Books and Media I Recommend – The Undiscovered Country

Book Review: The Map that Changed the World

My favorite getaway: renting a place, bringing a bunch of books (or better yet, discovering new books in the rental home), cooking in the Instant Pot, hiking, and playing the ukulele. I have apparently infected at least one offspring with similar interest in reading.

This week’s book? A story about a man living in England in the 1800’s, who ultimately is credited with what is modern day geology.

What’s cool, is the book cover actually unfolds into a large reproduction of the original map.

William Smith’s life is entirely relatable. He learns math and measurement, and has a keen eye for observation. As a young man, he helps develop a coal mine, and notices that the layers of earth, hundreds and thousands of feet down, seem to have a recurring pattern. Furthermore, as he gains experience digging canals, he sees the same patterns laid out across the region of Bath, where he is employed. Over a number of years, he is employed to dig canals, drain swamps, marshes, farms, all the while collecting rocks, fossils and developing his theory of Stratification (a term he coins).

I note that I am entirely a geologic novice, and Permian and Cenozoic terms come and go without lodging in my brain. However, Smith catalogues and builds ideas, and eventually a map of Bath. He links various strata with geologic eras, with aspirations of mapping all of England.

The trouble is, he’s a working man, traveling and helping companies and individuals. Furthermore, he (imprudently) maintains two offices and a home, that he cannot afford. His marriage to a mentally ill woman does not help, and his ideas lay dormant and unpublished for far too long. He DOES publish a fabulous map, sells 400 copies at “7 guineas each”, a disappointing non-recognition of his thousands of miles of travel and careful analysis.

This map is a massive work: it lays out across England, the layers of rock, coal, sandstone, chalk, etc, and the sequence of layers hidden below. In future years, it will end up launching the coal industry, farming, minerology, and influencing Charles Darwin.

In his adult years, he is fraudulently scooped, with others publishing his work as their own. He is denied admittance to the Royal Geological Society, snubbed because he is an orphan, and not born to high society.

With accumulating debt from his properties and failed business, he ends up going to debtor’s prison, losing everything, and then starting over, nearly penniless, living in rentals and traveling to do survey work.

Based on some chance meetings, he ends up getting recognition for his original solo research and work, FIFTY years later, and is finally recognized and rewarded, in his old age, as the Father of Modern Geology.

I can’t help but think that, so much of our lives are happenstance:

Whom you meet and connect with
How random chance connects you with a job you flourish in, or fail miserably at
What the local culture (class-based snobbery, or open-minded scientific inquiry) encourages or prohibits
How you develop useful skills, and work hard
How you see that others may not; what do you do with that knowledge
How you personally persist past obstacles, or succumb to pressures

CMIO’s take? This could have been a story of any scientist, any informaticist, any CMIO. This could have been MY story. And that’s what the best books are about.

Laocoön, The Aeneid and Captain Picard

https://en.wikipedia.org/wiki/Laoco%C3%B6n_and_His_Sons

My high-school aged son is avidly devouring classic literature, and the echoes of those epic struggles from my own education, float back to me. On our winter break one evening, he had left the Norton Anthology of Western Literature out on the coffee table. Soon I was in the midst of battle at Troy, at Carthage, in Rome.

Aeneas of Troy, in the classic by Virgil, faces a long journey with many trials. Even in 20 BC, storytellers mastered Story. Sometimes the smallest moments are the best parts of a story:

Laocoön runs out from the city to warn his fellow citizens of Troy, that the large wooden horse left behind by hastily departed Greeks, was a trick: ‘beware of Greeks, even bearing gifts.’ To punish him, the gods send a pair of serpents to devour his sons and then kill him. The image above of Laocoön dying defending his sons is such a moment. The city elders, seeing him killed by the gods, are then convinced that he is wrong, and bring the Trojan Horse inside the gates. Of course, you know the rest: the city of Troy falls that night as hidden Greek solders pour out, open the gates and ransack the city.
Aeneas initially resolves to stay and defend his city to the death. His touching moment with his father and their resolve to stay together and flee is a pivotal moment of change for both of them.
Aeneas meets Dido, queen of Carthage, in his storm-tossed journey, and falls madly in love. Soon after, the gods send him a message that he and his lineage are to become the founders of Rome. He leaves immediately. Dido kills herself in despair.
With supernatural help, Aeneas journeys to the underworld to see the future: that his descendants establish Rome and create the Roman Empire.

These moments, to which I’ve summarized so prosaically, are told in verse and with rich detail and sensory imagery.

Interestingly, the Norton Anthology also included the ancient translation of Gilgamesh, perhaps the oldest recorded epic story. Being a science fiction geek, perhaps I should not have been surprised that my first exposure to this classic, written in antiquity, circa 1700 BC, first reached my ears via Captain Picard, on the all-time most popular episode of Star Trek, The Next Generation TV show called Darmok (no, not the new, apparently amazing show, that is behind the CBS paywall). Careful, don’t read the links unless you have time; you won’t come out for awhile.

CMIO’s take? Great storytelling captivating, and timeless. Smart people lived thousands of years ago. Sometimes Captain Picard teaches you ancient literature.

Bowling Alone or Kicking in Groups? Wellness concerns…

I’m part of WellDOM, the Wellness initiative within the Department of Medicine at University of Colorado. As such, I continue to support the idea of Sprints, the way we boost physician and team efficiency and effectiveness using the Electronic Health Record. However, we know that a large part of physician burnout and wellness have to do with other components: a Culture of Wellness and Personal Resilience, in addition to Practice Efficiency.

