Atul Gawande

A failure often does not have to be a failure at all. However, you have to be ready for it-will you admit when things go wrong? Will you take steps to set them right?-because the difference between triumph and defeat, you'll find, isn't about willingness to take risks. It's about mastery of rescue.

No one teaches you how to think about money in medical school or residency. Yet, from the moment you start practicing, you must think about it. You must consider what is covered for a patient and what is not.

Just using a checklist requires [doctors] to embrace different values from ones we've had, like humility, discipline, teamwork.

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.

At times, in medicine, you feel you are inside a colossal and impossibly complex machine whose gears will turn for you only according to their own arbitrary rhythm. The notion that human caring, the effort to do better for people, might make a difference can seem hopelessly naive. But it isn't.

We look for medicine to be an orderly field of knowledge and procedure. But it is not. It is an imperfect science, an enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line. There is science in what we do, yes, but also habit, intuition, and sometimes plain old guessing. The gap between what we know and what we aim for persists. And this gap complicates everything we do.

No travel ban or quarantine will seal a country completely. Even if travel could be reduced by eighty per cent-itself a feat-models predict that new transmissions would be delayed only a few weeks. Worse, it would only drive an increase in the number of cases at the source. Health-care workers who have fallen ill would not be able to get out for treatment, and the international health personnel needed to quell the outbreak would no longer be able to go in.

Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of coordination.

The vast majority of doctors really do try to take the money out of their minds. But to provide the best possible care requires using resources in a way that keeps you viable but improves the quality of care.

In every industrialized nation, the movement to reform health care has begun with stories about cruelty.

Outsiders tend to be the first to recognize the inadequacies of our social institutions. But, precisely because they are outsiders, they are usually in a poor position to fix them.

The writing I love has something memorable in it - an image, a smell. It's the connection between the moment and the whole concept, weaving the micro together with the macro so that it has a hold on people - that's writing.

Doctors quickly learn that how much they make has little to do with how good they are. It largely depends on how they handle the business side of their practice.

You want to ensure people can do it right 99 percent of time. When we have to fire one of our surgical trainees, it is never because they don't have the physical skills but because they don't have the moral skills - to practise and admit failure.

To become a doctor, you spend so much time in the tunnels of preparation - head down, trying not to screw up, trying to make it from one day to the next - that it is a shock to find yourself at the other end, with someone shaking your hand and asking how much money you want to make.

I was never born to write. I was taught to write. And I am still being taught to write.

People say that the most expensive piece of medical equipment is the doctor's pen. It's not that we make all the money. It's that we order all the money.

Most people are squeamish about saying how much they earn, but in medicine the situation seems especially fraught. Doctors aren't supposed to be in it for the money, and the more concerned a doctor seems to be about making money the more suspicious people become about the care being provided.

Our great struggle in medicine these days is not just with ignorance and uncertainty. It's also with complexity: how much you have to make sure you have in your head and think about. There are a thousand ways things can go wrong.

The possibilities and probabilities are all we have to work with in medicine, though. What we are drawn to in this imperfect science, what we in fact covet in our way, is the alterable moment-the fragile but crystalline opportunity for one's know-how, ability, or just gut instinct to change the course of another's life for the better.

I chose surgery because I thought that perhaps this would make me more like the kind of person I wanted to be.