Top 200 Atul Gawande Quotes (2024 Update)
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101. “The problem is that the wise course is so frequently unclear. For a long while, I thought that this was simply because of uncertainty. When it is hard to know what will happen, it is hard to know what to do. But the challenge, I’ve come to see, is more fundamental than that. One has to decide whether one’s fears or one’s hopes are what should matter most.”

— Atul Gawande

102. “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.”

— Atul Gawande

103. “People who reach certain levels of frailty, more important than getting their mammogram, more important than getting their blood pressure tweaked, they’re at high risk of falling. If they fall and break their hip, they not only die sooner, they die miserably.”

— Atul Gawande

104. “The result: those who saw a palliative care specialist stopped chemotherapy sooner, entered hospice far earlier, experienced less suffering at the end of their lives – and they lived 25 percent longer. In other words, our decision making in medicine has failed so spectacularly that we have reached the point of actively inflicting harm on patients rather than confronting the subject of mortality. If end-of-life discussions were an experimental drug, the FDA would approve it.”

— Atul Gawande

105. “One has to decide whether one’s fears or one’s hopes are what should matter most.”

— Atul Gawande

106. “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.”

— Atul Gawande

107. “No, the more familiar and widely dangerous issue is a kind of silent disengagement, the consequence of specialized technicians sticking narrowly to their domains. “That’s not my problem” is possibly the worst thing people can think, whether they are starting an operation, taxiing an airplane full of passengers down a runway, or building a thousand-foot-tall skyscraper.”

— Atul Gawande

108. “Our reverence for independence takes no account of the reality of what happens in life: sooner or later, independence will become impossible. Serious illness or infirmity will strike. It is as inevitable as sunset. And then a new question arises: If independence is what we live for, what do we do when it can no longer be sustained?”

— Atul Gawande

109. “Arriving at meaningful solutions is an inevitably slow and difficult process. Nonetheless, what I saw was: better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes willingness to try.”

— Atul Gawande

110. “People with serious illness have priorities besides simply prolonging their lives. Surveys find that their top concerns include avoiding suffering, strengthening relationships with family and friends, being mentally aware, not being a burden on others, and achieving a sense that their life is complete.”

— Atul Gawande

111. “We want perfection without practice. Yet everyone is harmed if no one is trained for the future.”

— Atul Gawande

112. “Each year, about 350,000 Americans fall and break a hip. Of those, 40 percent end up in a nursing home, and 20 percent are never able to walk again.”

— Atul Gawande

113. “Spending one’s final days in an ICU because of terminal illness is for most people a kind of failure. You lie attached to a ventilator, your every organ shutting down, your mind teetering on delirium and permanently beyond realizing that you will never leave this borrowed, fluorescent place. The end comes with no chance for you to have said good-bye or “It’s okay” or “I’m sorry” or “I love you.”

— Atul Gawande

114. “As you get older, the lordosis of your spine tips your head forward,” he said to me. “So when you look straight ahead it’s like looking up at the ceiling for anyone else. Try to swallow while looking up: you’ll choke once in a while. The problem is common in the elderly. Listen.” I realized that I could hear someone in the dining room choking on his food every minute or so.”

— Atul Gawande

115. “The anthropologist Lawrence Cohen describes conferences and conventions not so much as scholarly goings-on but as carnivals – “colossal events where academic proceedings are overshadowed by professional politics, ritual enactments of disciplinary boundaries, sexual liminality, tourism and trade, personal and national rivalries, the care and feeding of professional kinship, and the sheer enormity of discourse.”

— Atul Gawande

116. “Block has a list of questions that she aims to cover with sick patients in the time before decisions have to be made: What do they understand their prognosis to be, what are their concerns about what lies ahead, what kinds of trade-offs are they willing to make, how do they want to spend their time if their health worsens, who do they want to make decisions if they can’t? A decade.”

— Atul Gawande

117. “The power of checklists is limited, Boorman emphasized. They can help experts remember how to manage a complex process or configure a complex machine. They can make priorities clearer and prompt people to function better as a team. By themselves, however, checklists cannot make anyone follow them. I.”

— Atul Gawande

118. “We are besieged by simple problems... Checklists can provide protection.”

— Atul Gawande

119. “Somehow, instead of holding on to the lifelong identity that was slipping away from him, he managed to redefine it. He moved his line in the sand. This is what it means to have autonomy – you may not control life’s circumstances, but getting to be the author of your life means getting to control what you do with them.”

— Atul Gawande

120. “The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that they have had an incorrect view of what makes life significant. The problem is that they have had almost no view at all.”

— Atul Gawande

121. “Living is a kind of skill. The calm and wisdom of old age are achieved over time.”

— Atul Gawande

122. “Measurements of people’s minute-by-minute levels of pleasure and pain miss this fundamental aspect of human existence. A seemingly happy life may be empty. A seemingly difficult life may be devoted to a great cause. We have purposes larger than ourselves. Unlike your experiencing self – which is absorbed in the moment – your remembering self is attempting to recognize not only the peaks of joy and valleys of misery but also how the story works out as a whole.”

— Atul Gawande

123. “Taking care of a debilitated, elderly person in our medicalized era is an overwhelming combination of the technological and the custodial.”

— Atul Gawande

124. “He moved his line in the sand. This is what it means to have autonomy – you may not control life’s circumstances, but getting to be the author of your life means getting to control what you do with them.”

