Gawande and Topol on the Thrill of the Operating Room

; Atul Gawande, MD, MPH


January 15, 2014

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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."


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