Maybe it’s because I’ve always known my brain was terribly flawed. Or because I’ve spent a lifetime wading in complexity and finding my way through it successfully with planning and organization tools that this author’s argument—that we can overcome complexity and minimize errors in medicine, government, disaster recovery and more by utilizing checklists—fell flat on me. I just couldn’t help but scratch my head: “do professionals not already know this?” And, at a higher level, “do professionals really not get the idea that the volume and complexity of what we know/can know far surpasses our individual ability to process it?”
There I said it.
Did anyone else think this while reading The Checklist Manifesto?
Let me be clear: Gawande is a brilliant thinker and doer, and an exceptional storyteller to boot but it concerns me (gross understatement) to think that the checklist is—or ever was—a novel idea for those performing my heart surgery, sending my heroes to space, or saving my countrymen from gunmen gone mad.
Gawande’s stories will both enthrall and upset you. You will never look at experts or expertise the same again. (Disturbing Factoid: 60% of patients with pneumonia receive incomplete or inappropriate care.) And I doubt, if you’re really honest with yourself, you’ll be enchanted by oversized personalities with oversized egos ever again—these are some of the very people who believe assistance from outside is unnecessary. These are also the people that others are less likely to (legitimately) challenge.
Another thought to ponder: if hyper-specialization is necessary to circumvent avoidable failure from complexity in our modern world, as the author asserts, who is looking at the big picture? Who is seeing the forest through the trees? Who is connecting the dots and understanding the implications and interdependencies of the actions made by all the—mostly independently operating—specialists? Who’s worrying about the integrity of the whole? Who even sees it anymore? This applies to our body, to our universe, our planet and to everything else significant in between.
Practically speaking, I found the portions of the book where the author addresses what constitutes an effective checklist both useful and relevant to my world in business and industry. He is very clear about the essential elements of a first-rate checklist: simple, measurable, and transmissible and gives tangible examples of each through effective storytelling.
The Checklist Manifesto is an important book because of the macro issue it points to (albeit indirectly): the long-term risk increasing complexity and, thus, specialization presents. Specifically, our ultimate inability to fully “see” the big picture when each of us—experts and laymen—is forced to increasingly focus on a more granular piece of the world.