In thinking more about these broader components, I’m reminded of the work of Robert Putnam’ Bowling Alone, a towering work, documenting the decline of civic virtue and engagement in this country, illustrated most profoundly by the fact that membership in bowling leagues has declined 40% from 1980 to 1993, while individual bowlers rose by 10%. There has been a dramatic drop in face-to-face social gatherings outside of work in the past few decades, and the thought is that this decline in the social fabric has led to isolation, loneliness, and a general decline in civility and personal resilience. See the recent Atlantic article “Kicking in Groups” on this, also.

We’re looking for objective measures that might allow us to survey for and detect burnout and resilience, that might get past ‘soft’ measures like “do you feel burned out” and perhaps measure “Do you have social groups that you meet with regularly at work” or “Do you have social groups that you meet with regularly outside of work”, and also “Do you meet regularly with a mentor or mentee?” We believe that measuring such behaviors MIGHT be a more objective way to determine who is more protected, and who is vulnerable, to burnout.

CMIO’s take? Physician/provider burnout is a real thing; difficult to address; and may be embedded in a larger change in the social fabric. Are you having success thinking about and intervening in this fraught area? Let me know.

Getting to Yes (Book review)

OK, nobody has time to read an actual book, so here is William Ury speaking at Creative Mornings about his book. Do you have 30 minutes to be a better person? Ever seen the arm-wrestle exercise? Watch the video.

I’ve read his book several times now. At least put it on your bookshelf. My take-aways for me and my colleagues and my work. We discussed this in our Large PIG book club recently.

Separate people from the problem. Personality is NOT at issue. Avoid blame on either side
Focus on interests, not positions. Be curious. See (and demonstrate your understanding of) the other party’s position clearly
Learn to manage emotions. Allow expression of strong emotions. Else, may block clear thinking
Express appreciation. Reflective listening (data, ideas, feelings, values). Seek others’ perspective.
Put a positive spin on your message. Avoid blame.
Escape the cycle of action and reaction. Instead, explore interests, invent options for mutual gain, leverage differences, brainstorm jointly as “wizards” (lower level persons who are permitted to work on ideas without leadership pressure)
Prepare your BATNA (Best Alternative To Negotiated Agreement) What will you do if you don’t agree?
Seek a third party who is trusted by both sides
Be SOFT on the people (care about the person), HARD on the problem (principled thinking)

I’ve read authors with similar points:
-Steven Covey: Listen first to understand, THEN speak to be understood
-Crucial Conversations: Make it safe to converse, Control your own stories, Contribute to shared pool of meaning, Ask other’s interpretations, Be tentative in your theories, Seek win-win opportunities.

CMIO’s take? This is a foundational book for Informatics and leadership in general. Find time to learn these lessons. Find the win-win.

Book review: Flow (second time review)

Here we are (again)! How can I review this? An incredible landmark of a book, it has sat on my bookshelf for more than a decade, and then on my ‘actively reading coffee table’ for another few years. Despite its mention in almost every important other book I have read, and my repeated abortive attempts to push through, I found this book alternatively revelatory and then densely incomprehensible. I frequently dove in, underlined many passages, got stuck, and put this book down for prolonged periods.

Finally I convinced my book club friends to tackle this, set a discussion date (Jan 2019), and that was my trick to completing the massive read.

What I’ll take away is the idea of linking happiness NOT to acquisition and idle pleasure, but to difficult challenges that are just outside my comfort zone and skill set, where with maximal concentration, I can succeed.

Fortunately for me, I have had many times in my life when I have achieved such Flow, and now I have a framework for thinking about it and setting up my day, my home, my work life to achieve this as often as possible for myself and for colleagues.

Incidentally, I have recently completed the massive tome ‘Alexander Hamilton‘ by Chernow, another incredible read (I was drawn in by, of course the immensely popular musical), and I am led to reflect that Hamilton must, in his voluminous lifetime of groundbreaking writings, must have set up conditions to achieve Flow for quite extensive parts of his life, despite tremendous tragedy, political rancor and his final demise at the business end of a duelist’s pistol. For example, he would read all day, head to bed, then wake up the next morning and just write, with no interruptions, for hours. As a result, his subconscious worked on problems overnight. Often his manuscripts had NO corrections, as he would scribble furiously a final draft, fully formed. This was how he tackled many of the Federalist papers, papers that are studies in minute detail by constitutional scholars to this day.

My favorite Flow pointers:

Attention is how you create your experience and consciousness, and psychic entropy is the opposite: the chaos that detracts from focus and intentional effort.
Flow requires: clear goals and feedback; concentration on the task; a sense of control; loss of self consciousness; transformation of time.
Flow occurs when the top of your skills barely match the presented challenge. Otherwise you get boredom or anxiety.
Source of dissatisfaction at work: lack of variety and challenge; conflicts with other people/boss; too much pressure, too little time. All CAN BE under our control.
Autotelic self: easily translates external threats into enjoyable challenges and maintains inner harmony, transforming potential entropy into creating flow.

CMIO’s take? I defer to these great words by Chuang Tzu: ‘When I come to a complicated place, I size up the difficulties, tell myself to watch out and be careful, keep my eyes on what I’m doing, work very slowly, and move my knife with the greatest of subtlety, until–flop! the whole thing comes apart like a clod of earth crumbling to the ground. I stand there holding the knife and look all around me, completely satisfied and reluctant to move on, and then I wipe off the knife and put it away.”