I had a revelation this morning. Aman, one of my work colleagues, told me yesterday that when the “pupil is prepared, then comes the teacher.” I was thinking to myself that sounds like a good concept and perhaps I need to think about that some. This morning, during my meditation routine, my mind went back to that concept. I was contemplating what teacher was lurking about waiting for me to be prepared?
Then the name came to me – Atul Gawande
Mr. Gawande is a unique person to say the least. He is a MD, CEO, and Published Author. He is known as a leader in public health, an accomplished surgeon and became known as a bit of a disrupter and innovator in developing public health solutions that were scale-able, effective, and lowered costs everywhere and across many diverse populations of people. He now runs a health organization sponsored by Amazon, Berkshire Hathaway, and JP Morgan Chase. His has done some amazing things. His parents were immigrants from India, and both physicians. He has a long list of accomplishments and a pedigree a mile long.
I read a few of his books awhile back ago. One of them was the “Checklist Manifesto.” I picked the book up because it had the word manifesto in the title. One of my favorite words. I was a unprepared pupil at that time. However, this morning when that name came to me, I went and got that book again and started reading. I was more prepared for his message this time around. The reason is my experience.
I have had this ongoing battle regarding my morning commitment to make a list everyday of what is the most important things that I can do that day. I have called that my 365 list and I have kept that habit everyday for well over 500 days. There have been ups and downs during this process. I cycle between effective and ineffective. I cycle between good lists and bad lists. The largest battle I have had is that the list has sometimes felt repetitive. Over time, I have developed a formula of habits that I keep everyday and the first part of my list everyday feels like a simply checklist and nothing inspiring. I add a few extra things, that are important at the time and do my best to coordinate those to my goals. However, I still fight the feeling that I am just repeating the same checklist everyday. Is that good or bad?
Well, according to Dr. Gawande it is not only good to have such a checklist, it is a implementation of brilliant simplicity. His book starts out with reviewing the efforts of Dr. Pronovost’s fight against infection in ICU patients at John Hopkins University. After all the research, and studies on fighting infection caused by bacteria being introduced by medical staff with tube insertions, he developed the answer. It was a simple stupid checklist. With all the complexity surrounding the doctors and nurses, they just could not perform the basic simple tasks like washing their hands, and putting on gloves routinely and correctly every time. He introduced a checklist that had to be followed every time a tube insertion was performed and jsut by having the nurse staff enforce the basics, their infection rate almost dropped to 0. His procedure was implemented elsewhere and the results were so phenomenal, now when you go to the hospital, you will see everyone washing their hands, putting on gloves and masks, using full dressings for every ICU patient. The checklist is being followed everywhere now.
Now I am not trying to save lives, or install a life support mechanism into the lungs and blood stream of a ICU patient. I am simply trying to get my fat, lazy middle aged self off the couch now and then. If a checklist can save lives, then a checklist can help me to follow the procedures that work everyday. I have noticed that by simply following my checklist, wake up a 5am, meditate, read something inspiring, write my 365 list, pray, run, perform body weight exercises, start my blog then I things just go better. If I miss a step, things just go a little south. Maybe not enough, but just enough. I am sitting here thinking, why am I feeling so lousy, and can almost inevitably look at my day and realize that I missed one of these critical items on my checklist. Every night, I review the list and I check these off. Just like the nurse does every time the staff inserts a tube in ICU, I am doing the same thing everyday. I am inspecting the performance of my checklist.
The checklist is evolving, but the point is that when followed, I am better. I am stronger. I am more stable. I am more capable of performing at a basic level. I am not tired, or emotionally whacked out. I am ready to take on the day and can be anxiously engaged in whatever I have decided is important that day. This is of course not the entire point of Dr. Gawande’s book. You will have to read it to understand the simplistic, yet powerful concept of converting the most critical tasks needed for optimum performance to a checklist that your team follows – no matter what. I have my answer, however, the simple checklist is not bad at all. If I wake in the morning and all I can think of is to write down the normal course of my day as a list of repeated things that I have learned work well – then that is not bad. In fact, that is infinitely better then I have every been in my entire life. The 7 things that I am now doing everyday have made me more productive, more healthy, more focused, and more in tune with my reality then I have been in the past.
So I am declaring that checklists are awesome. Make a few.
Guy Reams
