Month: January 2011

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Other

The Checklist Manifesto by Atul Gawande

This book is a paean to the power of checklists and specifically a call for their use in medicine — Gawande is a surgeon. I bought it after reading a couple of fascinating articles he wrote for the New Yorker, and to be honest if you’ve read those articles (and watched his TED talk) you have a pretty good idea of what’s in the book.

But I still found it absolutely fascinating reading it again. It’s that thing Malcolm Gladwell is so good at: an idea simple enough that it can be explained in a paragraph but with far-reaching implications. The difference is that while Gladwell’s ideas give people a lot of pleasure they don’t actually seem very useful, whereas this idea has specific, practical [cheap!] applications which can be tested. It really could change the way medicine is practiced.

At its simplest, the idea is that when performing a complicated task like surgery, it is not enough to know what the best practices are, because people are fallible. And so a simple checklist to make sure that the basics are done properly can significantly reduce the rate of complications like infection. And it really is the basics: making sure that everyone knows what they’re doing, that they have the right patient, that pre-operative antibiotics have been given at the right time, that everyone is sterile, that they have an ample supply of blood on hand and so on.

Apparently the idea is most well-developed in aviation; ever since planes became complicated enough that missing a pre-flight check might mean a fiery death, pilots have formalised the process. And not just pre-flight checks, or the obvious things like take off and landing procedure. Apparently pilots have whole collections of checklists for use in specific situations like particular warning lights coming on.

As yet, in medicine they have apparently only tested a simple checklist for surgery, which did successfully improve outcomes, and they have come up against resistance because, I guess, doctors feel it undermines their expertise and knowledge. This book makes a convincing case that medicine would be better if it was a lot more like aviation. Being methodical and disciplined may not be the most glamorous or heroic sounding qualities, but they can be life savers.

It’s hard to do the book justice — checklists just don’t sound very interesting — but I found it completely gripping as well as persuasive.

» 757/767 Mechanical Checklist – Landing is © Kent Wien and used under a CC by-nc licence.

Categories
Nature

Life Ascending by Nick Lane

Full title: Life Ascending: The Ten Great Inventions of Evolution. The ten ‘inventions’ are: The origin of life, DNA, photosynthesis, the complex cell, sex, movement, sight, hot blood, consciousness and death. Lane explains how each of these work and how they evolved, at least as far as current knowledge can take us — which in some cases, like the origin of life, is apparently rather further than I had realised. The consciousness chapter, if you’re wondering, was rather less persuasive.

What sets this book apart from most popular accounts of evolution is that Nick Lane is a biochemist rather than, say, a palaeontologist or an ethologist. So this is a book which focuses on evolution at the micro level: it’s all biochemical pathways and enzymes and the genes which code for them. This is the real nitty gritty of how evolution works, how it actually achieves things; but it’s also the stuff which I generally find is a complete headfuck. No matter how many times I have read accounts of the inner workings of a cell over the years, it just doesn’t stick.

So it is not a small compliment to say I found this book was not just full of new and interesting information, but also managed to be clear, engaging and enjoyable. I still ending up having a long pause halfway through, and I’ve already forgotten a lot of it, but I enjoyed it as I read it.

» The picture is Cytoplasm to vacuole targeting from the Journal of Cell Biology, used under a CC by-nc-sa licence. Picked because it’s a striking image rather than because it’s relevant in any way beyond basic thematic appropriateness.

‘The cytoplasm to vacuole targeting (Cvt) pathway uses Atg11 to direct Atg9-containing membrane from mitochondria (top right) to forming autophagosomes (center) before eventual fusion with the vacuole (bottom right). Original painting by David S. Goodsell, based on the scientific design of Daniel J. Klionsky. (JCB 175(6) TOC1)’

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Other

Gay marriage through the eye of a needle

Oh, for fuck’s sake. Someone is blaming the recent bird deaths on ‘the fact that America is violating God’s prohibition on homosexuality with support for gay marriage and the repeal of Don’t Ask, Don’t Tell.’

This is annoying on so many levels, but the particular one which is bothering me today is this. I’m no biblical scholar, but I do know that Jesus said absolutely nothing about homosexuality. I don’t remember him saying much about sex at all, in fact.

On the other hand he did say quite a lot about money. Most memorably, of course, he said:

And moreover I say unto you, it is easier for a camel to go through the eye of a needle, than for a rich man to enter into the kingdom of heaven.

