Atul Gawande:: Failure and Rescue – The New Yorker
Sunday, 8 July, 2012 Leave a comment
Unless I’m very much mistaken this extract, from a truly inspiring piece of writing – from Atul Gawande, author of The Checklist Manifesto – reinforces THE lessons we all need to learn:
"Practise without sound theory does not scale"
It is not sufficient to assume that the appearance of knowledge (including statistical correlations) at physical, conscious* or "superficial" level alone is a reliable basis for decision-making when dealing with high complexity.
“High complexity is incompatible with high precision” – this is known as L. Zadeh’s Principle of Incompatibility
Our (conscious*) cognitive ability is limited so, dealing with complexity, requires synthesis of brain and the sub-conscious mind (our experiential memory): Creative Intelligence – curiosity, cognition and intuition.
Vital systems, networks and sub-systems within complex systems can be invisible to conventional tools. To learn about them requires observation which drives innovation. Because decisions required to maintain the health (or resilience) of complex systems are often counterintuitive so require "deeper" observation e.g. MRI scan, insight and understanding of (causal) interconnectedness.
Viewing complexity enables a better understanding of why systems, that are merely inter-connected (as in linear business supply chains), lack the requisite variety to regulate highly complex systems.
Non-linear systems, such as our neural and biological systems, are fractal in nature: "self-similar", yet unique.
The ability of a system to perform the range of functions, for which it was designed, is determined and "controlled" by its internal (endogenous) structure, the number and integrity of interactions amongst its component parts: it’s complexity.
Complex systems are "self regulating" and self organising, across scales, as they acquire the requisite complexity (problem solving capability), developed through "experiential interactions", that enable the system to adapt, evolve and to survive in its changing environment.
Unseen, unrecognised and untreated "impediments" or blockages to the flow of information, amongst hubs (vital organs) affect the ability of the system to perform consistently or predictably in a stable environment.
A complex system can appear to be stable and robust but, even relatively minor, sudden endogenous or exogenous changes can place an increased demand that may expose inherent [undetected] fragility.
Dynamic systems are "robust yet fragile", but a mere statistical risk assessment fails to observe the structure, processes and integrity of linkages (upon which the ability of the system to function, adapt and survive depends) at sufficient scale: a level at which sources of both, endogenous (internal or self-generated) uncertainty and risk can be identified, (causal relationships) mapped and, therefore, managed…BUT ONLY once the complexity of the specific system is known.
Complex or "living" systems (consisting of dynamic sub-systems and networks), whether biological, financial, ecological have a shared or common purpose i.e. to sustain the processes that underpin system functionality.
They adapt to the ecosystem of systems and networks within which they exist…and without which they could not.
Since Ontonix developed the technology to measure complexity, it has become abundantly clear that, increasingly, survival is reliant upon systemic RESILIENCE: gained from functioning interdependently.Evolving collaboration and innovation, developing "anticipatory awareness".
Challenging and abandoning conventional theories, tools and techniques that have failed or been superseded is a fundamental part of R&D: the source of innovation. When these are deployed without an understanding of causality, even minor, changes can have major (unforeseen) consequences – Butterfly Effect. The system can be, (inadvertently) effectively, constrained, adding to risk, uncertainty and volatility!
Complexity, like Cholesterol, is vital for the system to function but too much of the wrong type impairs the resilience of the whole.
Getting the physical skills is important, and they take some time to practice and master, but they turn out to be no more difficult to learn than those that Mrs. C. mastered as a seamstress.
Instead, the critical skills of the best surgeons I saw involved the ability to handle complexity and uncertainty. They had developed judgment, mastery of teamwork, and willingness to accept responsibility for the consequences of their choices.
In this respect, I realized, surgery turns out to be no different than a life in teaching, public service, business, or almost anything you may decide to pursue.
We all face complexity and uncertainty no matter where our path takes us. That means we all face the risk of failure. So along the way, we all are forced to develop these critical capacities—of judgment, teamwork, and acceptance of responsibility.