Saturday, January 3, 2015

Atul Gawande Better: A Surgeon’s Notes on Performance 2008 Profile Books London.

This is a repost from a few years ago, but there aren't many weeks that I don't try to be a 'Positive Deviant' .... see below.

The sorting trolley at the local library can be the source of good reads without having to go to the shelves. When I’m in a hurry, must not tarry and cannot not allow myself to get sidetracked, I stick with the sorting trolley.
There will be the usual squad of noirish detective fiction. The odd sf and fantasy. Literature. And a  few non fictionals. Like this one. Better: a surgeon’s notes on performance.

I opened it a quarter of the way through, my usual check, and began to read. Page 65, the chapter heading was Casualties of War. Why soldiers refused to wear their goggles and that the reason for the increasing eye injuries. I glanced back at page 64, where a section conclusion said, Ask a typical American hospital what its death and complication rates for surgery were during the last six months and it cannot tell you.

About ten pages later I realised I was hooked. I checked the book out and took it home. I began from the beginning. The introduction is not a chapter that can be skipped as it states the premise of the investigation by way of a telling example from Gawande’s own, at the time of his residency, practice. 
“What does it take to be good at something in which failure is so easy, so effortless?” Gawande asks on page 3. This is when I really settled into this book for this is a resonating question in that it can be applied to almost any difficult endeavour.  Convincing the naysayers of the importance of preserving biodiversity at any cost?  Just one of the questions I regularly ask myself.

Though it is the examples for each of the three main topics that make the riveting reading, what area of human work wouldn’t be better with diligence, doing right and ingenuity? In relation to diligence, for example, there’s an essay on washing hands. In doing right, what doctors owe to society is investigated. Ingenuity is explored through the Bell Curve.

Yet it is the Afterword, with its Suggestions for Becoming a Positive Deviant that I want to remember. These are a set of suggestions for personal improvement that are plain and do-able, though they are aimed at doctors and surgeons at the forefront of doctoring.

1.     Ask an unscripted question. Make a human connection and life immediately becomes less of a machine.

2.     Don’t complain. Or in other words, don’t make yourself and other people feel bad by taking a negative view. Don’t necessarily see life through rose-coloured lenses but observe something and get a conversation going (my paraphrase, this sentence).

3.     Count something. Be a scientist in your world. The only requirement is that you should count something you’re interested in. Learning something interesting that you can then talk about, giving it to your community. 

4.     Write something. Add a small observation about your world. Don’t underestimate its effect on your world. Everything we know, all knowledge is observations made by interested people communicating for the benefit of us all. The published word (be it book or blog) is a declaration of membership and also a willingness to contribute something meaningful. Don’t underestimate the power of the act. Writing lets you step back and think through a problem.

5.     Change. Be an early adapter. (Not a late adapter, not a skeptic.) Find something new to try, something to change. Count how often you succeed and how often you fail. Write about it. Ask people what they think. See if you can keep the conversation going.

Don’t you agree that these suggestions are ways that anybody can take up and make habitual without too much pain?

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