But I don’t remember any of these bible-wielding nutters ever standing up after an earthquake, or a flood, or a load of dead blackbirds, and pointing the finger at Goldman Sachs, or Bank of America, or CitiGroup, or BP, or Exxon Mobil, or for that matter Apple or Google or Wal-Mart. Nope, it’s always the gays, the atheists, the liberals.

Admittedly, it would be equally nutty to blame natural disasters on Wall Street. But at least it would provide a bit of variety.

Categories
Culture

This is Paradise! by Hyok Kang

Or to give it its full, bookshop-friendly title: This is Paradise! My North Korean Childhood, written by Hyok Kang with the French journalist Philippe Grangereau, and translated by Shaun Whiteside.

When I was looking for books from North Korea for the Read The World challenge, I was quite surprised I could only find two actually by North Koreans. The DPRK is such a bizarre Cold War relic that you might think there would be more interest in it. I guess reading about North Korea just doesn’t seem as important as reading about the Soviet Bloc did back in the old days.

Reading the reviews, it sounds like the other book, The Aquariums of Pyongyang: Ten Years in the North Korean Gulag, is probably the better of the two, but it seems to be focussed on life inside the labour camps. I decided to read This is Paradise! because it is about a more normal childhood in rural North Korea. Normal in North Korea being batshit insane by the standards of anywhere else.

Still, it wasn’t quite what I expected; I thought it would mainly be about the political aspects of living in a communist personality cult: the parades, the synchronised gymnastics, the patriotic hymns, the giant floodlit statue of the Dear Leader, the propaganda. All of which does feature, particularly at the start of the book, but because of the period it covers (Kang was born in 1986), it is overwhelmingly about the famine. Even a mad personality cult struggles to maintain its energy in the face of millions of deaths. Not that there is much sign of the state losing its iron grip on the population, but everyday life becomes completely dominated by the famine, which is apocalyptic in scale. It is like reading Solzhenitsyn’s descriptions of scrabbling for nourishment in the gulag, except it’s not a gulag, it’s a whole town, a whole community — except of course for the party officials.

The official slogans changed as the famine ravaged the country. At the very beginning, in 1995, the cadres encouraged us o accept what was called a ‘forced march towards victory’. The term referred to the ‘forced march’ undertaken by Kim Il-Sung and his partisans during the war against the Japanese occupying forces. The following year, the battle-cry was ‘Let us speed up the forced march towards the final victory.’ When the hunger had reaches its worst, another new slogan appeared: ‘Let us not live today for today, but let us live today for tomorrow’. By now, the poorest people had been reduced to eating boiled pepper leaves or bean leaves. Some families came to us to beg us for left-over tofu that my mother cooked, or even the whitish liquid produced when it was being made. They drank it mixed with saccharine. After a certain period of time their faces swelled up. When I saw people with puffy faces tottering towards the house, I knew that was what they were coming for. Shortly after that we too had to start eating pine bark.

The end of the books is about the family’s escape, firstly into China and then through Vietnam and Laos to Cambodia, from which they went to South Korea.

It is a remarkable story. It’s not especially well written, though. It would be unfair to call the prose ‘bad’, but it is a very plain, methodical recital of events. It has very little in the way of descriptive detail and very little emotional content or insight. Definitely worth reading for the content, though, if not for the prose.

Categories
Nature

Wildlife Photographer of the Year exhibition at NHM

I made my annual trip to the Wildlife Photographer of the Year exhibition at the Natural History Museum. I thought it was particularly good this year. Here’s a pleasing and particularly original long-exposure photo of a gannet colony by Andrew Parkinson:

You can see all the winners on the NHM website, but obviously it’s better to go and see the pictures blown up nice and big on lightboxes if you have the chance.

Categories
Culture

Books [and films] of the year 2010

I’ll keep this brief, because if you want to know what I thought of them you can read what I said at the time, but glancing back over the books I read in the past year, I would pick out these five as ones which, for whatever reason, stand out in my memory:

Cities of Salt by Abdelrahman Munif
Gomorrah by Roberto Saviano
The Fortunes of Wangrin by Amadou Hampaté Bâ
The Big Death: Solomon Islanders Remember World War II
The Bleeding of the Stone by Ibrahim Al-Koni

The first two in particular are books I would strongly recommend if you’re looking for something to read.

And while I’m here, some film recommendations, some of which may be a little difficult to get hold of, but hey-ho:

Draquila — Italy Trembles
[which serves as quite a good companion piece to Gomorrah, incidentally]
The First Movie
Skeletons
A Prophet

EDIT: oops, almost forgot:
Four Lions