Healthcare; University of Albany; American Society of Healthcare Engineers; University of California at San Francisco; National Council for Community Behavioral Healthcare; Goodwin Procter; Royal Bank of Scotland; Society of Neurological Surgeons; Agency for Healthcare Research and Quality; Institute of Medicine; Boston Children’s Hospital; Pricewaterhouse Coopers; International Society for Quality in Health Care; Press Ganey; Chicago Humanities Festival
Received income in an amount equal to or greater than $250 from: Henry Holt; Picador USA; Conde Nast Inc.; Harper Collins; Pearson Publishing; Houghton Mifflin; McGraw Hill; Harvard Business School Press; Profile Books Ltd.; New England Journal of Medicine; Penguin Books/India; Sosoh Publishing; Commonwealth Publishing Co.; China Renmin University Press; Lua de Papel; Antoni Bosch Editor; Asa Editore; Editorial Diagonal del Grup62/Edicone; Verlasgruppe Random House GmbH; Uitgeverij Nieuwezjds; Baronet; Znak; Humanitas; Giulio Einaudi Editore S.p.A.; Sextante; Book21; Gramedia Pustaka Utama; Shinyusha Co. Ltd.; Domingo Publishing; Cheers Publishing Co; Mehta Publishing House; Misuzu Shobo; Codecs; First News-TriViet Publishing Co.; Cengage Learning; Internazionale Magazine; Eriko Yamauchi; CBS Television; Public Broadcasting Service; TNT Network; Fresenius
Received research grant from: Blue Cross Blue Shield; Boston Consulting Group; EMC; The Gates Foundation; The World Health Organization; The Branta Foundation; Harvard Risk Management Foundation; MacArthur Foundation; New Zealand Government; The Rx Foundation; Agency for Healthcare Research & Quality; Health Research & Educational Trust

Gawande and Topol on the Thrill of the Operating Room

Tables

Authors and Disclosures

Authors and Disclosures

Authors

Eric J. Topol, MD

Atul Gawande, MD, MPH

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