— Atul Gawande

125. “Why would a football fan let a few flubbed minutes at the end of the game ruin three hours of bliss? Because a football game is a story. And in stories, endings matter.”

— Atul Gawande

126. “As a person’s end draws near, there comes a moment when responsibility shifts to someone else to decide what to do.”

— Atul Gawande

127. “International organizations are fond of grand-sounding pledges to rid the planet of this or that menace. They nearly always fail, however. The world is too vast and too various to submit to dictates from on high.”

— Atul Gawande

128. “This is the consequence of a society that faces the final phase of the human life cycle by trying not to think about it. We end up with institutions that address any number of societal goals – from freeing up hospital beds to taking burdens off families’ hands to coping with poverty among the elderly – but never the goal that matters to the people who reside in them: how to make life worth living when we’re weak and frail and can’t fend for ourselves anymore.”

— Atul Gawande

129. “We witnessed for ourselves the consequences of living for the best possible day today instead of sacrificing time now for time later.”

— Atul Gawande

130. “When, as the researchers put it, “life’s fragility is primed,” people’s goals and motives in their everyday lives shift completely. It’s perspective, not age, that matters most. Tolstoy.”

— Atul Gawande

131. “Death is the enemy. But the enemy has superior forces. Eventually, it wins.”

— Atul Gawande

132. “If we took away the ability to put defibrillators in people in their last years, people would be shouting in the streets.”

— Atul Gawande

133. “Do what is right, and do it now.”

— Atul Gawande

134. “If the conversation people think is coming is the ‘death panel’ conversation, that’s a total failure.”

— Atul Gawande

135. “Instead they choose to accept their fallibilities. They recognised the simplicity and power of using a checklist.”

— Atul Gawande

136. “At least two kinds of courage are required in aging and sickness. The first is the courage to confront the reality of mortality- the courage to seek out the truth of what is to be feared and what is to be hoped. But even more daunting is the second kind of courage – the courage to act on the truth we find.”

— Atul Gawande

137. “A year on, Eleanor remained haunted by what happened to her. She still had no idea where the bacteria came from. Perhaps the foot soak and pedicure she had gotten at a small hair-and-nail shop the day before that wedding.”

— Atul Gawande

138. “Lacking a coherent view of how people might live successfully all the way to their very end, we have allowed our fates to be controlled by the imperatives of medicine, technology, and strangers. I wrote this book in.”

— Atul Gawande

139. “Yet – and this is the painful paradox – we have decided that they should be the ones who largely define how we live in our waning days.”

— Atul Gawande

140. “The only way death is not meaningless is to see yourself as part of something greater: a family, a community, a society. If you don’t, mortality is only a horror. But if you do, it is not.”

— Atul Gawande

141. “A study led by the Harvard researcher Nicholas Christakis asked the doctors of almost five hundred terminally ill patients to estimate how long they thought their patient would survive, and then followed the patients. Sixty-three per cent of doctors overestimated survival time. Just seventeen per cent underestimated it. The average estimate was five hundred and thirty per cent too high. And, the better the doctors knew their patients, the more likely they were to err.”

— Atul Gawande

142. “Even worse than losing self-confidence, though, is reacting defensively. There are surgeons who will see faults everywhere except in themselves. They have no questions and no fears about their abilities. As a result, they learn nothing from their mistakes and know nothing of their limitations. As one surgeon told me, it is a rare but alarming thing to meet a surgeon without fear. “If you’re not a little afraid when you operate,” he said, “you’re bound to do a patient a grave disservice.”

— Atul Gawande

143. “Our ideas of what our priorities are shift as we come face-to-face with some of the struggles.”

— Atul Gawande

144. “When my father met her, he was surprised to learn she lived by herself. He was a urologist, which meant he saw many elderly patients, and it always bothered him to find them living alone. The way he saw it, if they didn’t already have serious needs, they were bound to develop them, and coming from India he felt it was the family’s responsibility to take the aged in, give them company, and look after them.”

— Atul Gawande

145. “Courage is strength in the face of knowledge of what is to be feared or hoped. Wisdom is prudent strength. At least two kinds of courage are required in aging and sickness. The first is the courage to confront the reality of mortality – the courage to seek out the truth of what is to be feared and what is to be hoped. Such courage is difficult enough. We have many reasons to shrink from it. But even more daunting is the second kind of courage – the courage to act on the truth we find.”

— Atul Gawande

146. “Death is the enemy. But the enemy has superior forces. Eventually, it wins. And in a war that you cannot win, you don’t want a general who fights to the point of total annihilation. You don’t want Custer. You want Robert E. Lee, someone who knows how to fight for territory that can be won and how to surrender it when it can’t, someone who understands that the damage is greatest if all you do is battle to the bitter end.”

— Atul Gawande

147. “What is troubling is not just being average but settling for it. Everyone knows that average-ness is, for most of us, our fate. And in certain matters – looks, money, tennis – we would do well to accept this. But in your surgeon, your child’s pediatrician, your police department, your local high school? When the stakes are our lives and the lives of our children, we want no one to settle for average.”

— Atul Gawande

148. “Whereas today people often understate their age to census takers, studies of past censuses have revealed that they used to overstate it.”

— Atul Gawande

149. “Western medicine is dominated by a single imperative – the quest for machinelike perfection in the delivery of care.”

— Atul Gawande

150. “People die only once. They have no experience to draw on.”

— Atul Gawande