Life-or-death medical matters are given the human touch in Radio 4's Reith Lectures

The first of this year's lectures was delivered by surgeon, writer and political analyst, Atul Gawande

Click to follow
The Independent Culture

"We have 13 different organ systems and we've identified nearly 60,000 ways they can go awry," announced the surgeon, writer and political analyst, Atul Gawande, in the first of this year's Reith Lectures on Radio 4. "The body is scarily intricate, unfathomable, hard to read. We are these hidden beings inside this fleshy sack of skin and we've spent thousands of years trying to understand what's been going on inside."

For hypochondriac listeners, this probably wasn't a good day. If there was an overwhelming message to be drawn from Gawande's first talk entitled "Why do Doctor's Fail?", it was "We're all going to die." In my case, though, it was the words "fleshy sack of skin" that brought about a cold sweat. Being a doctor himself, Gawande was decidedly unsqueamish about the human body. "In the operating room, I kinda loved the blood and guts of it all," he said with relish.

If the past few years' Reith Lectures have brought wilful pomposity (from Niall Ferguson) and glorious mischief (from Grayson Perry), Gawande's talk was a more serious proposition altogether. In dealing with concepts of human fallibility and the yawning gaps in our knowledge, Gawande was all about the big philosophical questions. His approach signalled a shift back to original ethos of the lectures, named after the founding father of the BBC, which revolved around education and enlightenment.

But that's not to suggest that Gawande was an ancient fossil exhumed with the intention of patronising us from on high and sending us into a mid-morning coma. He was passionate, energised and, contrary to the stereotype that surrounds those in the medical profession, full of warmth and humanity. His talk began with his son Walker's life-threatening illness at just 11 days old. On his admission to hospital, an oxygen sensor was attached to the wrong hand, leading to a potentially fatal misdiagnosis. The error was discovered and Walker lived to tell the tale, but another baby in intensive care for the same problem wasn't so lucky, suffering multiple organ failure.

Gawande's aim was not to discredit the medical profession but to unearth its challenges and gauge how we deal with ignorance and ineptitude. Rather than the miracles of modern medical science, he was interested in its failures. In her introduction, Sue Lawley noted that he was "in the disturbance business", alluding to his many books in which he looked the attitudes, systems and behaviours that underpin contemporary healthcare.

"I like digging into the complexities of reality, and what we really face," he explained.

Populist he wasn't, but Gawande was mesmerising speaker who knew how to tell a story and knew how to work a crowd. Knowledge may be power, he seemed to be saying, but it would work a lot better if we had more of it.

The limitations of medical science were having very clear consequences on 44-year-old Karen in Radio 4's The Listening Project. Four years after being diagnosed with breast cancer, she was in her final few weeks of life.

Karen had three children and here was recorded with her eldest, Nicole, who has been her full-time carer for over a year. This was not the time to reflect on how human knowledge had failed them. Instead, with their voices trembling, they discussed their worries both about the present and future.

Most devastatingly, they talked of the fear of going to bed at night, in case Karen shouldn't wake up. "I'll never be ready to go. I never want to leave you," she told her daughter. As they reflected on what was to come, they weren't the only ones sobbing.