5 small ways to make a meaningful difference in the world.

I just finished reading Better: A Surgeon’s Notes on Performance by Atul Gawande. It’s a fascinating collection of essays about how all-too-human physicians are striving to close the gap between good intentions and perfect practice in a field where tiny mistakes cost lives.

In his essays, Gawande addresses massive tasks, like eradicating polio and eliminating hospital staph infections. When faced with such daunting tasks, it’s easy, he says, for one physician to feel like they couldn’t possibly matter in the grand scheme of things. It feels hard to make a meaningful difference in the world when you can only tend to one person at a time.

Gawande knows he’s not the only physician—or human being—to wrestle with the question of significance. So in a short afterword, he explains how when given the opportunity to lecture at his medical school about anything at all, he decided to address this question, for his own sake and that of his students.

These are his five suggestions on how to make a meaningful difference in the world, or in Gawande’s words, to be a “positive deviant”—someone who tilts all outcomes towards the better.

(While Gawande has medicine in mind, you’ll find his advice isn’t confined to doctors.)

1. Ask an unscripted question. This simple strategy lets people be people: not cogs in a machine, not problems to be solved. His examples are simple, straightforward: “Where did you grow up? What made you move to Boston? Did you watch last night’s Red Sox game?”

As a bonus, you may find out delightfully surprising intel, as Gawande did, when he found that a quiet, buttoned-down nurse had once dated Jimi Hendrix.

(This reminded me so much of Whole 9’s Great Social Experiment, where their stress-busting assignment was to ask an unscripted question every day for 30 days.)

2. Don’t complain. It’s boring, it doesn’t solve anything, and it just gets you down (along with everyone else within earshot).

You don’t have to be Pollyanna: just be ready to talk about something, anything else than your latest tale of woe.

3. Count something. Gawande says it doesn’t matter what you count, as long as it’s something that interests you.

(For medical professionals, sometimes counting isn’t just an interesting experiment, it’s a matter of life and death: we’ve all heard the horror stories about how a surgical patient got stitched back up with a sponge or scalpel still inside him. A simple accounting can prevent these grievous mistakes.)

Gawande insists that “if you count something interesting, you will learn something interesting.”

(This reminds me of “you get what you measure.”)

4. Write something. Gawande says: “It makes no difference whether you write five paragraphs for a blog, a paper for a professional journal, or a poem for a reading group. Just write.”

Perhaps your writing makes a contribution to the world—and if so, that’s wonderful. But the act of writing itself is good for you. Writing forces you to articulate your thoughts, to reflect on a problem or experience, to step back and take a needed look at the big picture.

5. Change. Don’t be a stick in the mud, unwilling to adopt new ideas or technologies, defensive about the way you’ve always done things.

Medicine—and life—are full of uncertainty. Don’t embrace every new trend that comes along, but remain open to the idea that there’s a better way to do things: new methods, new technologies, new paradigms. And when you encounter one of them, embrace it.

How do you put these into practice in your own life? What would you add to the list?



Books mentioned in this post:


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  1. Emma says:

    I love the concept of writing something that may make a contribution to the world. Especially as a blogger that’s super inspiring. Can’t wait to read this book.

  2. Doret P says:

    By doing number 4 (writing), I find I can do number 2 (don’t complain) when I’m with people. I think something that I would add is “do something.” I have a friend who is one of the most upbeat people I’ve ever met and she is always doing something – for others, especially returning vets. She always manages to be there for them and yet, she is also there for herself and her family. She is always on the go.

  3. LoriM says:

    I’m anxious to read his books. I don’t get the “count something”. I try to count the food I eat. How does that contribute to the world, though? What are other examples?

    • Missy G. says:

      Not sure if this counts (ha!), but last year, I started counting and tracking the books that I have read. From that, I could see themes in my readings, and then would intentionally select books to expand subject matters, narrators, settings, etc, so that I can grow my knowledge about history and other cultures.

    • Anne says:

      When he says “count something,” he really means count anything! The number of surgeries you perform, the number of books you read, the number of tulips in your garden, the number of steps you take or miles you walk or how many carrots you put in your dinner or how many trees are on your walking route. The idea is to notice, to pay attention, to be (in a small way) a scientist in the world.

  4. How very refreshing to hear of another doctor who is quite humble; maybe because he’s asking such big question. I think there’s this pop culture belief that doctors are proud and snooty. Has anyone else noticed this collectively held perception? The doctors I’ve personally known outside of their practices are lovely.

  5. JW says:

    Can I just tell you how wonderful you are, Mrs. Darcy? I saw your post on FB about the book challenge, which led me to your blogs. Your posts are a very bright spot into my life.

  6. Karenlynna says:

    My word for the year is Better, so this book fits my theme for 2016. The five points would make a great printable “recipe” card to post on our family bulletin board!

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