There are books that influence other books, and ideas that multiple authors undertake sometimes with wildly different results.

Better is a book that is accompanied with a healthy dose of Deju Vu. I have previously read Dr. Gawande’s “Being Mortal”, written years after Better – which was published in 2007, which had rocked my world and changed my perceptions on life, death, and above all quality of life. Better, therefore was a bit of a letdown. A lot of the stories, Better is essentially a collection of anecdotes, were familiar and there was no real great insight or overarching theme other than just to be “better.”

Perhaps because I am not a doctor, and yet know enough about how medicine and hospitals work from the fringes where veterinary medicine resides, that Better did not bowl me over as I was expecting. It is in fact telling, that Veterinary Medicine is not mentioned once in Dr. Gawande’s Better given that a lot of the issues he seeks to shed light on; medical costs, liability, and vaccinations are handled wildly differently by veterinarians than human doctors. There is a feeling that even though this is a book about looking at problems differently, the research has been performed on an ad hoc basis rather than in any systematic fashion.  

This is a book about out of the box thinking and overcoming inertia. Human medicine has become so specialized and therefore a victim of institutional dogma that change can easily been seen as heresy. Better suggests that it is often not the ideas that matter, particularly when those ideas fail create passion in others, so much as the people who champion those ideas.

It is not a book full of great revelations, it is a book that shows excellence and failure, and what those stories look like. The hope, upon reading such a work, is that others are inspired to replicate some of the ideas, or at least try not to stand in the way of those ideas when they are presented by others. And it is hard to argue the point that we can all do better, by being passionate and by not settling for the status quo.

All of this is not to say that Better is not enjoyable. These are interesting, and at times inspiring, tales that are worth reading. This is not a book to change your view of the world, I suspect not even in human medicine, but it is possible at this is too high a standard to hold any book to.

Dr. Gawande’s other books do have the reputation for this incredible high standard, but is it ok the settle for just being entertained and to find something interesting.

We all have asked ourselves at some time, or wondered out loud, how would we react in a disaster situation. Would we freeze? Would we pretend that everything was alright? Would we heroically jump in while others watched? Would we panic?

Ms. Ripley’s remarkable, and impeccably researched book; “The Unthinkable: Who Survives when Disaster Strikes – and why,” attempts to answer these questions. It does so by looking at how others have responded in extraordinary circumstances, but it also gives the reader pointers on how to better prepare oneself for potential emergency situations and how managers may produce better emergency protocols and procedures.

The book manages the rather remarkable feat of being both a gripping read when discussing the highly personal stories of people during the worst day of their lives; September 11th, The Virginia Tech Shooting, Hurricane Katrina, and numerous plane crashes, but also highly intellectual when looking at the social, evolutionary, and cultural reasons why people behave as they do.

A fundamental issue that “The Unthinkable” explores, is that the public is more often than not given either no information or the wrong information. With the wrong information, or a lack of information, we cannot evaluate risk. This is importantly because our minds will often, from an evolutionary impulse try to get more data, or try to make the facts fit an existing pattern if the brain does not have previous experience of the particular situation. Fire drills, and safety briefings on planes, are important not merely for the information they impart, but they give our brains a pattern to follow. We behave differently in emergency situations; “superheroes with learning difficulties” as Ms. Ripley so eloquently puts it. Another fascinating aspect of this need for better information to evaluate risk is that our brains do much better at properly evaluating how information affects us when we read the information as opposed to watching the same information on a format such as television.

The structure of “The Unthinkable,” is based around “The Survival Arc” of Denial, Deliberation, and the Decisive Moment. That people can go through these three phases multiple times in an emergency, but also respond differently, is another feature that keeps the book constantly engaging.

It is rare to read a book that could actually save your life, and also shake you out of complicacy. But “The Unthinkable” is just such a book. It is also most intriguing to read a multi- disciplinary book such as this that looks at personal history, culture, and up brining, but also delves into psychology, evolution, and group behavior. For those that are responsible for others “The Unthinkable” teaches us that we need to be thinking about the unthinkable, if for no other reason to help mold how we may respond and how we may protect those in our charge. As an individual, “The Unthinkable” is a road map to survival and to understand our reactions to extreme events.

