probably the first book that I ever read written by a Medical Surgeon. Below are some notes / takeaways from the book.
B: “necessary fallibility” — Some things that we want to do and simply beyond our capacityB: But sometime over the last several decades — and it is only over the last several decades — science has filled in enough knowledge to make ineptitude as much our struggle as ignorance.B: If the knowledge of the best thing to do in a given situation does not exist, we are happy to have people simply make their best effort. But if the knowledge exists and is not applied correctly, it is difficult not to be infuriated.PK: I was scared reading a lot of medical examples that author quotes, e.g. the one where he makes a mistake in the surgery that he did. But, I believe the Doctors (who save human beings) are to be fully believed and that is when the medicine that we take suggested by them completely works on us.
B: One needs practice to achieve mastery, a body of experience before one achieves real success. And if what we are missing when we fail is individual skill, then what is needed is simply more training and practice.
PK: I am reminded of the 10,000hrs concept from Malcom Gladwell’s “The Outliers”. There are some of my friends who don’t believe in this concept, at least about 2 years back when I had read Outlier and described it to them, they were not ready to take it, I don’t know about their impression now (you will know if you are the one I am referring to here).
B: But, really, does it take all that [an M.D. and a Ph.D. in public health from John Hopkins, referring to Peter Pronovost] to figure out what anyone who has made a to-do list figured out ages ago? Well, maybe yes.PK: :-)B: The author asserts, “Expertise is valuable but most certainly not sufficient” in solving complex problems.B: “Forcing functions”: relatively straightforward solutions that force the necessary behavior — solutions like checklists.
B: Author repeats this line / concept “You want people to make sure to get the stupid stuff right.” multiple times in the book, I think it is one of the strong takeaways I have from the book.
B: A great line to show that group work can be more productive / effective than individuals, “Man is fallible, but may be men are less so.” This thought is reinforced in multiple places in the book.
B: No, the real lesson is that under conditions of true complexity — where the knowledge required exceed that of any individual and unpredictability reigns — efforts to dictate every step from the center will fail.B: I asked a WHO (World Health Organization) official whether the organization had a guide book on how to carry out successful global public health programs. She regarded me with a look that a parent might give toddler searching the dog’s mouth for the thing that makes the barking noise. It’s a cute idea but idiotic.B: Giving people a chance to say something [introducing themselves, and mention concerns] at the start seemed to activate their sense of participation and responsibility and their willingness to speak up.PK: Looks like a great principle to adapt when unknown people come together to attack a problem or a situation.
B: Good checklists, on the other hand, are precise. The are efficient, to the point, and easy to use even in the most difficult situations. They do not try to spell out everything — a checklist cannot fly a plane. Instead, they provide reminders of only the most critical and
important steps — the ones that even the highly silted professionals in them could miss. Good checklists are, above all, practical.
B: The power of checklists is limited, Boorman emphasized. They can help experts remember how to manage a complex process or configure a complex machine. They can make priorities clearer and prompt people to function better as a a team. By these, however, checklist cannot make anyone follow them.B: What experts like Dan Boorman have recognized is that the reason for the delay is not usually laziness or unwillingness. The reason is more often that the necessary knowledge has not been translated into a simple, usable, and systematic form.PK: Another takeaway from the book for me was, how important it is to work with organizations like WHO to have a larger impact in the society. Thanks to NASSCOM for giving me the opportunity to work as an intern with them during my Ph.D. life, I believe, the experience and the impact one could have working with such organizations is humongous.
PK: As most of you know, my current area of research is Privacy and Security in Online Social Media, during any introductory lecture on this topic, I use the picture below. This is a picture from the incident where a Airbus A320 crashed / landed into the Hudson river and Jkrums
tweeted about it “http://twitpic.com/135xa
– There’s a plane in the Hudson. I’m on the ferry going to pick up the people. Crazy.” This tweet is one of The 10 Greatest Tweets of All Time
. Got to know a lot more about the incident than what I knew before and
how team work and following guidelines / principles can be so effective.
B: The fear people have about the idea of adherence to protocol is rigidity.B: We’re obsessed in medicine with having great components — the best drugs, the best devices, the best specialists — but pay little attention to how to make them fit together well. Berwick notes how wrongheaded this approach is. “Anyone who understand systems well know immediately that optimizing parts is not a good route to system excellence.”B: The same can be said in numerous other fields. We don’t study routine failures in teaching, in law, in government programs, in the financial industry, or elsewhere.
PK: Just focussing on the domain / profession that I am involved, I have never come across any research or reports showing the failures in teaching. If any of you know or find any, please share it with me.
PK: I took away a lot of things from this book, but some concrete steps that I would like to try or see develop: 0. a good checklist for students / researchers (including myself) writing an academic research paper, addressing minute details of preparing the draft. I strongly believe that this checklist may differ from authors / collaborators to authors / collaborators, as mentioned in the book, but having some baseline can be very good. 1. a good checklist for event organization like a conference / workshop. 2. a good checklist for creating a usable / commercializable ideas / startups. I can see some of my friends running startup screaming now saying, there cannot be a checklist for this one 🙂 I am going to keep my eyes and ears open for developing such and many more checklists which can be useful for students / faculty / academia.
Among many new words that I picked from this book, here are a few to note:
– Asystole: Total cessation of heart function
– vicissitude: a change of circumstances or fortune, typically one that is unwelcome or unpleasant