On Monday, we talked about hand washing. Seems like a simple enough topic, right? "Everyone, just wash your hands. Do it." It shouldn't be much more complicated than that, and yet it is. Something most of us are taught from our earliest of years, to frequently wash our hands (especially after contact with "germy" things), is such a burden to doctors. In Better, an entire chapter is devoted to the subject. How do you get doctors to wash their hands more frequently? What efforts need to be taken to get a desired result? The hand washing battle looks like one that will never get to the conclusion desired by everyone involved, but that doesn't mean it isn't worth the time. It just means that hospitals and those individuals inside need to be more, as Gawande puts it, diligent. Diligence is key. Constant, earnest effort may not solve the problem, but it will get them close. (At least that's the hope.)
As a math major, I can't help but think of this situation in terms of calculus and limits. You can never reach a limit. It's impossible. But you can get close. Very close. We throw out the word "infinity" like we really understand it, but we don't. Some things are beyond our capabilities, beyond us, but we continue to reach for them with diligence. We will never reach perfect hand washing technique. I think I can assert that. Therefore, making progress is hard work both because it simply is and because we're working at something that will never be perfect.
This year, I am living in a house with nine other guys, just as I have done the past two years. While living with men who share my faith and some of my interests is a very rewarding experience, there are difficulties that arise. We have different schedules, so eating dinner together is usually impossible. We have different personalities, so finding activities to do together does not always work. Most frustrating for me in the past has been our different standards when it comes to cleanliness, specifically in regard to doing dishes and maintaining the bathroom.
I'm a neat freak. I enjoy cleaning and organizing. It didn't take long for me to discover that not everyone in the house felt the same way. As a house leader, I tried to impress upon people that we should each do our part to start the dishwasher and unload it after the cycle is over. Most people got the idea, but there were a couple that either didn't understand the message or rejected it (probably the latter). Despite our efforts to get everyone to do the dishes, the same 4 or 5 of us always ended up doing dishes and keeping the kitchen clear of messes. Our diligence didn't make a dent, and I'm sure we'd still be in the same situation this year if it weren't for changes in residents.
Despite failure to improve kitchen cleanliness, we actually managed to improve bathroom cleanliness. What was the difference? I think it came down to one event that some might say was drastic. Residents continued to leave their things all over the place even though we have a house rule that states community space must be kept clean. After weeks of diligence with no tangible results, the resident in charge of cleaning the bathroom once a week posted a message that anything left out in the showers or on the counters would be thrown out. Some ignored the message, and he later proceeded to clean up and put everything that had been just lying out in the trash. Our bathroom was much cleaner thereafter. Though some people were understandably ticked off having some of their things tossed out, they adopted cleaner practices thereafter.
The difference between the two situations in my house was the type of efforts made in each. I think sometimes, it takes a drastic measure to make change. You have to be careful with using these, though, because they can leave people more than temporarily peeved. Diligence can take us closer to where we want to be, but we have to be careful about how we get there.
(Responding to my previous post, I would say that bell curve grading is not the fairest method but is quite motivating. Also, when dealing with people's lives I think every effort should be made. There are some endeavors where it might just not be worth it at a certain point, but I don't think medicine is one of them.)
1 comment:
The keeping the house clean problem is similar in structure to the issue with teams of students doing project work. There can be a free rider problem in both cases. One way to solve this in small groups is to come up with a quid pro quo. In that case the outcome might very well be that the sloppy kids don't do any of the cleaning, but they do something else for everyone (shopping, cooking, taking out the trash, whatever) in exchange. Equal division of the work sounds fair, but it can be inefficient. An economist solution to the problem would be to divide up all the work equally at first, and then let folks trade with each other if they want to. This breaks down when the numbers get too large. Then people go back to free riding.
Also, people might not realize that when they shirk in their responsibilities, it does both those who are affected. The story you told about throwing out stuff sounds like the effect happened by raising awareness.
On your other point about grading, if in a class one kid gets a 99 on the final, another kid (Tiger) gets 100, and then next highest score on the exam is in the low 80s, the kid with a 99 better get an A. It's where the B+/A- border is that raises everyones hackles
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