It could save our lives.  

Chip Heath & Dan Heath write books that I have loved and have bought for others.

Switch, Made to Stick, and to a lesser extent, The Power of Moments; have become bibles of management theory to myself, those that I work with, consult for, and mentor. (Click on the links above to read my reviews of those books.)

So why, oh why, did I have no interest in Decisive: How to Make Better Choices in Life and Work, when it came out. I have come to believe, now having finally read it, that it comes down to the title. Being decisive is never something that I feel I have struggled with. I’ve made bold choices in both my work and personal life; and they have never been things that I have agonized over or second guessed myself after the fact. What did I need with a book about how to make decisions, even if it was from the brothers Heath?

And that’s a shame.

Decisive is a great, and very useful book just like all the other books by Chip Heath & Dan Heath. This is a book about choice. Yes, it also covers decision making, but really it is about how to expand one’s choices and evaluate them better. Like all books by Chip Heath & Dan Heath, it is impeccably researched; and it is that research that drives their advice and conclusions – even when it come comes inconvenient.

A central tenant put forth in Decisive is that when faced with binary decision (do A or do B), it actually helps the process to actively seek out more choices. This would seem to fly in the face of advice from the Heath Brother’s previous book Switch about choice overload. To their credit, the authors freely admit the seeming contradiction with regards to choice overload, and then explain elegantly how to increase your choices and not get overloaded.

Another surprisingly easy tool to implement from Decisive is that when we are faced with a personal decision, that we should ask ourselves what we would advise our best friend to do if they were in our shoes. It does sound odd, but the exercise does actually work and give you a differ perspective. To attain distance.  

These tools are all, if you’ll forgive the pun, wrapped up in an acronym; W.R.A.P.

  • Widen Your Options
  • Reality Test Your Assumptions
  • Attain Distance Before Deciding
  • Prepare to Be Wrong

That humans are not good at making decisions, and often hobble themselves, should not come a news. What makes decisive interested to me; however, is that it is possible to improve the quality of those decisions. Which leads me to wonder if not reading this book when it first came out was not a bad decision of my own.

That’s something I can admit to, as long the Chip Heath & Dan Heath could rethink their decision on the book title.  

Whether in personal life or professional life, when toxicity rears it’s head, how we react defines toxicity’s power over us.

The revenge of “why should I bother when nobody else does,”  or “if they are going to speak to me that way then I’m going to speak to them that way,” becomes a race to to the bottom where everyone loses. A race where the most awful person wins a price nobody wants. It defines an toxic environment. To state that this is a vicious circle is to state the obvious. However, to do the opposite does not automatically create a virtuous circle. 

Being positive is never the easy choice. Toxicity is always easier. As Yoda would say of the dark side; “…easier, more seductive.” Revenge feels good. But that feeling is fleeting. Like in math, a positive number and a negative number added together can give a positive or a negative result. But two negative numbers always results in a negative result.

2 + -1 = 1

-2 + 1 = -1

-2 + -1 = -3

2 + 1 = 3

We all have a responsibility for not contributing to a toxic environment. We won’t always succeed, but if our positives outweigh our negatives, the chances are that we will have positive results. If we engage in negative behavior, particularly in an already toxic environment or as a response to toxic or negative behavior, we are guaranteed to have negative results. 

Real life is not simple math, but it is an example of how relationships between people, particularly groups of people, actually work.

Nobody said it would be easy. It might not even be fair. Or enjoyable. But rejecting toxicity, and not allowing it to contaminate you and therefore others, is the only way to behave that makes any sense. 

Not words to deliver enlightenment, but hopefully words to reassure that there really only is one path.

This is the hardest book review that I have ever undertaken to write.

