Better

As I prepare for my new job at Baylor University, I’m even more alert than usual to the many analogies, metaphors, and parables out there that help me think about education.  My reading this summer has been unusually rich in that regard. Over the last few days I’ve been deep into Atul Gawande’s Better: A Surgeon’s Notes on Performance. I don’t think I can recommend this little book too highly. Parts of it are expanded versions of essays that originally appeared in The New Yorker. Parts of it are new to me. All of it is insightful, inspiring, thoughtfully cautionary.

Two parts I’ve blogged about before, in their New Yorker incarnation: the story of Virginia Apgar and her scoring system for assessing newborns’ health, and the story of Warren Warwick and his zealous devotion to the best possible outcomes in treating cystic fibrosis.  Both of these stories strongly influenced my work in the classroom over the last eighteen months, and both have helped me think more complexly and imaginatively about the vexed issue of assessment in education. I suppose that’s one reason I bought Gawande’s book earlier this week: I had just finished working with a colleague on a conference proposal for a seminar on assessment and I wanted to revisit Gawande and test my current thinking against his. I was inspired anew.

At an even deeper level, though, Gawande’s book strikes me as perfect reading material for all of us who live in what Nassim Taleb calls, with haunting precision, “the antechamber of hope.” Why do we struggle? To what end? With what hope of success? Why do some intense efforts yield extraordinary, lasting results while other lead to muleish opposition and setback after setback? To cite just one of Gawande’s examples: why have the enormous strides in antisepsis in the operating room not been matched by widespread, thorough habits of handwashing in doctors? Why are some simple, basic barriers to dramatic improvement so immoveable?

The Virginia Apgars and Warren Warwicks of the world seem to breathe a purer oxygen than most of us do. They are awake, and indefatigable. They also love the idea of improving our processes of improvement, what Doug Engelbart calls the “bootstrapping” level of augmentation. Most of all, they are curious, game, scrappy, always thinking, always pushing. They are what Gawande calls “positive deviants”: outliers who make change possible, and life better, for everyone.

Here’s how Gawande sums it up at the end of his story of medicine in India, where truly dire conditions have not blocked great innovations among the doctors there:

True success in medicine is not easy. It requries will, attention to detail, and creativity. But the lesson I took from India was that it is possible anywhere and by anyone. I can imagine few places with more difficult conditions. Yet astonishing success could be found. And each one began, I noticed, remarkably simply: with a readiness to recognize problems and a determination to remedy them.

Arriving at meaningful solutions is an inevitably slow and difficult process. Nonetheless, what I saw was: better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.

And as Gawande notes in the story of Warren Warwick and the treatment of cystic fibrosis, it takes a willingness to be open with one’s efforts and candid about one’s failures.

So there’s the adventure: become a positive deviant. The two words describe the task well, for they suggest the tension and difficulty inherent in making true deviation truly effective, and not simply an exotic nuisance (or worse, a scapegoat).

I haven’t quite finished the book. I see the Afterword approaching: “Suggestions for Becoming a Positive Deviant.”

I’ll report back.

9 thoughts on “Better

  1. Dude? Baylor? Texas?

    Woah sez Neo.

    At least you are just an hour from Austin for my NMC trips.

    Curiously….

  2. Thank for revisiting this book. For me the biggest take-away has been the importance of preparation and attention to detail in professional practice. Gawande highlights how many things have to be meticulously coordinated for a successful surgery to take place–services like purchasing, delivery, cleaning and repair.

    True success in medicine is not easy. It requries will, attention to detail, and creativity. …Nonetheless, what I saw was: better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.

    Every page has a lesson that those of us in higher education can learn from. Even the most mundane details can be motivational in the face of moral clarity….

  3. Thanks for the tips… I’ve just finished reading Howard Gardner, Csikszentmihalyi and Damon’s book Good Work. It is about when excellence and ethics meet. It too is worth a read since much of what we are about these days in education is doing good work in difficult times (for education). I will certainly pick up a copy a Better. Good luck at Baylor.

  4. Gardner – good luck at your new digs.

    I wonder if you could reflect a bit on “It takes diligence,” on the one hand and “keeping up with the technology” on the other. Personally, I feel a need to sit some out in an attempt to keep an eye on the ball. But once having made a choice to implement in a particular way, I feel in urge to try what’s next. So I admire those who can stay with it.

  5. Baylor?! I heard a rumor from some fellow MWC grads (class of ’03) that you were leaving. I was sent a link to your blog merely to prove that fact, but I ended up reading for quite a while. Your blog contains the same sense of excitement, discovery, honesty, and genuine community that made being in your class so exciting. Reading through your thoughts on teaching and learning have done much to energize me for the coming school year. (I teach elementary school . . . and you might be interested to know we’re starting to explore the use of blogs and wikis with the little ones.)

    Meg Hoffman (formerly Horne)

  6. “Positive deviant”– perfect-o! I love the mix of fierce determination and willingness to fail and openness with the process: “will, attention to detail and creativity.” Exactly.

    You go be that positive deviant at Baylor (and just a couple of posts ago I was calling you the blogger-bard; this I like even better). I very much look forward to following your adventures in a new land.

  7. This looks like just the kind of reading that hooks me. I especially like these few lines:

    “better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.”

    I’m excited about reading this book – it’s been added and moved to the top of my ‘to read’ list.

    Thanks for dropping by this morning 🙂

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