A few years ago, Gawande wrote two articles in The New Yorker about medical innovation: The Score (about Apgar scores) and The Checklist. Since then, he has done actual research promoting the use of checklists and this book (free from publisher) is mostly the story of his contribution, with sidebars about the origin of checklists in aviation and their use in building construction. The word checklist suggests that it is all about making sure certain things get done but Gawande takes pains to say that is only half of it. The other half is helping people who don’t know each other work together — by having them introduce themselves and by making sure everyone is heard.
Use of checklists, judging by the results, is a big advance and for that reason alone this would be a solid book — the story of one person’s part in an important innovation. I am sorry he didn’t tell parts of the story that reflect badly on others — such as the Office of Human Research Protections decision that Johns Hopkins research must be stopped immediately because introducing checklists and tracking their effectiveness was dangerous. (Doctors might be embarassed by the results!) I wouldn’t expect a Harvard Med School prof to get nauseous with rage, the way Richard Harris, an earlier New Yorker writer, appropriately did in A Sacred Trust (how the AMA tried to block Medicare), but every story needs a villain. And there are plenty of villains in American medicine.