There are books that I do not feel I have the intellectual rigor to do justice too, The Righteous Mind by Jonathan Haidt for example, which was one of my favorite books of 2018, and there are books that I can’t say much more about other than “read it,” Traction by Gino Wickman falls into this category. White Fragility is both; however, it also shook me to my core, and I felt I had no choice but to try and do it justice. I can count on one hand the books that have upended my beliefs, as White fragility has done, during my life.

I was initially skeptical of Ms. DiAngelo’s New York Times bestseller. I was uncomfortable with a white author discussing race for a primarily white audience. Considering myself a reasonably “woke” individual, but never as pretentious to use such a term, what can I, as a reasonably well read and liberal individual be taught through a third party’s experience of racism?

That I am part of the problem.

Ms. DiAngelo’s book is a tour de force and a wakeup call for those that consider themselves allies, but all too often support racist structures and prejudiced behavior.

“Our simplistic definition of racism as intentional acts of immoral individuals engenders a confidence that we are not part of the problem and thus our learning is complete.”  – From White Fragility

White Fragility changes, some may say clarifies, our definitions of words that have melded into, as Ms. DiAngleo would probably agree, a binary good and bad. I cannot be those things because I, or they, am a good person. By not being to get past this logjam, true discussions of racism are impossible.

As quoted in White Fragility; “Racism is a structure not an event. A structure of oppression that goes beyond individual prejudice and discrimination.” In other words, racism is tied to societal power. Only whites can be racist because only whites, in the United States, hold societal power. That whites cannot help but be racist, is partially explained by being brought up in a racist society.

These are powerful and disturbing words for most white people to hear, let alone believe. It is helped by defining other terms, not just in their racism framework but in anthropologic one.  Prejudice is prejudging someone based on the social groups that the person belongs to and based on little or no additional information. “All humans have prejudices,” writes Ms. DiAngelo. Discrimination is action that is based on prejudice. It is therefore possible to be racist, because one comes from a racist society, but not be prejudice or practice discrimination.

In a devastating section of White Fragility, Ms. Diangelo shows us how “whiteness” has become the norm for “human” and challenges us to think about the patterns of friendship, culture, and society in general that we grew up in and continue observe today that reinforce a racist society. That believing we are in a post racial society, or that by our uniqueness of experience or background, means that we are immune to group messages and “white solidarity,” is expertly dismantled by Ms. DiAngelo’s totally logical arguments.  That “good schools” has become a metaphor for a “more white neighborhood,” is the most obvious example of this.

“The way I see the world, drives my actions in the world.” – White Fragility

White Fragility is not an easy read. This is not because of Ms. Diangelo’s prose, which are excellent, but because this is a book that you will disagree with. That is its purpose, to challenge your basic assumptions about the society we live in. To see the world in a different way. To understand the world as people of color understand the world. And hopefully understand the strictures that are in place that make it so hard for white people to have discussions about race, in any meaningful form.

White fragility is a starting point to allow our world view to be changed, and perhaps to make us more open to hearing feedback on when the society we grew up in, and live in today, intrudes on our interactions and friendships with people of color.

Read this book.

Scott Stratten, and latterly with his wife Alison, have written five other books on the intersection of customer service, social media, and marketing. I have reviewed most of them, which you can find here, routinely listen to their podcast, The Unpodcast, and I have a framed and signed “Don’t try to win over the haters. You are not the Jackass Whisperer” poster in my office. I am an unashamed fan boy.

Their books have swung from deep dives into marketing theory, to jokey and fairly superficial explorations of the absurdities that the marketing, and wider business world, is full of  – always with humor sprinkled throughout.  Although by no means an expert, I am certainly familiar with their work and their thinking on a variety of subjects.

Their latest book, would seem to an addition to their collection of books with a “gimmick.” A 125 question and answer book to see whether when presented with an example of “jackassery” one responds with a “Jackass Reaction” or a “Whisperer Reaction.”

But…

That is not what if going on here at all.

