In Praise of Atul Gawande’s “The Checklist Manifesto”

I first smacked my forehead (ouch!) against a wall of decision fatigue when I was the Editor in Chief of iMedia Connection (a daily trade journal covering a different collision between marketing and technology). The best part of editing involves coaxing order from mess, making points pointier and helping writers to say what they want to say. The part that makes the days long is having to make a lot of decisions that matter in the moment but not in the long run: yes, let’s run with that one, the other one, and, oh wait, did that thing we’ve been waiting for come in? Editing — like management — is an endless series of arbitrary decisions, but somebody’s gotta pick and that’s the EIC.

I wouldn’t feel my decision fatigue until lunch. If we were heading out for a group lunch, the editorial staff would look to me. “You’re the boss, so where do you want to go for lunch?” Something in my hungry stomach would sink and I’d chose a place. Eventually, I changed my response. “I’m happy to pay for lunch, but I’ve made dozens of decisions already today.” I’d then point at one of the editors. “You pick the place. Nobody is allowed to complain.”

That was years ago, and in the interim — even though I’m no longer in that job — the scope and number of decisions I have to make each day has grown. Email vexes me in particular: do I check it when I first wake up? If I do, then I risk falling down a rabbit hole for the rest of the day. If I don’t, then I might miss something important. On top of that, the number of things bleeping at me, vibrating and waving their electronic hands like importunate fifth graders who know the answer to a question, keeps increasing year after year. I joined Ello because I was curious, for example, but now it’s another damned thing to check.

Greg McKeown’s remarkable book Essentialism helped me to recognize some of this and to intervene in my own behavior, but with smart phones breaking down all barriers our environment no longer does the work it used to do to help us know who we are at a given moment and what we’re supposed to be doing or not doing.

It’s not just me.

For the past dozen years or more I’ve been reading books tracing the same picture: life is getting evermore complicated. And, even though the human brain is the most sophisticated and powerful comprehension machine in the world, we just can’t keep up with the onslaught of information coming from new gadgets, screens, media and the increase in chatter from the old ones like radio, TV, books and the like. These are books with titles like Chaos, Frontiers of Complexity, Think Twice: Thin Ice, but also other books like Mistakes Were Made (But Not By Me), Predictably Irrational, and Thinking Fast and Slow.

Like the old saying about how people complain about the weather but nobody does anything about it, most of these books were of the point and exclaim variety rather than being helpful. “Look at how irrational we are!” “Look at how things appear chaotic but actually have hidden patterns of order!” “Look at how you can never make a smart decision, but don’t give up!”

On the other side of the bookstore (when I can find one), the self-help books don’t help much. They’re too involved in a method to which I must enslave myself before seeing any benefit. I can Get Things Done, but only if I start managing endless lists that suck up a ton of time. I can Hack my Life (yuck) but that involves having a gadget or twist tie for everything. Often, when I read these books I feel like I’ve just shelled out twenty bucks for a commercial for the author’s consultancy.

All this is why I’m excited by Atul Gawande’s 2010 book, “The Checklist Manifesto: How to Get Things Right,” which I read in a day. Gawande is a globetrotting Harvard Medical School surgeon who works with the World Health Organization and writes for the New Yorker.

Gawande is intimidatingly smart and eloquent with an eye for evocative detail, but he didn’t write a book about himself. Instead, it’s a passionate defense of the simple checklist as a tool for embracing and mastering the complicated tasks in front of us day to day.

Wait, didn’t I just backhand David Allen’s list-oriented Getting Things Done approach a few paragraphs ago? (Answer: yes.) How is Gawande different?

First, The Checklist Manifesto isn’t a self-help book. It doesn’t have a handy appendix that helps you to create your own list, nor does it advertise how there are other books in the series that you can buy, or how you can hire Gawande as an efficiency expert to make your business run better (you can’t, although my sense of the author is that he would probably come up with a referral for you if you asked).

Second and more importantly, The Checklist Manifesto isn’t about self-help at all. It’s not about individuals doing things, it’s about how groups of people working together can work together better, and how empowering the group is more important than empowering an individual… even if the individual is the boss, like a surgeon, editor or CEO.

This is different than crowd-sourcing (another raft of books I’ve read in recent years) where trusting to the mass can reveal information uncloaked by individual or observer bias.

Instead, this is about teams working in environments of massively overlapping subspecialization. We have lots of technologies that help us to track and manage the what of collaboration, but surprisingly few to help us with the who.

That’s where the checklist comes in.

Here’s an example that Gawande articulates from skyscraper construction when he talks with a man named Finn O’Sullivan about two lists in O’Sullivan’s field office. The first list is the microscopically detailed construction schedule:

But the list on O’Sullivan’s other wall revealed an entirely different philosophy about power and what should happen to it when you’re confronted with complex, nonroutine problems– such as what to do when a difficult, potentially dangerous, and unanticipated anomaly suddenly appears on the fourteenth floor of a thirty-two-story skyscraper under construction. The philosophy is that you push the power of decision making out to the periphery and away from the center. You give people the room to adapt, based on their experience and expertise. All you ask is that they talk to one another and take responsibility. That is what works. (pages 72 to 73)

Gawande’s vision of the checklist isn’t merely another device (albeit a simple one) to outsource our increasing cognitive burden somewhere else. Instead, The Checklist Manifesto puts that device into the moments where tasks move from one person to another. It puts interaction at the heart of a project, not at the periphery.

For anybody working as a member of a team (and this pretty much means everybody), managing a group or leading a company, The Checklist Manifesto will help you to rethink how to collaborate to enhance the work at hand and avoid avoidable mistakes.

It’s also a spritely read with terrific stories.

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