Book Review—Better by Atul Gawande
My Personal Take on the Quest for Improvement
Whenever I list Better as one of my top reads for business and professional development, the most common question I get is: “Why should I read a book about surgery if I’m not in the medical field?” My answer is simple: while Gawande’s world may feature hospitals, patients, and surgical procedures, his real focus is on continuous improvement. He grapples with one of the most human questions there is: How do we get better at what we do? Sure, in his stories the stakes can be life-or-death. But for most of us, the stakes aren’t quite so dramatic—and yet, the lessons still resonate deeply.
Gawande’s talent as a writer comes from his knack for storytelling. He seamlessly weaves together anecdotes from operating rooms, research labs, and clinical trials, then breaks them down into practical strategies we can use in everyday life. Scalpels and stethoscopes might be his stage props, but the guiding philosophy—consisting of self-reflection, consistent small changes, and measurable outcomes—is completely universal.
The Power of Small Details
One of the biggest takeaways from Better is how small, seemingly trivial actions can produce massive results when done consistently. Gawande’s go-to example is something as straightforward as hand-washing to prevent infection—a step that can be neglected in the rush of a busy hospital.
For me, that was a game-changer. I’m nowhere close to being a surgeon, but I’ve definitely cut corners in my own life, assuming “it’ll all work out.” Reading Gawande’s statistics on how even routine hand hygiene saves countless lives each year made me ask: What are my own “hand-washing moments”? The first thing I identified was proofreading emails and messages. I used to dash off replies without a second glance, which led to typos, confusion for colleagues, and the occasional missed attachment. These days, I pause for a few seconds, recheck what I’ve written, and only then hit Send. Such a minor tweak has saved me plenty of headaches—and that’s what Gawande emphasizes: tiny improvements, done often, add up.
Embracing the Checklist Mentality
This emphasis on little but crucial details dovetails perfectly with the checklist approach Gawande popularizes, not only in Better but also in his follow-up, The Checklist Manifesto. He mentions how pilots, engineers, and surgeons rely on checklists to make sure critical steps never slip through the cracks. What might seem mundane on the surface is, in reality, a powerful fail-safe.
Feeling inspired, I started dabbling with daily checklists—particularly on days when my plate was extra full. I used to rely on sticky notes (that is— until my toddler started pulling them off the wall to scribble on) and my memory, which occasionally led to minor (and sometimes major) oversights. Now, I’ve switched to a simple digital task list with boxes I can tick off. It might sound old-school, but having a structured approach has boosted my productivity and cut my stress. Even in high-pressure moments, I rarely drop key tasks anymore. It’s the same concept Gawande details in the operating room, just on a much lower-stakes scale.
The Courage to Own Mistakes
One of Better’s sections that really stuck with me is Gawande’s emphasis on honesty and self-reflection—especially when it comes to admitting mistakes. In a surgical context, an error can mean life or death, but even outside of healthcare, there’s a huge payoff for anyone who’s willing to say, “I messed up.”
I’ve definitely experienced that sinking feeling in meetings, where you realize you are the bottleneck or the one who misunderstood the instructions. I used to look for excuses: “The deadline was unrealistic,” “I didn’t get the data in time,” or “Nobody told me.” But Gawande’s stories about doctors who hold “morbidity and mortality” conferences to dissect what went wrong made me realize there’s real power in simply saying, “That was on me, and here’s my plan to avoid it next time.” Interestingly, owning my errors has built more trust with colleagues than any amount of excuse-making ever did.
Ingenuity Under Constraints
Another part of Better that resonated was how doctors in low-resource settings accomplish extraordinary feats through ingenuity and improvisation. Gawande highlights medical teams working in underfunded hospitals or remote clinics, where fancy equipment is a luxury. Yet they innovate on the fly—creating new techniques and repurposing old devices to deliver quality care.
This made me think of how many times I’ve assumed a lack of resources spelled doom. In reality, constraints often force creative problem-solving. After finishing Better, I made it a point to shift my thinking from “We can’t do that” to “What can we do with the tools we have?” It’s a mindset that has pushed me to explore unconventional fixes rather than throw up my hands or wait for an ideal budget or timeline.
Doing the Right Thing
Gawande also dives into what it means to “do right.” In medicine, this could mean taking extra time to reassure a scared patient, or bending a rule to save a life. Outside medicine, it might look like being transparent with a client about a looming deadline issue, or stepping in to help a coworker instead of sticking to your job description.
