Trevor Noah’s Insights on the Power of Language

Trevor Noah’s Insights on the Power of Language

Trevor Noah’s book, Born A Crime: Stories from a South African Childhood has a glowing 4.8-star average review on Amazon. He’s a comedian who is currently heading the satirical news show The Daily Show.

 

 

Trevor was born during apartheid, which, in his words, “was a police state, a system of surveillance and laws designed to keep black people under total control.” He grew up in the complex post-apartheid South Africa. Being a mixed child–from a white father and black mother–he was literally born a crime, because the law prohibited interracial marriage or “carnal intercourse” between blacks and whites. For most of his childhood, he navigated life as an outsider, since the way he looked and how he was brought up did not align with the typical constructs of the South African sub-societies. A chameleon was what he called–and still does–himself.

 

Using Language to Change Perceptions

 

Yet one poignant insight that he gleaned from his outsider-ness was the power of language in “hacking” racism. Apartheid did not only separate black and white people; it separated every identifiable skin color and subculture to weaken its opposition. Crediting his mother, who really is the heroine of his book, he says, “Living with my mom, I saw how she used language to cross boundaries, handle situations, navigate the world.”

 

If you’ve seen any of Trevor’s stand up, you’ll see that he’s incredibly skilled in accents and imitations. He speaks something like six or seven languages.

 

I learned to use language like my mother did. I would simulcast—give you the program in your own tongue. I’d get suspicious looks from people just walking down the street. “Where are you from?” they’d ask. I’d reply in whatever language they’d addressed me in, using the same accent that they used. There would be a brief moment of confusion, and then the suspicious look would disappear. “Oh, okay. I thought you were a stranger. We’re good then.”

 

In another instance, a group of guys intended to mob him because they thought he was white. But as they plotted in their language, Trevor, who understood what they said, replied in kind and suggested that they all mob someone else together.

 

They were ready to do me violent harm, until they felt we were part of the same tribe, and then we were cool. That, and so many other smaller incidents in my life, made me realize that language, even more than color, defines who you are to people. I became a chameleon. My color didn’t change, but I could change your perception of my color. If you spoke to me in Zulu, I replied to you in Zulu. If you spoke to me in Tswana, I replied to you in Tswana. Maybe I didn’t look like you, but if I spoke like you, I was you.

 

Language, Connections, and Trust

 

Language is key in defining a tribe.

 

Language brings with it an identity and a culture, or at least the perception of it. A shared language says “We’re the same.” A language barrier says “We’re different.” The architects of apartheid understood this. Part of the effort to divide black people was to make sure we were separated not just physically but by language as well. In the Bantu schools, children were only taught in their home language. Zulu kids learned in Zulu. Tswana kids learned in Tswana. Because of this, we’d fall into the trap the government had set for us and fight among ourselves, believing that we were different.

 

Yet, he continues, language’s power to divide can easily be reversed.

 

The great thing about language is that you can just as easily use it to do the opposite: convince people that they are the same. Racism teaches us that we are different because of the color of our skin. But because racism is stupid, it’s easily tricked. If you’re racist and you meet someone who doesn’t look like you, the fact that he can’t speak like you reinforces your racist preconceptions: He’s different, less intelligent. A brilliant scientist can come over the border from Mexico to live in America, but if he speaks in broken English, people say, “Eh, I don’t trust this guy.” “But he’s a scientist.” “In Mexican science, maybe. I don’t trust him.” However, if the person who doesn’t look like you speaks like you, your brain short-circuits because your racism program has none of those instructions in the code. “Wait, wait,” your mind says, “the racism code says if he doesn’t look like me he isn’t like me, but the language code says if he speaks like me he…is like me? Something is off here. I can’t figure this out.”

 

Reflecting on my own experience with languages, I realized that I was spared weird looks and condescending stares when I moved to the US because I was reasonably trained in English. I don’t recall an incident where an English speaker had to slooowlyy spell out each word they’re saying with his head tipped down, with that wide-eyed, condescending look that I see a lot in situations related to immigration or airport security. At least, this act won’t last long because I could meet them where they’re at in comprehension and speed of pronunciation. But certainly, I see it a lot when I travel with other non-native English speakers who may not be as quick in understanding the rapid speaking pace of a native speaker. It annoys me tremendously.

 

Incidents like this reveal the deep interconnection between language and trust. People naturally don’t trust those who are different than them. But a common language, even though skin-deep differences exist, can override that prejudice and engender trust.

