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DR. ATUL GAWANDE | G Force

Skilled with scalpel and pen

Dr. Atul Gawande, the author of three books, finds time to write during the downtime between surgeries. Dr. Atul Gawande, the author of three books, finds time to write during the downtime between surgeries. (Erik Jacobs for The Boston Globe)
December 21, 2009

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There’s not much downtime in Dr. Atul Gawande’s days. In between cases at Brigham and Women’s Hospital, the 44-year-old surgeon researches articles for The New Yorker magazine and his best-selling books. The Newton resident’s first book, “Complications,’’ was published seven years ago when he was a surgeon-in-training at the Brigham. His third book, “The Checklist Manifesto,’’ about how simple lists can make complicated tasks from surgery to airplane flying safer, goes on sale next month.

LIZ KOWALCZYK

Q. You’re a surgeon at the Brigham, a Harvard Medical School professor, a staff writer for The New Yorker, a best-selling author, a researcher, leader of the World Health Organization’s Safe Surgery Saves Lives program, associate director of Harvard’s Center for Surgery and Public Health, and the father of three children. How do you do it all?

A. I don’t have a good answer for that. The only thing I can say is I have really cool jobs, so it never feels like it is not worth trying to keep everything going. My wife is an unbelievable asset. She makes up for the fact that I’m a mediocre father and lets me spend vacation time, weekends, and nights trying to write.

Q. When do you write?

A. I have about 30 minutes of downtime between surgeries. You can get a lot done in 30 minutes. Half of my work with writing is research. I can read through papers and cases during that time. It’s when I’m sitting there watching them mop the floor. I’ve already seen the patient and the anesthesia team is [preparing] them. When it comes to the writing itself, I will sometimes clear a couple of days where I don’t have clinic.

Q. How many hours do you sleep each night?

A. I don’t do well without enough sleep. I’m a person who needs seven hours.

Q. Your first book, “Complications,’’ describes mistakes doctors make and even your own lapses. Were your colleagues at the Brigham upset that you wrote such a revealing book?

A. The striking thing to me was the level of support I got. When the public affairs staff heard this second-year resident no one knew wanted to write an article for The New Yorker about a mistake I had made, they wanted to vet it or no can do. Dr. Mike Zinner [Brigham surgery chief] said, “I’ll vet it, I’ll take responsibility.’’ Then he turned to me and said, “I don’t have to review it.’’ Later, he indicated that Harvard is a big place, and if you go down in flames, we’ll still be standing.

Q. Is surgery safer now than it was 10 years ago?

A. In 10 years, a significant amount has changed. At first, we spent a lot of time diagnosing the fact that we’re unreliable and often unsafe in delivering care for patients. But we have not been very clear about how to tackle it. In the past few years, we’ve been more successful at that. We’ve worked to improve our infection rates and developed ways to keep sponges out of people’s bodies [after surgery]. Safety is improving, but I don’t know by how much.

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