By coming at the subject from an indirect angle, the Stratten’s have laid bare our worst instinctual reactions to other people’s worst behavior. It shows that, in many instances we are just as much the problem rather than the innocent victim that we too often paint ourselves as. The implicit message is that the only way to deal with bad behavior is not to react to it out of outrage, but out of understanding and an attempt to solve the real underlying issue. To be the better person.

Of course, the book, and by assumption the authors, are not suggesting that all behavior is acceptable, but that “pick you battles” is really mantra we should all live by. That we have a responsibility to make the world a better place, and that starts with our interactions with each other. I find this particularly interesting as there was an element of “shame culture” in the earlier Unpodcast episodes. Jon Roson’s excellent “So You’ve Been Publicly Shamed,” which I reviewed here, goes much deeper into the culture of naming and shaming online; and the Jackass Whisperer seems to be a repudiation of that shame culture.

The Jackass Whisper is over the top, although most of the inciting incidents seem to be based on real occurrences (we really are doomed as a species), the reactions, both as a Jackass or as a Whisperer, are so over the top that it becomes useful to use them as a gauge for how you, the reader, would deal with such a thing. If one is being honest it is easy to see where your reaction is really not helpful, although perhaps satisfying at the time in terms of revenge.

It is, or course, easy to read this book superficially – as I did initially if I’m honest. But it subtly asks questions of us that are not easily answered. Is this the person I want to be? Do I really have to react like this to perceived provocations?

I’ll leave you to guess in the comments on my Jackass scale, but really that is not what is important about the Jackass Whisperer. It is the thought, and potential internal discussion, on the nature of reaction that a thoughtful reading of the book provokes, that makes it well worth your time and the purchase price.

courage
Farnziska Iseli’s book “The Courage Map: 13 Principles to Living Boldly” is a short book that makes the case for adding more courage into our lives to make them more interesting, more enjoyable, and more successful.

Ms. Iseli then further breaks down courage, as the title suggests into 13 key principles. These 13 principles are obviously important to Ms. Iseli, and have informed her business, personal, and travel life. It is also obvious, that some of these principles have been thought about extensively over a number of years give the book a sense of intellectual rigor that is sometimes not found in other books of its type.

The Courage Map can be a little schizophrenic; however, as personal development books go. On the one hand, it dips in and out of travel book territory to underline and exemplify the 13 principles at the core of the book and one finds oneself wanting to either hear more about a particular principle or about the anecdote about Iranian border guards.

This is a little frustrating, because it lends the book the air of a spoiled adventurer, which Ms. Iseli patently is not. For those who do not know, Ms. Iseli is a highly successful serial entrepreneur and speaker. I found myself throughout wanting to find out more about Ms. Iseli’s travels and gain a deeper grasp over what her trips meant to her and he philosophy of courageous living. Almost as if there were two books fighting each other.
This is a shame, because there is some really good thinking in “The Courage Map.” There are short throw away phrases that resonate long after they have passed in the book. Who doesn’t understand what a “poop shower” is? I for one am glad to add it to my vocabulary. Likewise, the insight that “kindness is like snow – it beautifies everything it covers,” a quote from Kahlil Gibran, is an immediate and pivotal idea to glean from any book.

Which chapters resonate with the reader, I suspect, will be wildly different with each  individual reader. I found the chapter on non-attachment particularly illuminating and gave a serious reason for thought and pause – really the purpose for any book of this type. While I found the chapters on “flow” and “love” a little too in the realm of new age mysticism.

There is a lot to take from Ms. Iseli’s book, and it is a book I expect to dip back into. Not all of it is for everyone I suspect. But its central theme, that we should all learn to live a little more boldly if we want to be happy, is an admirable quality and certainly one that is helped with a thoughtful reading of “The Courage Map.” While perhaps a little frustrating for some readers, there is some great stuff here in “The Courage Map,” which makes it worth your time to read and keep on your shelf.

design your future

When you review books, and particularly when you are behind in reviewing the stack of books at your bedside like I currently am, you form opinions of them as they wait to be read.

