Review by L Flood
This is an inspiring book. The title did, perhaps, suggest those paperbacks we all avoid in the airport departure lounge shop: the ‘be more assertive’, ‘how to succeed in…’ self-improvement titles that never seem to work on this side of the Atlantic. Even the subtitle worried me. Every decision or operation I have ever undertaken has ‘achieved results’, however dizzy, deaf or disfigured the patient!
Press on though. At a glance, this book is obviously easy and entertaining reading. The layout is excellent and the presentation informal, and the author is a great raconteur. The tales of the firemen and the decision to get out, or the poor SAM operator forced to decide friend or foe, are unforgettable. It would spoil the impact to tell more of either story, and I will forgive the author for calling HMS Gloucester a British ‘battleship’ (some chance with current Defence cuts!). The comparison of our practice with that in the airline industry has been exhaustively covered recently, but is well done here. I suspect most of us have seen the gorilla in the basketball team video by now, but, again, the lesson learnt is well presented.
The content is best described by listing the early chapters: ‘Before the incision is made’; ‘Checkmate – the checklist phenomenon’; ‘To err is surgeon – human factors’; and ‘Why surgeons make bad decisions’. Seven chapters tell us how surgeons can evolve into expert decision-makers, or not. In the era of evidence-based protocols, the stress on the role of intuition is fascinating. Experience alone is not enough, we are told, but if you must land in the Hudson River, it cannot hurt.
This book left me even more concerned at the UK shortening of surgical training. The author warns of the perils of over-confidence, of sensory overload, of the ‘search satisfying error’ (a fascinating section).
Overall, the book is great value and great entertainment for a surgeon at any stage of training, whether novice or part-time, retired.
Amazon Link: Smart Surgeons, Sharp Decisions: Cognitive Skills To Avoid Errors & Achieve Results
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