BETTER: A Surgeon's Notes on Performance by Atul Gawande
As a student doctor, Atul Gawande's greatest concern was to be competent. Yet in a profession where the difference between being adequate and being good can be a matter of life and death, he came to realise that he should always be striving to become better at what he did. After years practising as a surgeon in the United States, he has identified three core requirements for improved performance: diligence, strong ethics and ingenuity. He goes on to give examples of each, from the hygiene specialists who seek to lower rates of hospital infection by getting people to wash their hands, through the doctors who treat the uninsured despite the strain this puts on their own finances, to the medical professionals in impoverished Indian districts who save lives in the face of a chronic lack of resources. Gawande is clearly a man who has thought deeply about the role of the doctor in the modern world, and it is his inquisitive mind that comes through most clearly in his powerful book. He has wrestled with dilemmas that his British counterparts do not face, not least whether it is morally justifiable for doctors to assist in carrying out the death penalty (having previously supported the death penalty, he is now against it). Although many of his preoccupations, such as the fear of litigation and the problems of medical insurance, are mainly relevant to the American context, this wise and often profound book should be an inspiration to doctors all over the world (Profile £8.99). IC

UP IN THE TREE by Margaret Atwood
Age 4-6
This small curiosity of a picture book was first published in 1978 in Canada, “in the very early days of children's book publishing”. Margaret Atwood not only wrote the text but hand-lettered it and drew the pictures. She had two colours to use: blue and red, with a brown that combined the two. The result is a quaint little rhyme about two children who get stuck in a tree when a pair of gophers steals their ladder. They are flown down on the back of a friendly owl and build stairs up the trunk to avoid trouble in future. The words have lots of exclamation marks and a Dr Seuss-ish simplicity: “It's fun in the sun/And a pain in the rain”, and tap into a ubiquitous childish fantasy about living permanently in a treetop. Yet the literal and basic pictures singularly fail to do what we have come to expect of illustrations - to add drama, incident and atmosphere (except for showing us the gophers and the odd snail, lizard or frog). Still, as a period piece for those nostalgic for a more innocent age, it has charm and is perfectly pitched for beginning readers (Bloomsbury £6.99). NJ

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