This is, of course, complete nonsense, the very definition of judging a book by its cover. But it happens.

For some reason when “Design Your Future: 3 simple steps to stop drifting and take command of your life” was sent to me, I took an instant dislike to it. I don’t know if it was the cover, or the tag line, or just more likely the subject matter. I rarely find that books meant to inspire me to change my life ever actually do. But I read it more out of a need to get it off my nightstand than anything else.

So by way of contrition let me be the first to say, I was wrong about this book.

I absolutely loved it.

Mr. Quartuccio has managed to mix basic cognitive behavioral therapy tools with basic goal setting and created a rather elegant way of looking at one’s life and life goals, without the pitfalls and baggage that makes people like me hate books of this type. “Design your Future” is an easy read with an elegant layout that does not feel simplistic.
The main idea of “Design Your Life” is that awakening, disrupting, and designing your life is a constant process that puts you in command (not control) of your life and helps you identify what is actually important to you. That most of us drift through life, afraid to make changes, but unhappy with our lives and with vague life goals that show a constant lack of progress, is probably not news to many people. That the stories we tell ourselves reinforce the status quo, and therefore continue to make us miserable, however, may be. What is really unusual is to finish a book with a real sense that these issues are solvable with a little work on your part.

One of the most intriguing tools in the book is the suggestion to write your own eulogy. Not as macabre as you might thing, writing your own eulogy actually gives a destination to your life. How long do you want to live? What are the things that you want to achieve before you die? What is actually important to you? By creating these fundamental goals for one’s life, one can then work backwards to see what the lessor goals need to be while also providing motivation. “I want to lose 20lbs” because I need to lose weight is a little adrift as a life goal, while “I want to lose 20lbs because my doctor says that will help me in my goal to make it to 80 years old” is more anchored into a general scheme to take control of one’s life.

I also really like the book’s emphasis on completing things rather than trying to make them perfect. “Ultimately, perfectionism is a guise for fear. Fear of being judged or being attacked or having your flaws exposed or whatever other weird hang-up you’re carrying. The book you’re reading is littered with so much imperfection it makes me cringe. But guess what? I’ve got a book.”

The nitpicker in me finds the over emphasis on meditation in “Design Your Future” a bit much, however, in fairness to Mr. Quartuccio he does acknowledge that all he wants to do is “ignite a personal curiosity” which he did in me.

Design Your Future is a surprising and useful book that talked directly to me. Perhaps it was just the right book at the right time; however, who cares. It’s a great read and made me think.

I’m off to write my eulogy.

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I know this is difficult
Because it is difficult for me too.

I know you are scared
Because we are all scared.

I know you are tired
Because everything is harder.

I know you are frustrated
Because what should be simple is fiendishly complex.

I know you are wanting this to end
Because the end is not in sight.

I know you want to get back to normal
Because normal was awesome.

I know you are glad to be busy
Because the alternative sucks far worse.

I know you value your teams
Because we all feel the same way.

I know we can do this
Because we kick ass on a daily basis.

 

Written as the introduction to a staff meeting.  

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The Vice President, Mike Pence, toured the Mayo Clinic, without a mask, in the middle of a pandemic.

When questioned by reporters as to why he was not wearing a mask in line with hospital policy, a policy that the Mayo Clinic stated that Mr. Pence was aware of in advance in a now deleted tweet, the Vice President stated that he is tested regularly as are those around him and he wanted to be able to “look people in the eye.”

Footage of Mr. Pence’s visit can be seen below.

Later that same day, a question was posed on Quora (where I spend an inordinate amount of time) that got me thinking.

Why didn’t someone in authority at the Mayo Clinic stand up and tell Mike Pence, “If you don’t wear a mask, you are not entering this hospital.” Should that person who was in charge on that day be fired for failing to protect the patients?

A fair question, but one of the reasons the question gave me pause for thought, was that I had faced a similar dilemma a couple of days earlier.

