Tag Archives: Self-improvement

Checklist Manifesto – Atul Gawande

Are you using enough checklists? It feels like the world is getting increasingly complicated, and I’m sure we’ve all experimented with various memory aides to try to remember everything we have to do. These range from the humble checklist to the mighty online planning tool with hyperlinked entries. For most of us, though, I suspect it’s hard to know what we’re doing right.

Gawande, a surgeon himself, is firmly convinced by the virtue of the checklist, and in his hands it becomes a powerful and thought-provoking tool to confront complexity. He begins by pointing out there are two reasons we fail: ignorance, if we don’t know something, and ineptitude, if we know how to do something and do it wrong. It is the second problem that is the most serious in the modern world, he argues, and checklists can make a dramatic difference.

There are approximately 150,000 deaths following surgery in the US, about 3x as many as deaths from car accidents, and so he’s got a point. If checklists can reduce even a small percentage of errors in surgery, it could make an enormous difference. Fortunately, Gawande has a number of stories of astonishing success from checklist adoption. When Johns Hopkins introduced a checklist for central line insertions, for example, infection rates dropped from 11% to zero; when Michigan did, it probably saved over 1,500 lives in 18 months. The results are much the same in fields as diverse as aviation or skyscraper construction.

He does caution readers not to overreach, however. Checklists longer than 5 to 9 items long become cumbersome, and people start ignoring them. Good lists therefore focus on the steps that make the biggest difference, and the ones likely to be forgotten. Too long, and they stop being effective. They also need to be carefully tested: much of the book is devoted to failed attempts at introducing checklists, as people have a tendency to ignore or fail to follow the list unless it is designed well.

The book’s a quick and easy read, but the idea is extremely powerful. Gawande talks about his own initial reluctance to adopt checklists, seeing himself as above them, and his more recent reversal of opinion. When he asked surgeons about the value of a checklist, 20% said it did not improve safety. When asked if they would want it used in surgery on them, however, 93% agreed. I suspect we could all benefit from a bit more humility and a few more lists.

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Training Genius: The Genius in All of Us (David Shenk)

“The genius in all of us is our built-in ability to improve ourselves and our world.”

David Shenk thinks you misunderstand genetics. It’s not personal – he thinks pretty much everyone does. He argues in The Genius in All of Us that in trying to distinguish nature vs. nurture, we have missed the fact that who we are is determined by their interaction. Genes are turned on and off by the environment in which we live, and in the vast majority of activities for which we never reach our genetic limitations, it is practice and context that will determine just how talented we are. All of us have the potential to be a genius.

He points to Cooper and Zubek’s experiments with maze-bright and maze-dull rats, chosen as such because they descend from generations of rats who have been relatively good or poor at solving mazes. In normal conditions, the bright rats impressively outperform the dull ones. In enriched or restricted environments, however, both types of rats performed almost the same, whether as geniuses or dullards. Genetics do make a difference, but that difference can be overwhelmed by the influence of context and environment, despite what humans usually assume.

Shenk makes an important point, that we often neglect or underrate the importance of environment and its interaction with genes. Unfortunately, perhaps due to the shortness of the book (136 pages of argument, plus 200 of endnotes and citations), it can often feel like he hasn’t explored the ideas, but rather just rushed through them without examining their implications. He focuses, for example, on the idea that we can all be geniuses with a supportive environment: equally meaningful, however, is the implication that no one can be a genius without hard work and environment, and I am suspicious his choice of one perspective over the other is intended to sell books, not provide insight. He also sometimes seems to get carried away by his own arguments, so much so that he leaves his focus on interactions and seems to imply that environment is actually dominant over genetics, a suggestion he rightfully criticizes in the inverse.

The nature of heritability is always a controversial one, and the debate is often unfortunately ideologically, not factually, based. In that respect, Shenk has done a good job attempting to stick to the science, referring to many studies and explicitly citing his research. Nevertheless, a more thorough examination of the issues would likely be more compelling, and less likely to leave the reader feeling unsatisfied.

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The Art of Learning by Josh Waitzkin

“My whole life I had studied techniques, principles, and theory until they were integrated into the unconscious.”  – Josh Waitzkin

Joshua Waitzkin was national chess champion in the U.S. 8 times, inspiring the movie “Searching for Bobby Fischer,” and more recently has earned two world champion titles in Pushing Hands, the martial arts version of Tai Chi. It’s fair to say that he knows something about learning.

Quite a bit of The Art of Learning is devoted to Waitzkin’s career in both chess and pushing hands, and unfortunately though enjoyable it is perhaps a bit short on wisdom. Interspersed with that, however, are discussions of how he sees the learning process and the principles he believes underlie expertise in any discipline.

