Positive Deviance

Atul Gawande is a good surgeon and a really good writer.

He's written a book called Better. It's about how the medical profession and non-medical professionals, and presumably almost anyone, can systematically become better at what they do.
Two examples are: industrial/human-factors engineering to improve hand-washing compliance; the DRASH system (a 900 square-foot mobile hospital that fits in five backpacks and can be setup in ~30 minutes) for Forward Surgical Teams in the military -- which cut the death rate from 25% to less than 10% for battlefield injuries.

Gawande's three basic observations of people who are positive deviants -- presumably better than about 95% of the relevant population:

1. They don't complain.
2. They write about what they do.
3. They count something.

One example of someone who fulfills those requirements, or at least the latter two of the three, is Jim Plagakis, a pharmacist.


I want to be a better student and a better systems engineer.

I'm pretty good about not complaining about school. I am not good at writing, or rather following a good writing process, nevermind writing about school. I don't count anything regarding school. I could, though. For instance, regarding writing, I could measure how long it takes me to write a page of text given a decent outline and enough background information and research.

I complain about system engineering and the general IT processes at my workplace. Often I'm complaining internally or to friends without any vested interest in IT. ...when I should be writing things down into coherent things that might be instrumental in changing our IT department and processes. I don't count anything at work, either. But there are probably multitudes of indicators available for investigation. I started to time my system deployments but haven't really continued to do so.

(Actually doing those three things is a real bitch when coping with depression.)

So, you should read Better. (And Complications. And Jerome Groopman's How Doctors Think.)

Walkin' the Line

Dear Readers,

Been a while, huh?

This post was prompted not by the plethora of ideas bouncing around my head, but rather by a song lyric from a band recommended to me by K. after I finished bitching about the past two weeks. That a song overcame my inertia isn't surprising. Music is supremely important.

The exposition of those other bouncing ideas has been suppressed by dysthymia and perhaps someday I'll write them out. There are a few good ones, too.

The song is Still Be Around from Uncle Tupelo's second album, Still Feel Gone (1991).

Throughout, a shimmering, light lead guitar balances the fermented lyrics. The guitar is reminiscent of some of the songs on R.E.M.'s Reckoning, which is their second album, coincidentally. Onto the lyrics:

I don't see you through the windshield
I don't see you in faces looking back at me
Alcohol doesn't have much that matters to say
Can't imagine where you and time to kill will stay

When the bible is a bottle
and the hardwood floor is home...
When morning comes twice a day or not at all...
If I break in two, will you put me back together?
When this puzzle's figured out
will you still be around
to say, you've just been there,
walkin' the line, upside down...

Walked and breathed many a cancerous mile
Where the bat of an eye is too slow to beat the coffin
They won't tell it on the TV, they can't say it on the radio
They pay to move it off the shelf and into our minds
'till you can't tell the truth when it's right in front of your eyes

When the bible is a bottle
and the hardwood floor is home...
When morning comes twice a day or not at all...
If I break in two, will you put me back together?
When this puzzle's figured out
will you still be around
to say, you've just been there,
walkin' the line, upside down...



The last line of the chorus, “Walkin' the line, upside down” is superb. Borrowing from Johnny Cash, kicking it on its ear so it fits perfectly. Walking the line drunk and alone, upside down. Sometimes I like clever a lot.

Shimmering is a trite, overused adjective for describing stringed instrumentals in songs. Including the R.E.M. album I mentioned. I apologize for using it. It's just so damned apt.

It's been two weeks since I've had a cigarette. I was smoking “only” three or four cigarettes a day at the end. Nonetheless, it's been difficult. I mainly smoked to cope with stress at work, and work has been insane. Hackers are a real bitch. As is unnecessary bureaucracy. Both of those are topics for separate posts. Comma dammit period.

I'm replacing nicotine, a stimulant and an antidepressant, with more coffee and alcohol. Alcohol is a depressant. And I suffer from recurrent major depression and dysthymia. Which makes smoking cessation a... bad idea. Whoa. Who saw that coming? And I don't want to use the patch or gum, because I like assuming the hardass façade and I want to quit like a hardass. I'm really stupid sometimes.

So the song's alcoholism is more apropos than usual. I haven't slept on the floor, and I've had much worse nights, but I'm now using moderate-to-heavy alcohol consumption as a coping strategy, without pushing my luck in terms of over-doing it. Occasional crazy nights are, I think, less bad than consistent drinking-to-survive. Especially when a CNS depressant is almost guaranteed to inflame any symptoms of depression.

I'm not walking cancerous miles, but I might as well be. Without consulting my psychiatrist, I am walking the line between depression and health, between intelligent decisions and stupid choices regarding psychoactive chemicals.

I'm not living at home. I'm not in a relationship that I can leech support from. If I break myself in two, who will put me back together?

And when the fuck am I going to figure out this puzzle?

A race.

A friend informed me that I'm blog-racing one of her friends. This is a very silly idea, but it may prompt me to write more, which is a good thing.


Dear Self-discipline,

Get your game face on.

Thanks,

Me

Cue Mighty Mouse Theme

For the past 7 years I've been told repeatedly, by different people, that I need to write more often, primarily for my own good. A love/mostly-hate relationship with Writing has left that concept as an ongoing avoidance, despite benefits that even I can see. Yesterday a very good friend gave me the same advice. (Thank you, for that, by the way.)

So, here I am. The coincidence with the imminent New Year, and pesky Resolutions does not go unnoticed.