Dr. Atul Gawande: Use Your Knowledge
I had very much looked forward to this morning’s keynote from Dr. Atul Gawande, and he certainly didn’t disappoint.
Dr. Gawande is a Harvard-trained surgeon and writer, having been a National Book Award finalist for his book Complications: A Surgeon’s Notes On An Imperfect Science, as well as climbing up the New York Times bestseller list for The Checklist Manifesto.
Gawande started his keynote on a solemn note, highlighting the percentage of war injuries to death from the Revolutionary War (42%) through the First Gulf War (24%).
Only in the most recent Iraq and Afghan Wars has that number begun to drop dramatically, to 10% in these latest conflicts.
What brought about this change?
Well, simply put, it’s not unlike the same relationship between data and progress that has been so pervasive in our conversations this year at Information on Demand 2010.
Gawande explained that as our technology for killing in war progressed over history, so, too, has our technology for healing, and even preventing, traumatic injuries.
It was a curious U.S. military colonel (and surgeon) who, after sifting through historical data from our more recent conflicts, discovered the antidote.
One, rank and file troops had finally taken to actually wearing their Kevlar in the field, which they had been resisting for years.
But also, medicine was moving closer to the troops, and we were able to, through these mobile surgical field units, able to reach soldiers inside the window of that critical “golden hour” which can often decide the fate of a patient after traumatic injury.
Furthermore, those surgical units had deconstructed surgery down to its most critical elements, whereby surgeons did only those most critical path procedures in the field, then “packaged” the patient up for further surgery or procedures in Baghdad or even at a base in Germany, where they had more equipment, personnel, etc.
The field surgeon would essentially put a sign on the patient explaining to the next surgeon: “Here’s what I did. Please finish.”
Finally, the military introduced the use of checklists to ensure that patients were receiving ample supplies of blood, checking for medical allergies, etc. — common, mundane tasks but which could be lifesavers under specific circumstances.
Those few things were all it took to drive the rate of death from 24% to 10% — so much so, that in fact, the military now speaks to the survival rate, as opposed to the death count we often heard in earlier wars.
That is truly data that matters.
As Gawande more bluntly put it, “The metrics of war are now measured in the wounded, not the dead…The whole picture has changed.”
It’s that bigger picture which was the underlying moral lesson of Gawande’s talk. What does such a change, he asked, tell us about what we’re doing and where we’re going when it comes to data?
As humans, we lived through milennia in a world of ignorance, where we didn’t understand our physical world, our environment, and the like. Though that has changed dramatically in the last half century, where, with reference to the Iraq and Afghan wars, we can save more and more lives in war, we still often don’t know how to execute on the knowledge (read: data) we already have.
Or, we often have the knowledge to solve major problems, but that knowledge doesn’t always reach the people who need it most and who can most act on it.
Having knowledge is not the same as using it, and using it effectively.
Gawande’s message was quite simple: Our challenge in the 21st century will be to learn how to cope with an increasing amount of complexity, data, and even knowledge, and then to find the right data and act on it and use it to human advantage.
To do anything less would be to leave untreated an open and scathing wound defined by ineptitude and ignorance, and we’ve come far too far for that.