How Childbirth Became Industrial by Atul Gawande
The public’s experience is that we have amazing clinicians and technologies but little consistent sense that they come together to provide an actual system of care, from start to finish, for people. We train, hire, and pay doctors to be cowboys. But it’s pit crews people need. - Atul Gawande’s commencement address at Harvard Medical School.
The Hot Spotters examines the possibilities of a strange new approach to health care: to look for the most expensive patients in the system and then direct resources and brainpower toward helping them. — by Atul Gawande [more inside]
What should medicine do when it can't save your life? Atul Gawande looks at the system of final-stage treatment for terminal patients, which, despite more than 40 years of a hospice movement for better end of life care, often ensures that patients die exactly how they least want to: in a hospital, hooked up to machines. Gawande tries to envision how, "when the chemotherapy stops working, when we start needing oxygen at home, when we face high-risk surgery, when the liver failure keeps progressing, when we become unable to dress ourselves" medical care can focus on quality of life, rather than prolonging it. [more inside]
As Scott Jerome-Parks lay dying, he clung to this wish: that his fatal radiation overdose — which left him deaf, struggling to see, unable to swallow, burned, with his teeth falling out, with ulcers in his mouth and throat, nauseated, in severe pain and finally unable to breathe — be studied and talked about publicly so that others might not have to live his nightmare.From the first of a series of articles by the New York Times, putting the spotlight on what happens when radiation therapy goes wrong. [more inside]