Saturday, April 12, 2008

five things

in his excellent book better, atul gawande suggests that there are five things one might do to make a positive difference in the world.

his advice was directed at medical students, but it translates nicely to those of us who are not future physicians.

for example, any of us can...

1. ask an unscripted question.

in the course of an examination, doctors routinely ask patients a rote list of questions. where does it hurt? how long has it felt this way? why did you stick your finger in there? and such.

how much more interesting, and potentially valuable, could it be to do the unexpected?

his conclusion was, "quite valuable." and not just in the exam room.

asked an apparently unrelated question, a patient might subsequently volunteer a detail important to his or her care. a colleague, given the same opportunity, might offer up a nugget that leads to a better treatment for that patient. or maybe it just leads to a mutual interest and a better relationship.

win. win.

2. don't complain.

gawande's observation: it's boring, it doesn't solve anything, and it gets you down.

all true. but it feels good sometimes, right? sure it does. but not as good as getting up and doing something about the problem. so, i conclude in my own little slice of the world, complain, but don't stop there. act. solve. feel even better.

(caveat: if you insist on sticking your finger in there, you give up the right to complain about it.)

3. count something.

gawande equates "counting" with observational science. the gathering and analysis of data. the science of observation can take many forms, however. me, i count the number of days i didn't exercise this week, and calculate how old and out of shape i became as a result.

at my current rate, assigning a negative life expectancy value to days missed, extrapolated over time, i figure i've got about a week to live. but who's counting?

4. write something.

"writing," the good doctor says, "lets you step back and think through a problem. even the angriest rant forces the writer to achieve a degree of thoughtfulness."

i can confirm this. in the nearly four years (four years!) i've been blogging, i've put up some angry rants. but in the process, i think i've become a passable writer.

even more importantly, i've gotten my head around a variety of subjects that, come to find out, are important to me. who knew?

another writer i know blames blogging for her lack of progress on other fronts, including a long-deferred novel. but for me, this writing has quite literally changed my life--for the better. i've organized my little brain in a way it never was before (and probably, none too soon).

5. change.

respond to new ideas. become an early adopter. find something new to try. don't be afraid to fail. because failure is an opportunity to improve.

in the course of their ski lessons, my children brag to each other how few times they fell. but as someone told me long ago, if you don't fall down, you're not trying hard enough.

change, as proposed by gawande, is an open invitation to fall down, over and over again. but that's not so bad, is it? as long as we get up one more time than we fall, we're ahead of the game.

(caveat: when expecting to fall, make sure you're not holding something sharp.)

in better, gawande describes scenarios that are, literally, a matter of life and death. from a polio outbreak in india to infants in the maternity ward to a young girl's cystic fibrosis, his illustrations are riveting. and often disturbing.

somehow, though, daunting as the situation might be, he never gives up hope. he simply gets up one more time than he falls down.

this may be about as well as anyone can hope to do.

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