The Checklist Manifesto: How to Get Things Right by Atul Gawande
In order to give myself permission to read the latest bestseller by Rhodes Scholar/surgeon/professor/MacArthur “Genius”/New Yorker/TED-anointed Dr. Atul Gawande (and yes, all his books are lauded, importantly nominated, finalist-ed, awarded bestsellers), I decided I had to first finish his previous titles in order. What might sound a bit like unnecessary pressure just to read a single book turned out to be quite the illuminating gift to myself. Finishing all four titles in just over a week is surely some sort of positive indication as to their absolute readability (and audibility – yes, going aural is highly recommended, especially if you happen to be in the midst of a massive, mindless move, the good doc is the perfect prescription to make the boxes pack and unpack that much faster).
This, Gawande’s third – Complications came first, Better was even better, Being Mortal is up next and was soooo worth the wait! – is actually the least medical of his thus-far quartet. The essential bottom line is that the humble, so-last-century (centuries?), non-techno, no bells-whistles-beeps-checklist is an unbeatable tool to making doctors better, more effective, and ultimately more successful. In order to prove the efficacy of the checklist, Gawande leaves the operating room to investigate best practices in construction, aviation, even high-return investing. As diverse as the methods might be in such unrelated fields, all can and do benefit from the implementation of a step-by-step checklist.
According to philosophers Samuel Gorowitz and Alasdair MacIntyre, two reasons stand out for why we fail: ignorance and ineptitude. Gawande read their short essay on human fallibility during his surgical training “and [hasn’t] stopped pondering since.” His careful ruminations have certainly found resourceful permanence in the pages here.
For most of history, ignorance kept doctors from curing too many illnesses. They just didn’t know. “But sometime over the last several decades … science has filled in enough knowledge to make ineptitude as much our struggle as ignorance.” With so many advances happening at nearly-impossible-to-keep-up-speeds, navigating the right path is not always clear: “… the greatest difficulties and stresses in medicine … is not money or government or the threat of malpractice lawsuits or insurance company hassles – although they play their role. It is the complexity that science has dropped upon us and the enormous strains we are encountering in making good on its promise.” What might have been ignorance has tipped far too much into ineptitude. Ouch. Literally. “It is not for nothing that the philosophers gave these failures so unmerciful a name – ineptitude. Those on the receiving end use other words, like negligence or even heartlessness.”
By telling the stories of doctors, engineers, pilots, financial gurus – and David Lee Roth’s brown M&Ms – as well as patients and clients and customers, Gawande shows over and over again the simple power of the checklist. He doesn’t neglect to admit just how much he relies on his own: “I have yet to get through a week in surgery without the checklist’s leading us to catch something we would have missed.”
Ridiculously simple as it sounds, Gawande will convince you that ‘How to get things right’ can be just a checklist away.