When my wife first mentioned Atul Gawande’s book, “The Checklist Manifesto,” I thought, “Someone wrote a book about that?”
My next thought was, I can check off the box in my calendar for coming up with a topic for my next column.
Gawande uses medicine as his jumping off point. He writes that a doctor can see some 250 different primary diseases and conditions during a single year’s office practice.
Moreover, he adds, “Clinicians now have at their disposal some 6,000 drugs and 4,000 medical surgical procedures ….”
“It is,” he writes with amazing understatement, “a lot to get right.”
Faulty memory and distraction are a particular danger in what engineers call all-or-none processes: whether running to the store to buy ingredients for a cake, preparing an airplane for takeoff or evaluating a sick person in the hospital, if you miss just one key thing, you might as well not have made the effort at all.
“The Checklist Manifesto” discusses how in a world with “complexity upon complexity,” something as low-tech as a checklist not only can make us more efficient, it can save lives.
Gawande details how in 1935 U.S. Army Air Corps test pilots in Dayton, Ohio, concluded that flying the latest batch of Boeing 299s “was too complicated to be left to the memory of any one person, no matter how expert.”
So they wrote down a list of step-by-step cockpit chores — on an index card.
The author notes that by the time we get to plucky Chuck Yeager and the rest of “The Right Stuff” gang of the 1950s, “checklists and flight simulators had become more prevalent and sophisticated,” and thus the dangers had dropped considerably.
Gawande also looks in on finance, speaking with investors who adapted those methods pioneered in health care and aviation to create Warren Buffett-like checklists. One example: Confirm that you’ve considered whether revenues might be over- or understated because of temporary market conditions.
I confess I felt validated by Gawande’s book: By packing a calendar annotated with daily checklists, I’ve come to believe don’t have to carry as much in my head. It’s the mental equivalent of traveling light.
My system is pretty straightforward: Almost everything is written in pencil, then checked off when completed or erased if canceled. Special events require special colors — birthdays in blue, soccer matches for which I’ll need to set the DVR in red.
I try to avoid the clutter of stars and asterisks.
Occasions that if missed could result in joblessness, dismemberment or divorce are highlighted. (No particular color, I’m not obsessive about this or anything.)
Sometimes, though, I’ll admit the system breaks down. I’ll find an entry either I cannot decipher — blame it on decades of using a keyboard — or simply makes no sense.
One recent Friday noted “GCI: Information.”
Was that something I was supposed to do? A place I was intended to be? Please don’t let it have been an anniversary ….
The best I can offer, dear reader, is that if I was scheduled to telephone you on a Friday or show up somewhere, blame it on the checklist.
Good, now I can mark off that blanket apology.