Like most veterinarians, the animal hospital I am Hospital Administrator for is operating locked down – with clients being made to wait in their cars and only patients and staff allowed in the building. In addition, all staff have their temperature taken before entering the building and wear a mask for their whole shift. That policy worked just fine, until the day a client walked into the lobby and refused to leave when asked by staff members.

I was called into the lobby by one of my front desk supervisors. When I arrived, the unmasked client was defiant and refused to leave the lobby when asked multiple times. The client was upset that her dog was sick and currently hospitalized. She felt that it was too hot for her dog to be brought out to her in her car for her to visit with, and therefore was demanding entry to see her dog. I explained that I knew nothing of the situation, and that I would be more than happy to help in whatever way I could, but none of that was going to happen until she left our lobby and returned to her car.

I have had to ask clients to leave the premises in the past, and I have even had to call police to make it happen. As I was talking to this client it was running through my head that I might have to do this again, or at least threaten to, to protect the doctors and staff. However, it was also running through my head that we had a hospitalized patient who was in the middle of treatment. Could the forced removal of a client from the building be interpreted as denial of care? It is doubtful that the client is going to continue their pet’s treatment at our hospital if the relationship breaks down to this point. What happens to the pet? Is the pet well enough for an orderly discharge? What happens if the pet dies either directly, indirectly, or just shortly after being discharged?

All of this with raised voices in the lobby, out of the blue, with no time for refection or the advice of others.

Now, as it happens, the client did return to her car and a quiet chat with the doctor, car side, resolved the immediate issue. But what if we would have called the police and had the client removed from our property, her pet discharged before being even close to well, and things had continued to deteriorate? Review and social media warfare for sure. Local news and / or regulatory involvement? Quiet possibly.

Upon reflection, I would do the same thing again and I actually feel more than ever that even if I had ended up calling the police it would still have been the right call. But I’m sure others would have disagreed. And some of those may have been people that I report to – including the staff it was my aim to protect.

I don’t run an organization anything like the size, or complexity, of the Mayo Clinic and one can’t imagine what it must be like to hold that position, in human healthcare, in the middle of a pandemic. Having a dignitary like the Vice President means national news coverage. It is the kind of publicity that public relations departments were created for. It could mean government dollars, PPE, and access; all of which are sorely needed right now.

If, of course, it goes well.

If it goes wrong, all of that could be in jeopardy and a lot more; The reputation of the Mayo Clinic in the eyes of half of the electorate, for example. As Mike Pence has stated, the risk from him is probably minimal, given the protective bubble he currently finds himself in. The example that he sets, however, is awful. It is an example of “the rules don’t apply to me” because of XYZ – much like my lobby client.

I cannot condemn the administrators at the Mayo Clinic though. Standing up to people because it is the right thing to do, can have serious consequences. Embarrassing the Vice President of the United States would have had serious consequences for the hospital, the staff, and the administrators. Being right is not always a defense from consequence. To make that kind of decision in the heat moment, is an almost impossible. And it is certainly impossible to make it and to not double guess yourself.

The issue reminds me of the incident at University Hospital in Salt Lake City where nurse Alex Wubbels was arrested for not going against a policy agreed upon between the police and the hospital. She would not provide a blood sample without the consent of the patient. The clip below shows Nurse Wubbels on the phone with the hospital administrator, and the police officer concerned, right before her arrest. The arrest of Nurse Wubbels was national news.

All decisions have consequences. In the Alex Wubbels case, the arresting officer was fired, and his supervisor was demoted two ranks. The City of Salt Lake also settled a lawsuit for half a million dollars. But this took serious guts on the part of the hospital, and of course Nurse Wubbels. It would have been so easy to bend the rules for people who you work with routinely, want and need to have a good working relationship with, and even been seen as doing the right thing in many corners.

Being right can often be a balancing act. Second guessing decisions made in the heat of the moment, particularly when confronted by authority, or just someone who is confrontational, is often unhelpful. As managers, we have to fall back on integrity and the momentary weighing of risks.

But the balancing act is rarely black and white.

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