August 9, 2018
A few weeks ago, a good friend who knows me well asked an interesting question: “What’s on your bedside table?” She knows I love books and learning, and that my eyes are much bigger than the time I set aside to read. Here's proof:
Reading has always been a key part of my growth as a physician and as a leader. What I read has evolved over time just as I have. As a medical student, I filled my days and nights with core science textbooks, such as Guyton’s physiology and Netter’s anatomy, and tomes of internal medicine, surgery and pediatrics. The textbooks became more specialized and heavily annotated as I progressed through my anesthesiology residency. I also started reading journal articles and systematic reviews. And, in fellowship, I used online tools and resources, such as Uptodate and ePocrates (that’s how old I am: I remember a time before the internet!).
As I started practice, my reading focused on keeping up with the latest clinical research in anesthesiology and critical care medicine. A healthy fear of not knowing enough was motivation to do my best to keep up with the latest papers.
Soon after my appointment as department head for Adult Critical Care with the former Saskatoon Health Region, I met with former CEO Maura Davies in her office. I noticed that she had a bookcase filled with unfamiliar titles, and I asked her for a book recommendation for a new leader who wasn’t all that sure of what to do or how to do it. Without hesitation, Maura handed me my first leadership book,
Leading Change by John Kotter.
I took my borrowed copy home and promptly read it cover to cover, making notes along the way. In this book, Kotter, a Harvard School of Business professor, outlines eight key factors for successfully leading almost any type of change. I had no idea at the time that this sort of information was out there and so accessible. The business section of my local bookstore suddenly became a lot more interesting! My bookshelves are now filled with almost as many books about how we think and behave as they are with books on how our bodies do and don’t work.
Understanding the human condition – how people make decisions and how to influence them – is fundamental if we want to be effective and compassionate physicians. After all, most of the work we do is directly with people: our patients, their families and our co-workers.
I’ve slowly switched most of my reading from medical journals and texts to books about how we think, and how to lead change. The Harvard Business Review has supplanted my New England Journal of Medicine subscription. This journal is full of ideas and advice for leaders, and regularly publishes articles on emerging concepts in health care. Here are three of my favourite articles that I turn to on a regular basis:
I spent most of my time as a medical student learning (or memorizing) theories and facts. Now, we understand it is just as important to understand how we think and make decisions. Cognitive errors, or mistakes in how we unconsciously process and respond to information, are increasingly recognized as being a significant contributor to medical errors, perhaps even more so than a lack of knowledge or information. For this reason, my next recommendation is
Thinking, Fast and Slow by Daniel Kahneman, a psychologist who received the Nobel Prize in Economics for his groundbreaking work on how humans are far less rational than we would like to believe. So much of this translates into clinical medicine and leadership. Our brains work in both rational and irrational ways, using probabilities and rules of thumb to make all sorts of interpretations and decisions. We need to understand what makes our minds vulnerable to diagnostic and cognitive errors if we want to be able to improve the accuracy and efficiency of our care.
While you are likely very familiar with Dr. Atul Gawande’s most famous book,
The Checklist Manifesto, I have learned more from three of his other books:
Being Mortal: Medicine and What Matters in the End. Dr. Gawande, a practicing general surgeon in Boston, is widely recognized as a thought leader in medicine and public health. He was recently appointed CEO of a health care venture formed by Amazon, Berkshire Hathaway and JPMorgan Chase that aims to deliver better outcomes, patient satisfaction and value in health care. I look forward to watching and continuing to learn from Dr. Gawande as he tackles some of our greatest challenges.
Breath Becomes Air by Paul Kalanithi, we are re-connected to the humanity of medicine, and the journey of our patients and their families. Dr. Paul Kalanathi was diagnosed with metastatic lung cancer during his last few months as a neurosurgery resident at Stanford University. He wrote this moving memoir over the last two years of his life.
One of my more recent discoveries is
Medical Axioms by Mark B. Reid. Dr. Reid is an academic hospitalist practicing in Denver, Colorado. From what he shares on Twitter, I imagine his hospital being similar in size and feel to St. Paul’s Hospital in Saskatoon. Dr. Reid is a “must-follow” on Twitter (@medicalaxioms). He started using his twitter account to share historical aphorisms of “famous dead doctors of the past.” When he ran out, Dr. Reid began sharing his own lessons from his practice and students. This book is a compilation of almost 1,200 of his axioms followed by a collection of great quotes from the history of medicine. He is a fan of Dr. William Osler, widely acknowledged as being the father of modern medicine. The spirit of Medical Axioms reminds me of a
book of essays by Osler that my classmates and I received as part of our History of Medicine class.
I have many more favourite non-medical-but-totally-relevant-to-medicine books, but I’m more interested in discovering my next favourite.
What are your favourite books? What non-medical book has helped you more than you anticipated? What did you learn? Are you interested in a virtual physician book club? If so, which books would you recommend?
Let me know at
Dr. Susan Shaw
Chief Medical Officer