Atul Gawande, MIT’s Neri Oxman at Boston Book Fest

Video: “creativity and innovation thought leaders”

The Boston Book Festival, which took place October 16, put on some exceptional panel discussions. One of the most interesting featured four folks who individually could have taken up all the time on their own:

• Atul Gawande, surgeon and author of The Checklist Manifesto;
• Steven Johnson, author of Where Good Ideas Come From: The Natural History of Innovation;
• David Edwards, inventor and author of The Lab; and
• Neri Oxman, computer scientist, designer and assistant professor at the MIT Media Lab (above, at PopTech 2009)

Video of their 51 minute conversation is titled “Good Ideas.” Edwards starts things off, talking about his network of idea laboratories.

Oxman is next, at 11:00, and she talks about product design that’s drawn from observing and reinterpreting nature, like soda cans made from thinner materials built on natural geometric patterns and “skins” for the exterior of buildings that are modeled after shark skin.

Johnson, starting at 24:30, talks about how, when he was researching his book The Ghost Map, about the 1854 London cholera epidemic, he found that every ‘fact’ he initially thought he knew about that episode turned out to be wrong. It wasn’t a lone genius who figured out the source of the cholera; instead, “it turned out it was much more complex, and I think, really, it was much more interesting — it was a collaborative effort, it was a networked effort.” He says his new book about where good ideas come is an evolution of what he covered more latently in The Ghost Map. “There are seven patterns of innovation,” he says, including “the slow hunch,” which stands in contrast to the so-called eureka moment.

Gawande, at 37:30, talks about the disconnect between great ideas and execution — essentially, the role of human error. “The fact of human failure, maybe as a surgeon, is particularly of interest to me,” he said.

“I think that we’ve arrived at a point where the amount of knowledge in the world that we are asked to cope with, the complexity and volume, is now exceeding our abilities as humans beings to master it all,” he says. People die in hospitals because they get infections from hospital staff who didn’t wash their hands, and military planes go down because pilots forget one step out of hundreds — those are errors that happen not from lack of knowledge, but from what Gawande refers to as “human ineptitude.”

Checklists, he says, turn out to be an elegantly simple way to grapple with complexity and the weaknesses of human ineptitude. They’re designed, he said, “for the fact that the human brain fails.” Military pilots now use them, “but we’ve been even slower to take these ideas across other fields. It took us 75 years to embrace this idea in medicine, but a couple of years ago we applied the idea. Tried it in intensive care units. We created a kind of ‘before take-off’ checklist for surgeons that was implemented in 4,000 hospitals. And in the pilot hospitals, what we found was that simply these series of checks could lower the death rate and complication rate from surgery by more than a third.” (His 2007 New Yorker story “The Checklist” provides details.)

So why doesn’t everyone use checklists? Because, Gawande says, checklists demand humility, an acknowledgement that we can’t keep everything straight without help. They also demand discipline and teamwork.

“This is the tiniest form of innovation,” he concluded. “But in this new century, not only must we come up with the great ideas, but we’re now struggling with how to make sure they reach everybody.”