Part I - The Computer and the Hernia Factor Summary and Analysis

Gawande believes that medicine in this country strives for machinelike perfection, through routinization and repetition. The rise of specialists is directly related to this quest—specialists perform one set of procedures over and over again.

The best example of this is that of the Shouldice Hospital, which is dedicated to hernia operations and has an exceptionally high rate of success. The surgeons perform only hernia operations and have repeated the procedures so many times that the steps have become automated. Aside from their expertise, the hospital is designed with hernia procedures in mind—no tvs, no bedside room service, all traits intentionally built in to force patients to walk around, thus improving recovery. Gawande questions whether the traditional training (4 years of medical school...