 

Nelson Mandela once said, “If you talk to a man in a language he understands, that goes to his head. If you talk to him in his language, that goes to his heart.” He was so right. When you make the effort to speak someone else’s language, even if it’s just basic phrases here and there, you are saying to them, “I understand that you have a culture and identity that exists beyond me. I see you as a human being.”

 

Check out Born A Crime: Stories from a South African Childhood for a treasure of hilarious and insightful stories. I recommend getting the audiobook, which you can get at a hefty discount using the trick outlined in this post.

 

Individuality and Creativity: A Christian Perspective

Individuality and Creativity: A Christian Perspective

This is the second post in an article series on individuality. Read the first here. This post is for those curious about what individuality means in the Judeo-Christian perspective, even if you don’t subscribe to it.

 

“That’s so him.” “Totally something she’d do!” “Who would’ve thought of that?!” These acknowledgements of individuality—what makes you, you—are not foreign to us. The existence of individuality in the human experience is indisputable.

 

Where does our individuality come from?

 

Well, this is a worldview question, with answers as numerous as the beliefs that exist on Earth. This post is specifically about the Judeo-Christian perspective and its regard of mankind and individuality. Though you may not subscribe to it, I’m inviting you to empathize and gain an understanding of how those that do see individuality from their point of view.

 

Mankind as An Image of the Divine

 

In the Judeo-Christian worldview, a person’s individuality is anchored to the very subject the whole religious system is about: God. The subject of individuality is front and center in the grand opening of its sacred text.

 

Creation, the beginning of the world, opens the Hebrew Bible in the first chapter of Genesis. It’s a much-debated chapter, but let’s set debates aside for a moment and consider the text through the lens of creativity, to see the narrative in the light of a creative process.

 

“In the beginning, God created the heavens and the earth,” it begins. The chapter narrates the creation of the world in six days, which builds up to the creation of mankind in the sixth. The text says,

 

Then God said, ‘Let Us make man in Our image, according to Our likeness; let them have dominion over the fish of the sea, over the birds of the air, and over the cattle, over all the earth and over every creeping thing that creeps on the earth.’ So God created man in His own image; in the image of God He created him; male and female He created them.”

 

Mankind is patterned according to God’s image, which is intriguing, because God prohibits the making of images, explicitly stated in the Ten Commandments. Other biblical stories show that mankind is in danger of carving a rock, assembling wood, or creating buildings, even if they were initially made for God, and worshipping these things instead of God. The biblical prophets write against this over and over again. There was to be no idol worshipped in place of Him, because no one thing can adequately represent the fullness of His character and glory. Nothing is big enough to fully represent who He is. But, in mankind there is an exception.

 

In the collection of essays Moral Grandeur and Spiritual Audacity, rabbi Abraham J. Heschel writes,

 

“And yet there is something in the world that the Bible does regard as a symbol of God. It is not a temple or a tree, it is not a statue or a star. The one symbol of God is man, every man. God Himself created man in His image.”

 

A person, a human being, is viewed with very high regard, because he is an image of the divine.

 

“Human life is holy, holier even than the Scrolls of the Torah. Its holiness is not man’s achievement; it is a gift of God rather than something attained through merit. Man must therefore be treated with the honor due to a likeness representing the King of Kings.“

 

This image of the divine is not limited to one person, group, or nation. It is present in every single person.

 

“…not one man or one particular nation but all men and all nations are endowed with the likeness of God… the divine likeness is something all men share.”

 

This foundation is also the Judeo-Christian basis of the equality of all men, the anchor of justice and how we ought to treat one another.

 

“This is a conception of far-reaching importance to biblical piety. What it implies can hardly be summarized. Reverence for God is shown in our reverence for man. The fear you must feel of offending or hurting a human being must be as ultimate as your fear of God. An act of violence is an act of desecration. To be arrogant toward man is to be blasphemous toward God.”

 

Power to Think and to Do

 

The concept mankind being an image of the divine is rich with meaning. One aspect of this is the capability to create, which is demonstrated by the Creator Himself. It is the capability to invent, to see beyond what is into what could be, and to work towards that destination one step at a time.

 

In the book Education, Ellen White writes:

 

“Every human being, created in the image of God, is endowed with a power akin to that of the Creator—individuality, power to think and to do.”

 

The power to think and transform that thought into reality is the most baffling and fascinating trait of humanity. It mirrors the divine pattern as told in the Creation narrative.

 

Then God said, ‘Let there be light’; and there was light. And God saw the light, that it was good; and God divided the light from the darkness. God called the light Day, and the darkness He called Night. So the evening and the morning were the first day.”