What I found compelling was Gawande’s real-life examples of people who go beyond standard expectations to serve others. These stories remind us that Better isn’t just about better metrics—it’s also about moral responsibility. It made me re-evaluate how I interact with colleagues, clients, and even friends. Am I doing the bare minimum, or am I finding small ways to add genuine value and empathy?
Culture of Continuous Improvement
One major takeaway from Better is that improvement isn’t a one-and-done project. Rather, it’s an ongoing process that thrives in environments where people routinely examine both their triumphs and close calls. In hospitals, Gawande gives examples of daily briefings, post-operative debriefs, and open forums where everyone can talk openly about pitfalls.
In my own workplace, I tried encouraging a similar practice. Instead of asking “Who messed up?” when things go sideways, we now ask, “What can we learn?” The shift is subtle but powerful. It replaces finger-pointing with genuine curiosity. Over time, repeated mistakes happen less often because people feel safe enough to bring up issues early—and we’re documenting what we learn for the future.
Measurement and Accountability
Gawande frequently emphasizes the need for measurement and accountability. In medicine, that might look like monitoring infection rates or patient satisfaction scores. By collecting data, practitioners can spot weak points and figure out what changes actually help.
I’ve folded this thinking into my own personal and professional life. If I want to improve at public speaking, for example, I don’t just vaguely practice. Instead, I measure specific elements: How many times did I say “um”? Did I maintain eye contact? How often did I lose my train of thought? It’s not the most glamorous way to learn, but it gives me a clear path forward. As Gawande illustrates, hard data can be a powerful ally when you’re trying to get better at something.
The Human Element of Improvement
Despite all the data, protocols, and checklists, Gawande never loses sight of the human side of progress. In surgery, skill alone isn’t enough; you have to consider a patient’s anxiety, the dynamics among operating-room staff, and the emotional toll of high-stakes work. That’s equally true outside healthcare, where any team is made up of individuals with goals, fears, and personal pressures.
Reading about how Gawande and other surgeons de-escalate tensions reminded me that improvement isn’t just about efficiency—it’s about building trust. Sometimes, all it takes is a simple check-in to find out a coworker is overwhelmed, or a friend is struggling. Acting on that empathy can make the difference between a mediocre outcome and a great one.
Beyond Checklists: Mastery and Adaptation
You might wonder if Gawande’s approach is too mechanical—just a never-ending loop of tick boxes, metrics, and quick fixes. What I love, though, is how he balances those systems with creativity and flexibility. Sometimes a challenge won’t fit neatly into a checklist, and that’s okay. The point is to handle routine basics so effectively that your mind is free for the trickier, more creative stuff.
Once I nailed down a few consistent routines—like daily email checks, weekly project recaps, and so forth—I was shocked by how much mental bandwidth I had left. It turned out that dealing with the fundamentals systematically freed me to dream bigger, problem-solve better, and even produce more thoughtful work.
Cultivating a Lifelong Mindset of Improvement
At its core, Better champions a view of lifelong learning. Mistakes aren’t signs of personal failure; they’re data points that guide us toward smarter decisions. Gawande doesn’t promise perfection. Instead, he shows that every misstep can spark a change for the better, provided we’re open to examining it.
These days, I see small setbacks—like a poorly received presentation or a dip in my energy levels—as a cue to refine how I operate. Maybe I need to rework my slides, or try a new morning routine. This shift from frustration to curiosity is exactly what Gawande’s stories encourage: an ongoing, deeply human quest to keep inching forward.
Final Thoughts: Why Better Matters
By the time I finished reading Better, I realized it’s not so much about surgical outcomes as it is about making all of us more attuned to improvement as a daily practice. Gawande’s examples may come from high-stakes operating rooms, but his central message—stay curious, be honest about errors, and never stop adapting—applies anywhere.
A Quick Recap of Key Takeaways
Small Details Count: Tiny, consistent acts (like washing hands or proofreading emails) can prevent big headaches.
Checklists Work: Structured processes free our mental space for bigger challenges.
Own Your Mistakes: Admitting slip-ups sets a transparent tone and fosters a culture of learning.
Ingenuity Thrives Under Constraints: Limited resources can spark the best kinds of creative solutions.
Ethical Action Matters: Going the extra mile to do right by people fosters real trust.
Measure and Iterate: Concrete data keeps improvement grounded in reality, not guesswork.
Never Forget the Human Factor: At the end of the day, empathy and genuine connection often make or break a success story.
That’s why I consider Better essential reading, even if you’ll never set foot in an operating room. It’s not just about medicine—it’s about the universal drive to do our work with greater skill, compassion, and integrity. If we can embrace Gawande’s principles in our own corners of the world, we’ll come a lot closer to living up to the book’s title in everything we do.