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Chapter summaries for Better by Atule Gawande
Biology Enriched
Extra Credit Better: A Surgeon’s Notes on Performance

Chapter 1: On Washing Hands
Mr. Gawande starts his literature on washing hands. He introduces two friends a microbiologist and an infectious disease specialist. Both work hard and diligently against the spread of diseases just like Semmelweis who is mentioned in the chapter. Something I learned, that not many realize, is that each year two million people acquire an infection while they are in the hospital. Mainly because the clinicians only wash their hands one-third to one-half as many times as they should. Semmelweis, mentioned earlier, concluded in 1847 that doctors themselves were to blame for childbed fever, which was the leading cause of maternal death in childbirth. The best solutions are apparently the sanitizing gels that have only recently caught on in the U.S. Then there was an initiative to make the sanitizing easier for all. The engineer Perreiah came up with solutions that gave the staff more time which was revolutionary in itself but the format worked only under his supervision. After he left it all went down the drain, so, Lloyd a surgeon who had helped Perreiah decided to do more research and was excited when he encountered the positive deviance idea, the idea of building on people’s capabilities instead of trying to change them. The idea worked and even got funding for ten more hospitals across the country. At the end of the chapter Dr.Gawande ponders upon the idea of how many he has infected because of his lack of cleansing.
Chapter 2: The Mop-Up
This chapter starts off with the difficulty of diligence. Yet there are some who have managed to deliver that expectation on an incredible scale. The task of distributing polio vaccines to millions of people, many in rural areas, was evidently a long and complicated task. The WHO had a team of only hundreds and had to teach the necessary vaccination procedures to the volunteers and local representatives,

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