 

First there’s a thought, then words. The words become reality. And God sees what happens and calls it good. Finally, He names what He has just made. What is this if not the core of a creative process?

 

White continues,

 

“The men in whom this power is developed are the men who bear responsibilities, who are leaders in enterprise, and who influence character. It is the work of true education to develop this power, to train the youth to be thinkers, and not mere reflectors of other men’s thought. Instead of confining their study to that which men have said or written, let students be directed to the sources of truth, to the vast fields opened for research in nature and revelation. Let them contemplate the great facts of duty and destiny, and the mind will expand and strengthen. Instead of educated weaklings, institutions of learning may send forth men strong to think and to act, men who are masters and not slaves of circumstances, men who possess breadth of mind, clearness of thought, and the courage of their convictions.”

 

Those we admire, leaders of the world, makers and changers of society, display this power of individuality—to think and to act. They are thinkers for themselves, not reflectors of other people’s thoughts. They are masters of their circumstances.

 

creativity

 

Individuality and Creativity

 

In the last post, I emphasized that individuality is an asset in creative processes, in works that have no set to-do instructions, in the making of something new (as opposed to imitating an existing creation). Where there’s no other guide, individuality, your power to think and to do, is your only resource. Indeed, it is in these types of original work that individuality shines forth the most.

 

Consider this. When God chose to write His opening act, His first introduction to the world, His grand entrance, His chance for a first impression in the first chapter of the Bible, He chose a creative story, a narrative of Him engaging in creative work.

 

In that first chapter, God is the sole agent, the ultimate actor, and the decision maker. He stares at His blank canvas, a void and shapeless world, and He begins that journey of creating something new.

 

I wonder if this creative process is also a discovery, something like the times when we engage in creative endeavors and surprise ourselves at what comes out. Maybe there’s an elevated, divine version of this, because at the end of each creation day, God sees what He has done, pausing for a moment of reflection, evaluation, consideration, and says that it is good. It is almost as if He doesn’t completely know if it would turn out good, at least not as predictable as mass printing labels from a manufacturing process. The artist sees and is satisfied with what He has carved that day.

 

It is easy to take stories like these for granted, to miss the essence and mystery of the creative process. We take it for granted because when we read stories of how inventors create, we already see the results. Thus we think it’s inevitable, a classic case of hindsight bias. Of course the plane should look that way, it’s obvious! Whereas if we put ourselves in the shoes of the Wright brothers, going forward in time, experimenting and trying out designs, the final product could have taken a different shape amidst the thousands of decisions they had to make.

 

We already know how important the sun is when we read the fourth day of creation. The trees are already outside our windows when we read about the third day, so it does not occur to us that trees did not really have to work that way. Things didn’t have to work the way they do now, because the creator started with a blank canvas. Someone decided where to put the stars, the waters, the sky, and the eyes. They were design decisions, made by an individual with thoughts and intent, with power to accomplish them.

 

Most importantly, there was freedom. God had full freedom to choose how He would shape the world among numerous options. He could have chosen a million other combinations, just like a writer could start his book a thousand different ways, a painter beginning with a thousand different strokes. The shape that we see at the end is the culmination of a nonlinear process, the artist’s individuality, mind and heart at work, which is all hidden in that final painting.

 

It is no small matter that God’s grand entrance—a story of His creativity—is also humanity’s most baffling trait. Stories of human creativity and inventions inspire us. The creators of the world, the change-makers, are those who know how to mine their individuality.

 

Experiencing Creation

 

If mankind is made in God’s image, and the first thing He wants us to know about Himself is His creativity, then it must mean that He wants us to employ our individuality and creativity to its fullest measure. Could it be that in engaging in a creative process, we are mirroring divinity? Anyone who has engaged in creating something must know the magical wonder stored within the process, from inspiration to fruition. Could it be that Genesis 1 is an invitation for us to write our own creation stories?

 

Want more? See also Individuality: What Makes You, You, how genius work happens, and how to use individuality as the engine of learning.

 

Abraham Heschel: Two Ways of Seeing the World

Abraham Heschel: Two Ways of Seeing the World

Feature image: Sunrise at Bryce Canyon National Park. Credit: Johnny Loi Photography.

 

The Watchman. Abraham, Isaac, and Jacob. The Temple of Sinawava. These are not religious allusions, but names of the rock formations in Zion National Park, Utah. Soaring to majestic heights, it is not surprising that they inspired spiritual experiences in those who named them.

