Slow ideas in turbulent times and a fast-changing world
Browsing through a magazine recently I came across an article with an irresistible title: “Slow Ideas.” Now that’s something I can relate to. All my ideas fall into the slow category—few and far between, and speed-wise more like a snail than a gazelle.
It turns out that the guy who wrote the article, Atul Gawande, is a surgeon and a staff writer for The New Yorker. In his spare time, he’s the director of Ariadne Labs at the Harvard School of Public Health. His major research interest lies in the field of health system innovation.
Gawande takes two seminal ideas from the history of modern medical science—anesthesia and antisepsis—to illustrate his theory. Both date back to the 19th century. One—anesthesia—caught on quickly despite resistance. (Some naysayers considered it a “needless luxury!”) Ether was first used experimentally in 1846 and by the early 1850s nearly every hospital in America and Britain was using it routinely.
In stark contrast, the use of antiseptics in hospitals and clinics was slow to catch on. The idea that infections are caused by germs—organisms too small to see with the naked eye—dates back to the 1860s when a surgeon named Joseph Lister (think: “Listerine”) read about a city that had eliminated the odor of sewage using a small amount of carbolic acid.
Logic and science pointed to a conclusion that in retrospect seems glaringly obvious: If something kills germs in sewers, why not try using it in operating rooms? And yet, it would be decades—a generation—before this idea (involving heat-sterilized instruments, sterile gowns and gloves, et cetera) would become standardized.
Why? In a nutshell, surgeons as well as patients benefited from the use of anesthesia—a clear-cut “win-win” situation with no downside for either. Post-surgical infections, on the other hand, threatened patients, not doctors. Creating a sterile surgical field placed new and exacting demands on surgeons. Keeping germs out of the picture—and the patient’s incision—isn’t easy. Just ask any first-year medical student.
The “slow ideas” theory is not confined to medicine. The Greek philosopher Aristotle adduced evidence of a spherical earth as early as 330 B.C., and in 240 B.C. Eratosthenes accurately calculated the earth’s circumference, but many went on believing the earth was flat at least until Ferdinand Magellan led the first seafaring expedition to circumnavigate the globe in the 16th century.
For diehard skeptics, however, that wasn’t proof enough, but then came the Apollo 8 mission in 1968 and the famous Earthrise photo revealing the earth as a luminous globe, not a mesa suspended in a galactic petri dish. But some people STILL believe the earth is flat (see, for example, Christine Garwood, "Flat Earth: The History of an Infamous Idea").
What explains this slow idea? To blame religion is an oversimplification, but it is true that, historically, the Pope and other clerics tended to view science as a challenge to Biblical teachings and thus to the One True Faith. Today, few Christians, even ones who believe in a literal interpretation of the book of Genesis, still think the earth is flat.
Applying the theory of slow ideas to the realm of politics and public policy is at once a fascinating and frustrating exercise. Climate change, for example, is a scientific fact. But our leaders have been excruciatingly slow to embrace the idea and even slower to focus on damage control.
Or take health insurance—if you can get it or afford it. Come Oct. 1, if you are lucky enough to live in Colorado, there’s a glimmer of new hope. That’s because the federal law mandating state health insurance markets (“exchanges”) is being implemented in Colorado (unlike, say, Missouri).
It’s about time. No other rich country in the modern world has the soaring medical costs or helter-skelter health insurance morass we do. Talk of “socialized medicine” is a red herring designed to change the subject.
Without cost controls and a single payer system, the new law is deeply—perhaps fatally—flawed. A slow idea that is arguably too little, too late.
Across a wide range of divisive issues (immigration, fracking, GMOs, guns) new ideas are stubbornly resisted and slow ideas are slower than ever. Meanwhile, too many of our leaders in business and government ignore the elephant in the bathtub—globalization and population growth, and the relentless pressures on the earth’s finite resources these two forces represent.
Today, the world’s population stands at about 7.2 billion and counting. When the delegates to the Constitutional Convention met in Philadelphia in 1887-88, fewer than a billion humans inhabited the earth; in 1950, it was a still “mere” 2.5 billion. Some pessimists in the scientific community say time is running out. We need some good ideas. And fast…
Tom Magstadt, a former CIA intelligence analyst, writes books and articles on politics and foreign policy and lives in the cabin of his dreams in Ouray County.