Dr Atul Gawande has rightly earned a formidable reputation at an early age with his first opus, written while he was still a resident doctor in an American hospital. He now commands our attention by a forthright and comprehensive review of current medical practices in India as witnessed by him. Published in the New England Journal of Medicine, the essay is assured wide readership. Alas! this Journal is not read by our ministers of health in New Delhi and various states or by the bureaucrats who man the ministries of health and education.