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B is for Byetta

At first I couldn’t decide whether B was for Byetta or for better. Then I realized that it didn’t matter.

Byetta is better. It is better at helping people with type 2 diabetes to lose weight than anything else. And the longer I use it the better it helps me at controlling my appetite and increasing my exercise. Byetta is pretty darn good too at bringing down our A1C.

You can read several of my articles here about Byetta. Most recently I brought you up to date with my experience at “Byetta, diaTribe, and Me.”

But this week I have been thinking more generally about better and the new book of that title. Better: A Surgeon’s Notes on Performance is the wonderful new book by Atul Gawande.

He is a general and endocrine surgeon at Brigham and Women’s Hospital and an assistant professor at Harvard Medical School. Dr. Gawande is also a certified genius.

That’s what the press often calls MacArthur Fellows, and he became one last year. Dr. Gawande is also “the best medical writer now practicing his craft” and one of my inspirations.

He is so prolific that I haven’t been able to read everything he’s written. Medline lists 23 of his professional articles, and that doesn’t include his many pieces for the popular press.

I read him regularly in The New Yorker and sometimes in the New England Journal of Medicine. This month he is a guest columnist for The New York Times. His articles in the online magazine Slate are delightful, especially “Juicy Journals,” about the excitement of reading medical publications, and “Where to go for Medical Advice on the Web.”

I especially appreciated that he wrote there, “I suspect the best sites will prove to be from patients. As much as we think we know what patients need, and as much as a doctor can help to sort the information wheat from the information chaff, much more of what is useful to patients is already being learned from their simply being able to talk to one another.”

Still, I haven’t even read Better. I heard it instead on a set of six audio discs, and I think that was probably even better. The experience was often incredibly moving because Dr. Gawande is so honest.

His report of visiting India and the heroic efforts of the surgeons he worked with there was especially emotional, in part because it tells of his return to his roots. Both of his parents are doctors in practice in a small Ohio town, but they came from India.

Three of the Better chapters, adapted from his earlier New Yorker articles, are some of the best pieces of medical writing ever. “The Score” is about the revolution in obstetrics and childbirth. “The Bell Curve” is about cystic fibrosis treatment and the physician bell curve. “Piecework” is about how much doctors should be paid.

Metropolitan Books published the book Better just last month. Audio Renaissance published the audio discs at the same time.

You can also see a brand new video of Dr. Gawande on this HealthCentral.com website. It’s in Health Central’s breast cancer area.

Dr. Gawande is a young man in his early 40s who just four years ago was still a surgical resident. But he has been writing for medical journals for more than 20 years – since he was a mere undergraduate at Stanford University. If he is half as good at surgery as he is at writing about it, we are blessed to have him in medicine.

And like his profession, Dr. Gawande is certainly getting better all the time. Because medicine is getting better, we now have wonder drugs like Byetta. With them we can get better too.

This article is based on an earlier version of my article published by HealthCentral.

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