 

From the ground to thousands feet above sea level, these rocks’ vertical dimension tells a mysterious story of time and nature. Carved to each groove is the invisible movement of waters over this Earth’s lifetime. History collapsed into formations. Rocks stand as though holding secrets, as natural monuments, as silent witnesses to the forces of nature that humans will never uncover.

 

Face to face with this hushed grandness, one cannot help but sense the drama hidden in the place. There are things bigger than me and I am overwhelmed.

 

I found myself in this tension at Zion and Bryce Canyon National Parks recently. I found that I could see these mysteries in two ways.

 

One was the questioning way. What happened here? How did the rocks get shaped this way? What was it about this area that made this structure possible? Is there consensus whether it was something catastrophic or gradual? Could geologists distinguish the footprints of a catastrophe vs. gradual canyon creation by water year by year?

 

The monkey mind could go on and on.

 

But then I found that there was another way of looking at the scene. Asking what happened was futile, since no one knew what exactly happened, how precisely the waters flowed to create the hoodoos in Bryce Canyon. No one was there. With that, I silenced my monkey brain.

 

Then it happened. Silence, awe, wonder, reverence.

 

It was a way of looking at things for what they were, just as they were, acknowledging the mystery and admiring it in peace.

 

I was reminded of Abraham Joshua Heschel’s words on the two ways of seeing the world in his beautiful book, Man Is Not Alone:

Standing eye to eye with being as being, we realize that we are able to look at the world with two faculties-with reason and with wonder. Through the first we try to explain or to adapt the world to our concepts, through the second we seek to adapt our minds to the world.

 

In one, the world is subject to us. In the other, we are subject to the world. One is scrutiny; the other is surrender, a succumbing to something other than us.

 

Wonder rather than doubt is the root of knowledge… to doubt is to question that which we have accepted as possibly true a moment ago… But if we must know in order to question, if we must entertain a belief in order to cast doubt upon it, then doubt cannot be the beginning of knowledge.

 

Wonder is not just about receiving information; it is the amazement at being able to see at all:

Wonder goes beyond knowledge… We are amazed at seeing anything at all; amazed not only at particular values and things but at the unexpectedness of being as such, at the fact that there is being at all.

 

Even before we conceptualize what we perceive, we are amazed beyond words, beyond doubts.

 

And here is the crux of the two modes of seeing:

When in doubt, we raise questions; when in wonder, we do not even know how to ask a question.

 

 

Couple this with Before Learning and After Learning, applying the two modes of seeing the world in the process of learning. Also read Wonder and Fear: Thinking Two Thoughts at Once on the experience of encountering nature.

 

Anatomy of Excellence

Anatomy of Excellence

A post on the anatomy of excellence befittingly takes some grit to go through. But I refuse to dilute it to a bite-sized listicle and I trust your intellect. Excellence deserves the 3500 words. Read it through at once or bookmark it to read it in pieces, but it’s worth getting to the end.


 

What makes people excel? What makes some stand out from the rest?

 

When we measure our performance against the crowd, we typically benchmark ourselves against this somewhat amorphous concept of the average. Average is an interesting concept because it can be understood both as praise or insult. In many areas of our lives, bowling, height, and playing guitar–we’ve all got some—average is probably our fate. But, as Atul Gawande writes in his book, Better: A Surgeon’s Notes on Performance, “in your surgeon, your child’s pediatrician, your police department, your local high school? When the stakes are our lives and the lives of our children, we want no one to settle for average.” For high stakes situations, “what is troubling is not just being average but settling for it.”

 

In Better, Gawande writes about the three things that make a person successful in medicine: diligence, moral clarity, and ingenuity. I here take the liberty to add to his list and compile the 5 virtues of excellence—the anatomy of excellence.

 

The Anatomy of Excellence

 

  1. Diligence
  2. Commitment to do right
  3. Personal responsibility
  4. Ingenuity
  5. The striving towards something better
  1. Diligence

 

Diligence is the drive to complete the littlest tasks that seem insignificant day in and day out. It is easily overlooked and underestimated because of its simplicity. Gawande writes,

 

The first is diligence, the necessity of giving sufficient attention to detail to avoid error and prevail against obstacles. Diligence seems an easy and minor virtue. (You just pay attention, right?) But it is neither. Diligence is both central to performance and fiendishly hard.

 

Why is diligence important? It’s important because it’s a mindset, an approach of doing things that’s in it for the long haul. It bears the stamp of the person’s character, not just natural talent, which in the greater scheme of things is more important. Character is what we’re looking for in the person we’ve entrusted work to. Some things cannot be achieved without diligence. Many are filtered out from achieving great things because they don’t want to do the tedious thing; they’re turned off by the unglamorous work.

