Better

Atul Gawande has written a wise book that has lessons on how to be better that apply beyond medicine. Better: A Surgeon’s Notes on Performance offers Gawande’s keen insight on how medicine can be better without having to rely on scientific breakthroughs or on technological innovations. Rather he gives advice on performance in diligence, doing right and ingenuity. In his section on diligence he demonstrates how virtue when applied to such simple routines as washing hands can make the difference in controlling antibiotic resistant bacteria. He also shows how strict adherence to protocol is what will determine whether polio, like small pox before it, can be eradicated completely. Diligence in collecting data and examining it to improve performance is what has significantly lowered mortality rates among the wounded in battle.

The next section of the book is equally good: the ethics of examining undressed patients, doctors in the death chamber and when is further treatment the wrong choice. In the final section he examines the different success rates of various medical centers and offers some insights on why the best are the best. Finally, in the afterward of the book Gawande shares some remarkable advice on how to become what he terms a positive deviant. Here’s his advice:
1. “Ask unscripted questions.” If you do this you will discover the unexpected. This applies both to people that you interact with as part of your job, and those you work with.
2. “Don’t complain.” As Gawande says, we are all tempted to take this route – we all have something that we are uhappy about. However, as he wisely puts it: “It’s boring, it doesn’t solve anything, and it will get you down.”
3. “Count something.” Numbers are revealing. However, they can also be boring, so his advice is to count something that is interesting to you. If you do, you will find something interesting.
4. “Write something.” In writing you step back and think about a problem. It forces upon you a certain amount of thoughtfulness. It can also put you in touch with a community of others thinking about what you write.
5. “Change.” He advises to be an early adopter of change. Avoid being a skeptic who resists changing anything. If you seek out the inadequacies of what you do you will find ample room for change. Look for something new to try.

It seems to Big Frank that these five pieces of advice apply far beyond the field of medicine. With all the self-help books out there, all the leadership books out there, and all the books on how to improve business/management/sales etc. etc. these five seem to have vast promise.