another book review

Better: A Surgeon's Notes on Performance by Atul Gawande

My review

rating: 5 of 5 stars
This is a great book. From it's title, I thought it was about how doctors figure out how to make their patients better. But instead, it is about how the medical profession makes itself and its performance better. Gawande classifies the methods he sees in several ways. First, there is diligence, doing right, and ingenuity. He explores these ideals while discussing the campaign to get doctors and nurses to wash their hands in hospitals, improving the field of obstetrics, saving the lives of more and more wounded soldiers, and improving life expectancy for people with cystic fibrosis. He emphasizes that improvement is possible, even with the tools and techniques we already have. We have to use them diligently, every day. It's not easy. At the end of the book, he has 5 suggestions for improving performance and generally making a difference in one's career. His audience is typically medical students, but these suggestions work for everyone:



1. Ask an unscripted question. In other words, get to know the people you are working with. They will mean more to you, and you will work with them better. It's just good for society, too.



2. Don't complain. Complaining drags us all down. I love to complain, so this is a hard one for me. But I also know that negative energy is infectious, and kill energy and creativity. But positive energy is also infectious. Neither he nor I am encouraging people to be chipper and annoying - just don't drag everybody down. Change the subject if necessary.



3. Count something. That I can do! Gawande's point is, find a question that interests you in your profession, and observe it. In order to improve performance, you need information on current performance, and also information on why current performance is what it is. So count something. Then give me the data and I will analyze it for you.



4. Write something. Gawande says you should show your writing to other people, write for an audience. I think that you can learn a lot about yourself and your profession through writing, even if no one else sees it. It helps to clarify thoughts.



5. Change. Don't be afraid to make changes when they are necessary.



Here is a quote that I like from the book, the essence of the book in one paragraph:



"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."



Gawande is a good writer, and his essays are interesting individually. Despite what I might have indicated here, he does not preach. He provides examples and offers up the lessons he learned from them. And he writes about really interesting topics. In addition to the ones mentioned above, he writes about doctors who participate in executions, trying to innoculate 4.2 million children in 3 days in India with a polio vaccine, the difficult question of patients' dress (or lack thereof) during medical examinations, doctors' income, and the extreme and pedestrian steps that some surgeons must take every day to treat patients in public medical clinics in India. Interesting stuff, well-written, reads quickly.


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Happy Birthday, Em!

Here is a big happy belated birthday to Emily! Hippo birdie 2 ewes, Em! I hope you had a good one! :-) I miss you.

The Matt Video

Others have blogged about this video, and now that I have watched it, I must blog about it, too. You should watch it. It made me laugh, and then smile, and then cry (in a good way). It's hokey and sweet, and it makes the point that the most serious place on earth really is the Demilitarized Zone in Korea. And that you don't have to dance well - you just have to dance.

Ooh, was that lightening??! Be still, my beating heart! Something to write home about. Hmm. Guess not.

Another Book Review

Sanditon: Jane Austen's Last Novel Completed by Jane Austen

My review

rating: 3 of 5 stars
This book was by Jane Austen and "Another Lady," mostly by the other lady. The first 11 chapters were by Austen, mostly, and it was obvious. By the end of the 11th chapter, though, there was no real indication of where the plot would go, except for using other Austen novels as a guide (seems reasonable), so most of the plot is by the other lady, as well. It is pretty much a published piece of fan fiction. Not bad fan fiction, but not great fan fiction, either, and not even close to the author it is meant to honor. That said, I enjoyed reading it, once I decided not to hold the bulk of the book up to Austen's level.



One thing the book did for me is to cast into fairly sharp relief those qualities of Jane Austen's novels that I like: the language, the social criticism and commentary, the character development, and the multi-dimensionality of the book's structure, among other features. This book had the language and the groundwork for the social commentary in the first eleven chapters, but those were short chapters and there was no room for character development or multiple dimensions. By the end of the 11th chapter, we knew very little about the apparent heroine, and the supposed hero had been mentioned once (and so maybe they were not the hero and heroine, after all!). The rest of the book is high on personal criticism, but is one-dimensional and is missing the social commentary, language, and character development. Another Lady tells us repeatedly about the selfishness of certain characters, practically rubs our faces with it, in a way that Jane Austen would never have done. Another Lady tried to capture Austen's language and the contemplative tone that most of her books have, but she didn't succeed. Still, it was fun and not actively painful. Plus, with two elopements on the same day, it's hard to complain.