 

Gawande describes an example of diligence by describing the tireless efforts to minimize patient infections in hospitals due to contacts with doctors and nurses. The solution is simple: they need to wash their hands–wash them well and often. As it turns out, implementing this easy and known solution is not straightforward at all. People get lax, forgetful, lazy, and busy.

 

Stopping the epidemics spreading in our hospitals is not a problem of ignorance–of not having the know-how about what to do. It is a problem of compliance–a failure of an individual to apply that know-how correctly.

 

The efforts to monitor this behavior faced many failures. They didn’t work or worked only temporarily, because changing human behavior is hard. You have to read the book to grasp the frustrations in maintaining this high level awareness of hand washing. The antidote of these infections is diligence–both in the medical practitioners and in the individuals responsible to supervise safety.

 

Through trials and errors, they found a way to motivate medical workers to wash their hands consistently, which was a valuable lesson in itself. Many of the previous efforts were top-down. This time around, they obtained inputs from everyone on the floor, creating a wider ownership to the hospital’s performance and a culture of accountability where everyone was watching out for everyone else.

 

There will not be a time when washing hands will not be important in hospital work. This is not a phase–diligence is necessary, forever.

 

We always hope for the easy fix: the one simple change that will erase a problem in a stroke. But few things in life work this way. Instead, success requires making a hundred small steps go right–one after the other, no slipups, no goofs, everyone pitching in. We are used to thinking of doctoring as a solitary, intellectual task. But making medicine go right is less often like making a difficult diagnosis than life making sure everyone washes their hands.

 

Small details matter. And diligent people who pay attention to these details consistently stand out from the rest.

 

People underestimate the importance of diligence as a virtue. No doubt this has something to do with how supremely mundane it seems. It is defined as ‘the constant and earnest effort to accomplish what is undertaken.’ There is a flavor of simplistic relentlessness to it. And if it were an individual’s primary goal in life, that life would indeed seem narrow and unambitious.

 

Understood, however, as the prerequisite of great accomplishment, diligence stands as one of the most difficult challenges facing any group of people who take on tasks of risk and consequence. It sets a high, seemingly impossible, expectation for performance and human behavior.

 

 

  1. Commitment to do right

 

Moral clarity is doing the right thing because it is right. It wouldn’t be a distinguishing virtue if it were easy, because often the right thing to do is not the easiest, cheapest, or most expedient option. When other priorities conflict, which approach would one take? Yes, this approach requires a certain moral compass, a belief that there are ethics associated with your work.

 

In medicine, human lives are at stake. A mistake or wrong decision by a doctor or surgeon can result in life or death. This makes medicine an inherently moral profession. But even when we don’t see the results of our mistake as immediately as doctors do, it doesn’t mean that our own work is not moral in nature. I’ve argued before that every work has a moral component that requires us to do the right thing. We may not see the direct consequences, but it doesn’t mean we are not culpable or responsible for our mistakes.

 

Gawande explores the difficult questions on the right thing to do with regards to physical boundaries, doctors’ mistakes, and doctors’ involvement in the death penalty. The first, he thinks about nakedness and the boundaries that should be in place to ensure trust between patient and doctor. In the second, he asks how much should doctors be paid and how much should doctors pay when mistakes happen? Lastly, he examines the decisions of doctors who, one way or another, are involved in the death penalty. These are hard and uncomfortable questions to ask, but the act of asking these hard questions–what is the right thing to do–is a mark of excellence.

 

The easy thing for any doctor or nurse is simply to follow the written rules. But each of us has a duty not to follow rules and laws blindly. In medicine, we face conflicts about what the right and best actions are in all kinds of areas: relief of suffering for the terminally ill, provision of narcotics for patients with chronic pain, withdrawal of life-sustaining treatment for the critically ill, abortion, and executions, to name just a few. All have been the subject of professional rules and government regulation, and at times those rules and regulations have been and will be wrong. We may then be called on to make a choice. We must do our best to choose intelligently and wisely.

 

Above all, we have to be prepared to recognize when using our abilities skillfully comes into conflict with using them rightly.

 

Part of the commitment to do right is to acknowledge the limit of our knowledge. When do we know what to do, and when do we not know what to do? What do we do at that point? When there’s a possibility of us being wrong, do we have the guts to quiet down our ego and seek the help of others? In facing hard cases, doctors are faced with decisions on whether to keep pushing or stop fighting. In commenting on the ones that display self-awareness,

 

Sometimes they still pushed too long and not long enough. But at least they stopped to wonder, to reconsider the path they were on. They asked colleagues for another perspective. They set aside their egos.

