Overkill?
(What Can I Say?)

Christmas mostly meant books. Hence I found myself at 9 p.m. last night, with the Tinmouth VT temperature already down to -8°F, sitting across from the fire with, yes, no less than 11 new books on the coffee table beside me:

Piracy: The Intellectual Capital Wars from Gutenberg to Gates, by Adrian Johns. An exhaustive and bizarrely detailed look at intellectual capital’s status through the ages, courtesy, what else, a University of Chicago prof. (This is going to be an amazing learning experience for me—and no idea is more basic to tomorrow’s economy, which, like it or not, will be based almost exclusively on intellectual property, not manufacturing.)

Resistance: A Woman’s Journal of Struggle and Defiance in Occupied France, by Agnès Humbert. The first English translation of an extraordinary French war diary published in 1946; I am mesmerized by the moral choices represented by the German occupation of France—what would I have done???????????????? (We all think we are people of great character, but when the crunch comes …)

Verdun, by Jules Romains, 1937. A towering novel about inhumanity … and folly!!!! … in World War I.

Half the Sky: Turning Oppression into Opportunity for Women Worldwide, by Nicholas Kristof and Sheryl WuDunn. More women are killed in any given decade just because they are women (“gendercide,” as the authors call it) than the total number of people killed in all the 20th century’s genocides. This book is the Mother of all Wake-up calls, or should be! (There is a lot of good news here, too, about action being taken by “real people” “on the ground.”)

Patton, Montgomery, Rommel: Masters of War, by Terry Brighton. The generals were almost the least of it in this retelling. Virtually every major battlefield decision by the Brits and Yanks was driven by national politics far more than the situation on the ground. (E.g., my beloved Mr. Churchill, and I mean it, squandered God knows how many British boys’ lives to beat the Americans to the punch in North Africa in order to shore up his sagging political fortunes of the moment in the House of Commons.)

The Perils of Peace: America’s Struggle for Survival After Yorktown, by Thomas Fleming. Turning the victory of 1781 into the birthing of a democratic nation was no sure thing—and that’s an understatement. Oh dear, what a mess the real world is! (Life = Muddling through.)

Lyndon Johnson and the American Dream, by Doris Kearns Goodwin. The ultimate biography of perhaps our most politically savvy politician ever—published in 1976. Again, I get off on the political machinations of the real world—incidentally, just about as pervasive in Big Corporate World as on Capitol Hill. (“Politics is life. The rest is details.”—bumper sticker not yet printed, by Tom Peters. “If you don’t ‘do politics,’ you don’t do ‘do.'”—bumper sticker not yet printed, by Tom Peters.)

The Department of Mad Scientists: How DARPA Is Remaking Our World, from the Internet to Artificial Limbs, by Michael Belfiore. Established in 1958 after the Russian Sputnik launch, DARPA has an amazing history, first revealed here, in 2009. And if you don’t think the government has a big role to play in R&D, think again!

7 Deadly Scenarios: A Military Futurist Explores War in the 21st Century, by Andrew Krepinivich. Frightening scenarios not in the least bit farfetched. I am not an alarmist, or at least I don’t think I am, but Detroit should remind us that we most likely ain’t seen nothing yet—be prepared, and don’t imagine that the madness of this past decade is some sort of anomaly!

The Unthinkable: Who Survives When Disaster Strikes and Why, Amanda Ripley. Extraordinary analysis, in a 2008 book, of surviving (or not) amidst calamities. Among its messages: (1) the real people at the scene, witness NWA/Detroit, are far more important than the so-called “first responders” who are never first; and (2) a little bit of prep can go a long way—one woman had practiced walking downstairs now and again in the Twin Towers, and calmly walked down on 9/11 while people on average were in a state of paralysis for 6 minutes; she was hardly “over-prepped,” but, like checklists in hospitals, the “little stuff” can make a BIG difference, such as life vs. death!

The Checklist Manifesto: How to Get Things Right, by Atul Gawande. Simple checklists, say the hard data, save more lives in hospitals than the most sophisticated equipment! Or as I like to put it, much as I love Gawande (I do, I do), doctors-discover-the-real-world-and-find-it-interesting (gosh, next thing we know the docs will begin backing up their judgments with evidence). (Hospital safety, alas, an oxymoron, and the failure to be informed by evidence, are a disgrace with horrifying consequences.*)

*NB: I am obsessed with health care, that is, patient safety and “evidence-based medicine.” Hence I am unable, in reference to Gawande’s book, to not gratuitously offer up this set of quotes I previously collected:

“America’s elites are very good at attracting money and prestige, and they have a huge technology arsenal with which they attack death and disease. But they have no positive medical results to show for it in the aggregate and many indications that they are providing lower-quality care than the much-maligned HMOs and assorted St. Elsewheres.”—Best Care Anywhere: Why VA Healthcare Is Better Than Yours, Phillip Longman

“The medical system has been unable to turn proven remedies into everyday care.* [*More: 55% chance of “receiving the best recommended care—which means getting scientifically appropriate, evidence-based medical treatment.”] Half the people who need to be treated to prevent heart attacks are not treated and half who are treated are treated inadequately. Patients go home with the wrong drugs or the wrong doses or misimpressions about the importance of taking their medications.”—The New York Times, from John Hammergren & Phil Harkins, Skin in the Game:How Putting Yourself First Today Will Revolutionize Health Care Tomorrow

“Study: Medical Errors Affect 20 Percent of Patients”—headline, Boston Herald

“1-in-7 Chance of Medical Mishap: Health Ministry Report”—headline, the Press, Christchurch, New Zealand (quote refers to odds of a screw-up during a hospital stay)

“The Institute of Medicine calculated that drug errors [on average, one per patient per visit—various sources; some estimates go as high as one-per-patient-per-day on average] alone add on average nearly $5,000 to the cost of every hospital visit.” —Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer, Shannon Brownlee

“Hospital infections kill an estimated 103,000 people in the United States a year, as many as AIDS, breast cancer and auto accidents combined. … Today, experts estimate that more than 60 percent of staph infections are M.R.S.A. [up from 2 percent in 1974]. Hospitals in Denmark, Finland and the Netherlands once faced similar rates, but brought them down to below 1 percent. How? Through the rigorous enforcement of rules on hand washing, the meticulous cleaning of equipment and hospital rooms, the use of gowns and disposable aprons to prevent doctors and nurses from spreading germs on clothing and the testing of incoming patients to identify and isolate those carrying the germ. … Many hospital administrators say they can’t afford to take the necessary precautions.”—Betsy McCaughey, founder of the Committee to Reduce Infection Deaths (New York Times)

“When I climb Mount Rainier I face less risk of death than I’ll face on the operating table.”—Don Berwick (Harvard med school, founder of the campaign to save 100,000 lives)