What did he do? He made a checklist.

That’s all. A checklist.

There are so many things to do when saving a patient’s life in the intensive care unit — on average, 178 individual actions per patient, per day — that even the most experienced and competent surgeons and nurses don’t get everything right all the time. They get it mostly right much of the time, but saving lives in the intensive care unit relies on keeping survival odds as low as possible, and even that little bit less than perfection results in infections and other little things that make it less likely a patient will survive.

So to make sure that all the little steps in the procedures happened and were performed correctly, Pronovost made a checklist. Nurses were empowered to correct doctors if they saw them skipping a step or doing something out of order. He did a test at one hospital and the results were so encouraging, Michigan rolled it out to every ICU in the state.

I’m simplifying, but you get the idea. A checklist bred consistency, and consistency allowed significantly more patients to live.

(The radio interview followed on a story in The New Yorker by Atul Gawande. The stats above are quoted from that story. Have a read for yourself — it’s well worth it.)

And that reminded me of another The New Yorker article written by Malcolm Gladwell not quite a decade ago (also a really good read) about geniuses like Wayne Gretsky and Yo-Yo Ma and the nature of their “physical genius“:

This kind of obsessive preparation does two things. It creates consistency. It’s what enables a pianist to play Chopin’s double-thirds Étude at full speed, striking every key with precisely calibrated force.

More important, practice changes the way a task is perceived. A chess master, for example, can look at a game in progress for a few seconds and then perfectly reconstruct that same position on a blank chessboard. That’s not because chess masters have great memories (they don’t have the same knack when faced with a random arrangement of pieces) but because hours and hours of chess playing have enabled them to do what psychologists call “chunking.” Chunking is based on the fact that we store familiar sequences—like our telephone number or our bank-machine password—in long-term memory as a single unit, or chunk.

If you think of physical genius as a pyramid, with, at the bottom, the raw components of coordination, and, above that, the practice that perfects those particular movements, then this faculty of imagination is the top layer. This is what separates the physical genius from those who are merely very good.

It’s something that appeals to my work ethic — that by working hard, you get ahead. Sometimes, really far ahead. Though in the back of my head, I don’t tend to connect a work ethic with the notion of genius. Geniuses come by their gifts naturally. They might have to work, but we don’t ever see it.

But these two articles shine a different light on the nature of it all. It’s entirely possible that once we find what an aptitude for something, a work ethic can take us far higher — that practice and repetition can lead to consistency, and consistency can lead to transcendence.

Even for a communications planner?

[x-posted from House of Naked]

The first sign came courtesy of Noah: At his suggestion, I just finished reading Steven Johnson’s excellent Emergence. It’s five or six years old now, but maybe more impressive because of how relevant it remains today. There is a lot to say about this book, but the pertinent thought here is about how our brains work.

The brain is a massively parallel system, with 100 billion neurons all working away at the same time. That parallelism allows the brain to perform amazing feats of pattern recognition, feats that continue to confound digital computers — such as remembering faces or creating metaphors.

We are wired for metaphor. It is our brain’s specialty to create connections between seeming disparate events or things.

Which brings me to a post by Grant McCracken about a conference called Interesting2007 that functions quite differently from your average industry conference. (Actually, come to think of it, this post came to me via Noah as well — maybe he’s secretly architecting my lesson?) You’re not allowed to talk about your personal area of expertise. No typical conference overstatement or self-promotion.

My first guess on why Interesting2007 was going to work (if it worked) was that everyone in the room was drawn from one of the creative industries (design, planning, art, advertising, film making, and so on). This means that everyone in the room at Conway Hall was good at metaphor capture and pattern recognition. So you could talk, as Adrian Gunn Wilson did, about how to cut wood, and the audience was bound to help themselves to that and much more.

All of this makes intuitive sense to me. We learn in metaphor. When we think about organizing, say, a conference, we engage with the problem rationally. What’s going to be of the most interest to our audience? Who are the best speakers to invite? What topics should they cover? It has to make “sense” — right? Well, maybe it doesn’t.

(I just should have figured out a better metaphor for this thought when writing this post…)