 

This insight is wiser and harder to grasp than it might seem. When someone has come to you for your expertise and your expertise has failed, what do you have left? You have only your character to fall back upon–and sometimes it’s only your pride that comes through. You may simply deny your plan has failed, deny that more can’t be done. You may become angry. You may blame the person–“She didn’t follow my instructions!” You may dread just seeing that person again. I have done all these things. But they never come to any good.

 

In the end, no guidelines can tell us what we have power over and what we don’t. In the face of uncertainty, wisdom is to err on the side of pushing, to not give up. But you have to be ready to recognize when pushing is only ego, only weakness. You have to be ready to recognize when the pushing can turn to harm.

 

In a way, our task is to “Always Fight.” But our fight is not always to do more. It is to do right by our patients, even though what is right is not always clear.

 

The right thing to do may be a vague concept, but perhaps it is good that it is vague. The key here is the striving to seek what is right and to commit ourselves to pursue it. This is what sets the excellent ones apart from the majority who is satisfied to follow rules blindly.

 

 

  1. Personal responsibility

 

I have found that it’s possible to get rid of a problem by pushing it around, postponing it, or tagging enough people in the effort until it becomes someone else’s problem. When you spread the responsibility of a certain task out, it’s easier to blame it on another person.

 

This is NOT problem solving. And not what excellent people do.

 

What they do instead is this: they lean (hard) into their problem, take ownership of the task, and make it their personal responsibility to get it done and get it done well.

 

This is a rant against the “Not my problem” syndrome. Imagine the person charged with uploading videos to a website, but the videos are long and people can’t find what they’re looking for–the key message as promised in the title–easily. He throws up his hands and says, “Not my problem. I did my job.” In other words, the perfecting of the video is not his job; it’s someone else’s problem. What can I do, I’m just an uploader?

 

Well, there are things he can do. He can point people to the minute and seconds where the key message appears, he can learn to cut and edit the videos, or at the very least, he can deliver the message to the right person on the team that can solve the problem.

 

If you’re a part of a team and you have a message you want people to hear, then it is incumbent upon you to make sure people get that message as easily as they can. And yes, it IS your problem.

 

The key thing here is having personal stakes in the work, making sure that once you touch the task, it will come out better at the other end. It’s about adding the maximum value to the product, as much as you possibly can.

 

Excellent people don’t just accept the scope of their task blindly. They investigate the wider scope–why do they need to do this task, what is the context. Once it is done, who are the recipients of the results? How can they receive this as easy as possible? They make it their business to not just finish the job, but to complete it—complete throughout the life cycle of the job, not just when it’s off their desk.

 

I don’t deny that there are limits to what we can do, that at some point, it really is not your problem anymore. But the point here is the attitude, because likely, the person who tends to say, “It’s not my problem. I’ve done all I can.” is likely not the person who has pushed the farthest in his effort.

 

Lean into your problem and contribute. Not everything is your problem, but the ones that are on your plate, make them yours and finish them with finesse.

 

 

  1. Ingenuity

 

Ingenuity is the creativity someone brings to the table to solve a problem. It is something that will not come out unless personal responsibility exists. This is the deep learning, the nonstop testing, and continual improvements in making your work, your craft, and your art better.

 

My favorite part of Gawande’s book is the chapter titled “The Bell Curve.” It tells the story of a small field in medicine that has been “far ahead of most others in measuring the results its practitioners achieve: cystic fibrosis care.”

 

Part of improving performance is conducting diligent measurements, data gathering, and benchmarking. What doesn’t get measure often doesn’t get improved. The Cystic Fibrosis Foundation has collected data from treatment centers across the country since the 1960s. It all began with a pediatrician named LeRoy Matthews, who had a bold claim that his patients had an annual mortality rate of less than 2 percent at a time when the rest of the field averaged at more than 20 percent. The average patient died at the age of three.

 

The Foundation assigned another pediatrician, Warren Warwick, to investigate Matthews’ claim. When the results came in, they confirmed that he was a positive deviant. In his center, the median estimated age of death was 21 years, seven times the age of patients treated in other centers. At the time, he had not had a single death among patients younger than 6 years old in 5 years.

 

Unlike pediatricians elsewhere, Matthews viewed CF not as a sudden affliction but as a cumulative disease and provided aggressive preventive treatment to stave it off long before his patients became visibly sick from it. He made his patients sleep each night in a plastic tent filled with a continuous aerosolized water mist so dense you could barely see through it. This thinned the tenacious mucus that clogged their airways, enabling them to cough it up. Using an innovation of British pediatricians, he also had family members clap on the children’s chests daily to help loosen the mucus.

