Atul Gawande

“To become a doctor, you spend so much time in the tunnels of preparation - head down, trying not to screw up, trying to make it from one day to the next - that it is a shock to find yourself at the other end, with someone shaking your hand and asking how much money you want to make.”

“In the end, people don't view their life as merely the average of all its moments—which, after all, is mostly nothing much plus some sleep. For human beings, life is meaningful because it is a story. A story has a sense of a whole, and its arc is determined by the significant moments, the ones where something happens. Measurements of people's minute-by-minute levels of pleasure and pain miss this fundamental aspect of human existence. A seemingly happy life maybe empty. A seemingly difficult life may be devoted to a great cause. We have purposes larger than ourselves.”

“Health care confronts us with a difficult test. We have never corrected failure in something so deeply embedded in people's lives and in the economy without the pressure of an outright crisis.”

“I write because it's my way of finding cool ideas, thinking through hard problems and things I don't understand, and getting better at something.”

“I was never born to write. I was taught to write. And I am still being taught to write.”

“Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of coordination.”

“All involve risk, uncertainty, and complexity — and therefore steps that are worth committing to a checklist and testing in routine care. Good checklists could become as important as doctors and nurses as good stethoscopes (which, unlike checklist, have never been proved to make a difference in patient care). The hard question — still unanswered — is whether medical culture can seize the opportunity.”

“People seemed to have two different selves—an experiencing self who endures every moment equally and a remembering self who gives almost all the weight of judgment afterward to two single points in time, the worst moment and the last one. The remembering self seems to stick to the Peak-End rule even when the ending is an anomaly. Just a few minutes without pain at the end of their medical procedure dramatically reduced patients’ overall pain ratings even after they’d experienced more than half an hour of high level of pain. “That wasn’t so terrible,” they’d reported afterward. A bad ending skewed the pain scores upward just as dramatically.”

“I believe that one version of the good in life can be defined by the moments I sometimes had playing tennis as a sixteen-year-old. You'd be out on the court and for an hour, two hours, sometimes an entire roasting hot day, and every single thing you hit would go in. Hit that ball as hard as you wanted, wherever you wanted, and it went in.”

“You want to ensure people can do it right 99 percent of time. When we have to fire one of our surgical trainees, it is never because they don't have the physical skills but because they don't have the moral skills - to practise and admit failure.”

“There are, in human affairs, two kinds of problems: those which are amenable to a technical solution and those which are not. Universal health-care coverage belongs to the first category: you can pick one of several possible solutions, pass a bill, and (allowing for some tinkering around the edges) it will happen.”

“No matter what measures are taken, doctors will sometimes falter, and it isn't reasonable to ask that we achieve perfection. What is reasonable is to ask that we never cease to aim for it.”

“Human beings are social creatures. We are social not just in the trivial sense that we like company, and not just in the obvious sense that we each depend on others. We are social in a more elemental way: simply to exist as a normal human being requires interaction with other people.”

“Oliver Sacks remains my hero to this day. He was one of the first medical writers I read. The other was Lewis Thomas, who is no longer alive but is just heroic to me.”

“I'm floating between multiple media. I really wish you could buy the hardcover book and it would come with the digital download and audible version. I spend stupid amounts of money because I'm usually buying my books in at least two formats.”

“The writing I love has something memorable in it - an image, a smell. It's the connection between the moment and the whole concept, weaving the micro together with the macro so that it has a hold on people - that's writing.”

“People underestimate the importance of dilligence as a virtue. No doubt it has something to do with how supremely mundane it seems. It is defined as "the constant and earnest effort to accomplish what is undertaken."... Understood, however, as the prerequisite of great accomplishment, diligence stands as one of the most difficult challenges facing any group of people who take on tasks of risk and consequence. It sets a high, seemingly impossible, expectation for performance and human behavior.”

“In every industrialized nation, the movement to reform health care has begun with stories about cruelty.”

“When I do an operation, it's half a dozen people. When it goes beautifully, it's like a symphony, with everybody playing their part.”

“Our health-care morass is like the problems of global warming and the national debt - the kind of vast policy failure that is far easier to get into than to get out of. Americans say that they want leaders who will take on these problems.”