Friday, October 23, 2015

Black Box Thinking by Matthew Syed

One of my favorite audiobooks was a now out of print chronicle of black box voice cockpit recordings. My attempts to get that audiobook back into print failed because they’d lost the masters. (Original tapes, not the Masters golf tournament.) But all is well now, with the publication of BLACK BOX THINKING, which is even better than that chilling book because author Matthew Syed (a former Olympian and Oxford scholar…what a combo that is!) connects the dots between failure and success, making the comparison between what happens in the air and what happens on ground…between aviation and the medical industry. Why is it that more people die from misdiagnosis than from car accidents? Syed, through the voice of narrator Simon Slater, points to the fact that radiologists and doctors do not have an accessible database of failures in similar circumstances in the same way that pilots do. Syed uses examples of actual cockpit decision failures to illustrate his points, as when United Airlines 173 crashed after it ran out of fuel in a holding pattern while trying to determine if the landing gear was down. (It was down, but the indicator light was faulty, and said it wasn’t.) People died because the navigator failed to be forceful enough to the pilot, his superior, with whom he felt deference. Then the Captain seemed surprised to learn they’d run out of fuel, and even the engineer wondered if there was a leak in the fuel tanks. Black box analysis showed there was no leak. The jet had operated exactly as it should. The intense focus of the crew on the non-existent landing gear problem caused them to lose track of time, which neuroscientists can explain. The point of telling this (and other air disaster horror stories like it) is to illustrate what happened next: the airlines learned from this mistake, and from all other crashes. So your chances of dying on a plane is less than one in a million. Under hospital health care your chance of dying or suffering major complications due to a preventable accident is one in less than a hundred. “This is the equivalent of two jumbo jets falling out of the sky every day,” says Syed. “The concealment of errors in medicine is the opposite of the airline industry.” Regarding golf, Syed’s quote is: “You can’t learn how to play golf in the dark.” Examples of medical errors are juxtaposed alongside other airline examples, but Syed is only getting started. He goes into Google, discusses Michael Jordan, Beckham, Mercedes, market forecasters, and others who learned from their mistakes. (Subtitle: "Why Most People Never Learn From Their Mistakes---But Some Do.") Combine Malcolm Gladwell with Steven Pinker, toss a ball or two into the ring, and you have Matthew Syed, who is also author of the bestselling BOUNCE.  

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