 

This one doctor changed the entire field. By 2003, the average life expectancy of a CF patient is 33 years.

 

Gawande visited two hospitals to compare treatment practices. First, he went to Cincinnati, a place that had middle ranking. He was surprised to be impressed by the quality of medical practice there. Everything was practiced “carefully and conscientiously—as well as anyone could ask for.”

 

Then he went to Minneapolis, where he met Warwick, the doctor who did the study on Matthews many years ago. Having learned from Matthews, Warwick seemed to add something different to the treatment.

 

In an interaction with a high school patient named Janelle, Warwick started with the friendly banter between doctor and his teenage patient. He found out that there had been a slight dip in her lung-function. Three months earlier, she had been at 109 percent, better than kids without CF, and now she was at 90 percent.

 

Most people would have settled for 90 percent, but not Warwick. He started asking, why did it go down, asking Janelle to find out what had been going on in her life. Met with a series of “I don’t know” plus attitude, he went on to do a lecture,

 

“’A person’s daily risk of getting a bad lung illness with CF is 0.5 percent.’ He wrote the number down. Janelle rolled her eyes. She began tapping her foot. ‘The daily risk of getting a bad lung illness with CF plus treatment is 0.05 percent,’ he went on, and he wrote that number down.” He went on to describe the different between a 99.5 percent vs. 99.95 percent chance of staying well. On a given day, there seemed to be hardly any difference. But, showing his calculations to the patient, in a year, it is the difference between an 83 percent and 16 percent of making it through the year without getting sick.

 

He eventually found out that Janelle had a new boyfriend and some new school changes that disrupted her treatments. He then insisted on Janelle to come for a few days to catch up on lost grounds. The interaction ended with this, “We’ve failed, Janelle… It’s important to acknowledge when we’ve failed.”

 

Gawande reflects on the core of Warwick’s worldview that makes his center better than average,

 

He believed that excellence came from seeing, on a daily basis, the difference between being 99.5 percent successful and being 99.95 percent successful. Many things human beings do are like that, of course: catching fly balls, manufacturing microchips, delivering overnight packages. Medicine’s distinction is that lives are lost in those slim margins.

 

Warwick’s combination of focus, aggressiveness, and inventiveness is what makes him extraordinary. He thinks hard about his patients, he pushes them, and he does not hesitate to improvise.

 

His ingenuity led him to innovate unconventional solutions to CF, inventing a new stethoscope, a new cough, and a mechanized chest-thumping vest for patients to wear.

 

When you lean hard into a problem, diligent in paying attention to details, committed to do the right thing for your patient, and use your individuality and creativity in trying new solutions, all of that opens up doors of innovation, solutions that are uniquely you. None of this will come out of superficial work.

 

 

  1. Something better

 

In the CF discussion, even though Matthews and Warwick’s methods had improved the entire field, their centers managed to stay ahead of the pack. From the gathering of data over the years, patterns emerged.

 

“You look at the rates of improvement in different quartiles, and it’s the centers in the top quartile that are improving fastest,” Marshall says. “They are at risk of breaking away.” What the best may have, above all, is a capacity to learn and change–and to do so faster than everyone else. 

 

Humanity is gifted with this infinite capacity to grow and those who know how to do this out of their own volition, excel. It is the striving toward something better that distinguishes those at the high end of the bell curve.

 

Paul Kalanithi, another doctor, writes in When Breath Becomes Air that “the defining characteristic of the organism is striving.” In Mind, Character, and Personality, Vol 1, Ellen White writes, “’Something better’ is the watchword of education, the law of all true living.”

 

There’s always something better to do, some way better to try.

 

 

Gawande concludes that to be successful in medicine is to have and practice these ingredients of excellence.

 

We are used to thinking that a doctor’s ability depends mainly on science and skill. The lesson from Minneapolis–and indeed from battlefield medical tents in Iraq, villages with outbreaks of polio, birthing rooms across the country, and all the other places I have described in this book–is that these may be the easiest parts of care. Even doctors with great knowledge and technical skill can have mediocre results; more nebulous factors like aggressiveness and diligence and ingenuity can matter enormously.

 

The great news is that this is accessible to everyone. Everyone can be diligent, commit to do right, claim personal responsibility, try new things, and strive to be better.

 

True success in medicine is not easy. It requires will, attention to detail, and creativity. But the lesson I took from India was that it is possible anywhere and by anyone. I can imagine few places with more difficult conditions. Yet astonishing successes could be found. And each one began, I noticed, remarkably simply: with a readiness to recognize problems and a determination to remedy them.