Waitzkin introduces a few vague lists of principles, but in essence argues the key to excellence is the gradual mastery of fundamental principles, over time interlinked into complexity and integrated into our subconscious.  The key to such learning is to take the small things you learn and ‘chunk’ them into larger ideas in your memory, ensuring efficient storage and retrieval. As a result, an expert martial artist and a beginner actually perceive different things. A complicated strike may be made up of six parts, but an expert perceives it as one moderately fast attack. The beginner, on the other hand, sees six different moves, all blindingly fast. Mastery of the fundamentals can actually change not just how you perform an event but also how you perceive an event.

Once you’ve achieved this chunking of basic concepts into complicated ones, he argues, you start achieving the deeper mastery critical for progress, and the correct decision can even seem intuitive. Studies of chess grandmasters, for example, have shown they do not see many moves farther ahead than weaker players. Instead, they have an intuition on which moves may be best, and so though they study the same number of possible moves, they study better quality ones.

Given Waitzkin’s success, the book is certainly inspirational, and mixed in with the story of his life are a few seeds of wisdom. I think my favourite story was that apparently as an offshoot of Soviet hypnosis programs, young Soviet chess players were taught to tap a piece quickly but softly against the table, in an effort to subliminally speed up the thinking of their opponent and encourage errors. Who knew?

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Sugar as Toxin – Fat Chance by Robert Lustig

“If the food comes in a wrapper, the wrapper has more health benefits than the food.”

Added sugar is everywhere. Something like 80% of all food items sold in the U.S. contain it, and Americans yearly eat about 130 pounds each. It’s a drastic change from history, when sugar was at best available only seasonally, when fruit ripened.

Lustig thinks that sugar is toxic, evil, causing the obesity epidemic, and a poison, and that’s before he really gets warmed up.  Not only have food companies started adding sugar to almost everything to encourage consumption, he says, but they also remove the fiber to improve shelf life. Yet it is fiber, Lustig points out, that helps us process sugar. This is why eating a fruit is fine, but fruit juice is not (calorie for calorie, fruit juice is worse than pop): the fiber is destroyed by the juicing process.

The answer to obesity, says Lustig, is threefold. First, we must control the environment in which we live, reducing our intake of substances like sugar that destabilize our bodily hormones and lead to overeating. Second, we need to increase our consumption of fiber. Third, we need to exercise. An overweight person who exercises may well outlive a thin person who does not, and 15 minutes of exercise a day appears to add about 3 years to a lifespan.

I can’t say I found Lustig’s analysis of public policy compelling: it’s not his area. On nutrition, on the other hand, he’s an expert. That said, I must admit this may be one of those (very) rare instances it may be easier to just read the news article or watch the video interview. Unless you want to understand the biology behind it all or really want a broader perspective on the issue, saying sugar is bad doesn’t really take a full book.

What Fat Chance has done is reinforce my impression that the chief advantage of most diets, regardless of content, is that they make you think about what you’re eating. Both vegetarians and non-vegetarians can be healthy, but vegetarians have to think about what they eat, and that matters. But if I were you I’d cut out sugar too. Maybe throw in some extra fiber.

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Why Introverts are Awesome – Quiet by Susan Cain

“The secret to life is to put yourself in the right lighting. For some, it’s a Broadway spotlight; for others, a lamplit desk. Use your natural powers — of persistence, concentration, and insight — to do work you love and work that matters. Solve problems, make art, think deeply.” – Susan Cain

Action. Boldness. Charisma. Harvard Business School and modern society are unanimous on the importance of these values. Not achieving them, therefore, signals failure: that we are too introspective, too reflective, and too contemplative. Susain Cain disagrees, and in Quiet argues that society grossly undervalues introversion. Choosing not to go to the party, or indeed to hide in the bathroom when you’re at the party, is not a sign of weakness: rather, it’s simply a preference for a life with less external stimulation, a model society might do well to learn from. 

To understand introversion, she traces it back to childhood. Highly reactive children, ones who respond strongly to stimulus, are actually more likely to be introverts than low reactive children. It is people who find external stimulation overwhelming who therefore seek to limit that stimulation, and so become more inwardly focused. For Cain, it’s a biological difference, not disadvantage.

Studying fish, she points out that bold fish are more likely to rush into traps and get caught than shy fish, but once in captivity, bold fish start eating the food earlier than shy fish and have a much higher survival rate. For humans, introversion predicts academic success in university better than cognitive ability, and an introvert’s focus on reflection means that in the lab they spend longer on tasks and do better at them. A world with less decisiveness and more forethought, therefore, might well be a better world. There is, after all, “zero correlation between being the best talker and having the best ideas.”

As befits a book written for introverts, Cain has written a book inspiring both action and reflection. At times it reads as a cheerleader for self-conscious introverts, encouraging them to be proud of their status, but it also relies on theories of learning and child-development to understand possible benefits to introversion and how people develop such traits. Of course, in serving as cheerleader for introversion, her examples of extraverted individuals can sometimes feel caricatured, and her description of introverts can sometimes feel like it includes all possible virtues. A few sections can also feel a bit slow, not contributing much to the thrust of the argument. Still, for any introvert feeling self-conscious in a world of extroverts, the book is a must read.

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