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Home » Want to Get Great at Something? Get a Coach by Atul Gawande (Transcript)

Want to Get Great at Something? Get a Coach by Atul Gawande (Transcript)

Here is the full transcript of American surgeon Atul Gawande’s Talk: Want to Get Great at Something? Get a Coach at TED conference.

Atul Gawande – Surgeon

I don’t come to you today as an expert. I come to you as someone who has been really interested in how I get better at what I do and how we all do.

I think it’s not just how good you are now, I think it’s how good you’re going to be that really matters. I was visiting this birth center in the north of India. I was watching the birth attendants, and I realized I was witnessing in them an extreme form of this very struggle, which is how people improve in the face of complexity — or don’t.

The women here are delivering in a region where the typical birth center has a one-in-20 death rate for the babies, and the moms are dying at a rate ten times higher than they do elsewhere. Now, we’ve known the critical practices that stop the big killers in birth for decades, and the thing about it is that even in this place — in this place especially, the simplest things are not simple.

We know, for example, you should wash hands and put on clean gloves, but here, the tap is in another room, and they don’t have clean gloves. To reuse their gloves, they wash them in this basin of dilute bleach, but you can see there’s still blood on the gloves from the last delivery. Ten percent of babies are born with difficulty breathing everywhere. We know what to do. You dry the baby with a clean cloth to stimulate them to breathe.

If they don’t start to breathe, you suction out their airways. And if that doesn’t work, you give them breaths with the baby mask. But these are skills that they’ve learned mostly from textbooks, and that baby mask is broken. In this one disturbing image for me is a picture that brings home just how dire the situation is. This is a baby 10 minutes after birth, and he’s alive, but only just.

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