 

Arriving at meaningful solutions is an inevitably slow and difficult process. Nonetheless, what I saw was: better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.

 

These are not natural-born talents. These are the stuffs of discipline, attitude, and approach to life, work, and learning. It can be acquired and practiced by all. Do one, and you may already do better than your peers. But do all of them and you can’t help but be excellent.

 

 

Between Jerusalem and Athens

Between Jerusalem and Athens

Between Jerusalem and Athens is a 7-part essay series on worldviews.

 

Since last year, I’ve been thinking about meta-questions: What caused us to think in a certain way? Where did ideas—those I subscribe to and those I don’t understand—come from? What influenced the prevailing thoughts in a given society? What are their strengths and shortcomings?

 

You may say it’s an exercise of intellectual empathy, an attempt to understand others and myself, and to learn the vocabularies by which we can converse across different worldviews.

 

Between Jerusalem and Athens as a title represents this cross-cultural look at the world, which is probably more a reflection of me than of the world itself. Jerusalem and Athens are not to be interpreted as two ends of a spectrum—the ideas in this series of essay extend beyond these—but as an analog of the cultural blends that shape my thinking. Jerusalem is an analog of the East, although there are many versions of “East”, which influences me through my heritage, birthplace, faith, and early education. Athens is an analog of the West, the intellectual culture inherited from ancient Greece, in which my life and work are immersed. Between Jerusalem and Athens is also a tribute to Abraham J. Heschel, whose writings have opened up new horizons in the way I see faith and spirituality—a peek into the philosophy of Judaism.

 

The 7 essays in this series, split into 9 posts, are descriptions of the world through my lens. Looking around, I see a siloed world—academically, in the workplace, spiritually, personally, in public service, media—segmented based on certain artificial categorizations. In many cases, these categories and classes have helped us focus, analyze, and make much progress as a species. But they are not without downfalls, as the categorizations may turn into barriers, dividing people. These essays are my response to the strengths and weaknesses of this approach, and my quest to find solutions by exploring other worldviews.

 

When A Single Narrative Is Not Enough

On avoiding single-mindedness and telling a one-sided story. “The danger of a single narrative comes when it is accepted in pure disregard of other possible narratives, solely labeling something as good or bad without acknowledging the alternative.”

 

From the Equad to the World

On the silos of knowledge that prevent communication and collaborations across artificial barriers that are much needed to solve complex real world problems. This is a vote for multidisciplinary thinking, the widening of the scope of our thinking beyond conventional academic categorizations.

 

Engineering With Soul: A Spiritual Dimension to Work

On the separation between the mind, body, and soul—the components that make up our humanity—that causes an unfulfilling life. Addressing the need for a balanced development on all aspects of our being.

 

Wonder and Fear: Thinking Two Thoughts at Once

On the reality that two seemingly contradicting experiences can coexist at once. A precursor to the last essay below.

 

Asian and Western Minds, Part 1: Why They Differ

Asian and Western cultures are descendants of two different ancient philosophies, namely the ancient Chinese and Greek cultures, respectively. This essay is on the core principles of each culture and how they affect today’s societies.

 

Asian and Western Minds, Part 2: How They Differ

This post highlights the key findings of Richard Nisbett’s social psychology experiments, observations on how specifically Asian and Western minds differ.

 

A Child of East and West, Part 1

The chronicle of an Indonesian in America. This is the story of my upbringing in the East and my cultural experiences after moving to the West.

 

A Child of East and West, Part 2

Continuing the story with my life in the West and the re-discovery of the East.

 

Theoretical Dichotomies: When Either-Or Thinking Gets You Nowhere

When a paradigm categorizes things too much and has difficulties reconciling paradoxes. Real life is messier than theoretical analyses.


 

There is a book that I return to many times, titled Education by the insightful Ellen White. Its profound first paragraph never fails to strike me every time I read it, and it serves as inspiration for the essays above. It is an argument for a life of learning that is wide is scope, multidisciplinary, practical, and well integrated. This, to me, is the perfect way to end this series.

 

Our ideas of education take too narrow and too low a range. There is need of a broader scope, a higher aim. True education means more than the pursual of a certain course of study. It means more than a preparation for the life that now is. It has to do with the whole being, and with the whole period of existence possible to man. It is the harmonious development of the physical, the mental, and the spiritual powers. It prepares the student for the joy of service in this world and for the higher joy of wider service in the world to come.

 

Image credit: FreeImages

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