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Book Review

The Math Gene: How Mathematical Thinking Evolved & Why Numbers Are Like Gossip by Keith Devlin

My review

rating: 2 of 5 stars
Devlin gives a hypothesis about how mathematical thinking evolved. He claims that the capacity for mathematical thinking is the same as the capacity for language (i.e., syntax), since syntactical thinking allows us to think "off-line" about objects, concepts, plans that are not in our immediate environment. Off-line thinking may be stimulated by non-environmental cues (e.g., thoughts), whereas on-line thinking is always stimulated by the immediate environment. Off-line thinking allows us to think about abstract ideas or objects, necessary for mathematical thinking.

Devlin also claims that doing math is like watching (or creating) a soap opera - it is all about relationships, but between mathematical objects instead of people. He likens mathematics to gossip.

Devlin's theories sound plausible to me, and it certainly seems that language and abstract thinking are related. It is interesting to read someone's ideas of exactly how they might be related. He gets into linguistics and archeology, too. It is also good to see someone describe, or attempt to describe, mathematical thinking for people who dislike or simply don't do math. I think this would be a worthwhile book for teachers of school math (arithmetic especially), since Devlin describes why arithmetic is difficult (his theory) and how it differs from true math. Anyone interested in math education should read it since it relates math to language and gossip, etc. Lots of good information, or at least some interesting ideas.

I don't like the way the book is written, however, neither the organization nor the writing style. For a mathematician, Devlin does not produce a neat, clean argument, although all the pieces may be there. He spends too much time saying what he will say and what he has said, and drags out what he says with extra words. Not concise. Maybe his publisher or editor wanted a long book. If one can get past the writing, organization, and repeated plugs for his other books, though, one will find an interesting, worthwhile theory.


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Finally

It is still May for a few more hours yet. Tomorrow is June, the month when the stress is supposed to all dissipate because all the reports will be in and done. It is not as clean as that, though, and everything is dragging on, so the stress continues, but it's not too bad. It helps that I finally have a non-horrible diagnosis for why I have been feeling tired, nauseated, dizzy, and tingly since before Christmas. It's not multiple sclerosis. It's not chronic fatigue syndrome. It's not a tumor. It's an inner ear disorder of unspecified everything. It might be problems actually in the vestibule. It might be damage to the vestibular-auditory nerve. It could have been caused by shoddy materials. Or my concussion 4 years ago (some gifts keep on giving). Or a virus. Or maybe it's something else. Anyway, I have been doing vestibular therapy, which consists of eye and neck exercises, and sitting up and lying down quickly. The problem is that I don't do them nearly as much as I am supposed to. The first eye exercise has really helped (or maybe it's a coincidence), so although I am still dizzy and kind of tingly, I haven't been as diligent as I should be with the exercises. And I haven't done any of them today. oops.

Here is poem, written to my friend Carol:

"Poor Toe"

A battle between wall and toe.
Wall won.
I thought of you.

That's all. Carol might understand it because she broke her toe months ago. Or she might not.

Did you hear about how cute and lovable walruses are? They are the sweethearts of the pinniped world.

Between cut-off and applause

Our concert was yesterday, and it went very well. We were all very emotional during the "Requiem" (Faure). So many singers had particular people they were singing for, people they have lost recently. One soprano lost both her sister and her brother in the past year, and she was having a hard time yesterday. Fred was performing (conducting) it in honor of both his partner's ex-wife, who passed away last year after a long, horrible battle with cancer, and his father, who died long ago. This requiem was the first big piece that Fred conducted, and that was at his father's memorial service. He cried after the last cut-off. I don't think the audience knew, but all the performers did, and so it was all more meaningful than most concerts, which are usually pretty emotional and meaningful anyway. It was a gift to be part of it, and to help people with their grieving. A gift both to us, and to them from us. It was a blessing to be part of that gift. Jennifer, our Soprano 2 vocal coach and resident soloist, performed the "Pie Jesu" (solo movement in the Requiem). She has the perfect voice for it, and put everything into it. It was beautiful. That doesn't really begin to describe it. Transcendental. I know she was working hard, but it was almost as if she just allowed it to happen, or that she was accessing some channel of perfect music that is all around us all the time, but happened to be accessible through her (and Fred and the orchestra) at that time and place. And amazingly, she did it at both dress rehearsals, too... Boy, she's good!

