“Complications: A Surgeon’s Notes on an Imperfect Science” by Gawande

The practice of medicine has been one of the most intriguing forms of science because it deals with the complex and intricate anatomy of human beings. Initially, the physiological aspect of human beings remained a mystery as religion and other sociological aspects attempted to explain the complexity in terms of creation and related theories. However, medicine has managed to explore the complexities of physiology through the discovery of medicines that can treat diseases and whose mechanism of action inside the body is well documented. Furthermore, medicine has also evolved and incorporated even open surgery for curative purposes.

Art goes through stages before it becomes the refined magnificent pieces that we find appealing to our eyes and emotions. Rarely do people concern themselves with these stages and only look at the results. Surprisingly, medicine also goes through these stages. Even after a thorough investigation using lab animals and simulations, it reaches a point when a technique or procedure requires human trial. Unknown to most people, is the fact that the procedures that practitioners employ with confidence have taken instances of trials, imperfections, and sometimes even death. Furthermore, the process of training new practitioners also sees them go through stages of trial before they achieve the coveted perfection. The lack of absoluteness makes medicine more an art than pure science. Gawande outlines this fact by specifically concentrating on surgery when he writes that: “Information is inadequate; the science is ambiguous; one’s knowledge and abilities are never perfect.” Every medical condition that requires surgery is unique. For instance, a surgeon may have designed a particular procedure for particular conditions, but it would still be difficult to consider all the variables that may be present with different patients. It is for this reason that Gawande refers to medicine as an imperfect science that relegates patients to the level of lab animals being used for the imperfect procedures hoping that all will turn out well.

The training of doctors in the US is more inclined to nurture perfect practitioners at the expense of patients. Through the adoption of practice makes perfect, practitioners are given the room to make mistakes as they strive towards perfection. Take the example provided by Gawande. Gawande was required to insert a “special line” into the patient’s chest. Gawande explains instances where patients lost their lives because the intern did not do the procedure the right way. Furthermore, the doctor training Gawande consoles him after making several mistakes in a procedure by telling Gawande that: “You will get it…it just takes practice.” It is not hard to discern how little regard the patient is given during practice.

The sociological implication of doctors practicing on patients is unethical. During the practicing sessions, the patient’s life is put at risk in the name of assisting interns to attain mastery of the procedures. The patient’s welfare and concern are given secondary consideration when an intern is allowed to practice procedures that may harm or even kill the patient. Human rights activists are already advocating strongly against the use of animals for lab trials. Proponents of the use of lab animals argue that it is for the general good of humanity. In the same sense, medicine argues that a few lives may have to be put at risk for the general good of humanity. Sadly this consideration gives the impression that some lives are of more value than others. Sociologically, it is unethical to use the life of a person for practicing because it directly puts the person at risk should anything go wrong.