I feel very fortunate to be part of this group. It demands a lot of time and energy, and there were many times this winter and spring when I wanted to quit because I was just so tired, but I am glad that I didn't. Something magical happens at the concerts. We are singing the same music we have been singing all along, but until the audience is there (and we can't stop to correct mistakes), we are singing for ourselves alone. With the audience, we are singing for them. We are giving them a gift. But we are also singing for ourselves and for Fred and for the orchestra, much more than in rehearsal. Lately, Fred has been showing his emotions more at concerts, or maybe I have just started noticing. He goes to a different spiritual plane during concerts. He is with us absolutely, and is connected to each singer and each instrumentalist, but he is also in some higher realm. Some of us are there with him, or near him, I think. It's not that we don't make mistakes, or that Fred makes no mistakes, or that we are not worried or tense about making those mistakes. We make brand new mistakes during the concerts, mistakes that we would never have imagined making. But it doesn't matter (usually), because the audience (usually) doesn't know, and the energy in the room takes us past it. That energy is part of what has always drawn me to choir. My high school chorus teacher always talked about positive energy, and it sounds a little hokey, but it's true. There is something about working in concert (literally and figuratively) with many other people, all toward one end and all together, that produces a magical energy. "Magical" isn't quite the right word. Maybe "transcendental" again. It takes us out of ourselves, and maybe onto that plane of Fred's, except that I don't think we are quite where he is. And it's odd, because I don't always recognize that transcendental energy at the time, and sometimes I wonder how it is that other singers noticed it or that the audience noticed it when I didn't. But I notice it afterwards. I notice that it was there at the time. And that it is now gone, and so I am now a little bummed. But the memory of it is still here. It doesn't hit you over the head. If you don't want to notice it, you won't. But if you are open to it, it will be there during the concert, and especially between the last cut-off and the start of the applause. Maybe I notice it then because Fred reflects it most in those moments. I think it is strongest in those moments of transition between our giving to the audience, and the audience giving to us. Typically, those moments are filled with coughing from the audience. A cough will take you right out of that transcendental space - grr! That was the case during most of the concert yesterday, until the end of the Faure, when even the coughers were spell-bound. Or maybe they had just gotten their cough drops down by that time. I'm glad they did; we needed that moment. Fred needed that moment. And later, when I am annoyed with Fred, I will remember his moments during the silences of the concert, and I will be kind. I hope.

All our soloists right now are wonderful, and I hope they stay with us. We were all a little worried when Lisa, our previous Soprano 1 soloist and vocal coach, left us to move to Chicago with her husband, the new bishop. Lisa is a wonderful singer and teacher, and so warm and helpful and kind, and some of us couldn't imagine that anybody could take her place or that we could continue in the same way without her. Well, no one has taken her place and we are not quite the same without her, but Jennifer is also a wonderful singer and teacher, and she is what we need right now. She is positive but honest and reasonable and not snotty or cliquish, as some soloists can be (especially the altos, for some reason). Linda is our Soprano 1 soloist. I don't think she has the teaching experience that Jennifer and Lisa have, but that's okay because Jennifer has it. Linda's voice is achingly beautiful. She claims that it is just hitting high notes (a common claim among the high-voiced soloists), but it is much more than that. She also accesses the channels of perfect music. And our male soloists did that, also. I hope they all stay with us!

My friend Lisa (Alto 1 section leader and all around great person) won the Inspiration Award this year, and I'm so happy for her. Congratulations, Lisa! I'm thrilled that people other than the Alto 1's recognize her greatness! And also that someone I voted for finally won. :-)