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Healing Architecture

I feel better already.

I feel better already.

We were in Barcelona last month with our two favorite architects, Julia and Elliot. Of course, we wanted to see the many buildings created by another favorite architect, Antoni Gaudi. A friend also clued us in that, if we wanted to see some really good architecture, we shouldn’t miss the Hospital de Sant Pau.

I enjoy discovering cities but had never thought about visiting hospitals as part of a tourism agenda. Hospitals seem very functional and efficient and somewhat drab. They also look pretty much alike whether you’re in Denver or Paris or Bangkok. They seem to be built for the benefit of the medical staff rather than the patients.

So I was very surprised to find that the Hospital de Sant Pau contained some of the most beautiful buildings I’ve ever seen. The hospital dates to 1401 but the major complex that we visited consisted of about a dozen buildings constructed between 1901 and 1930. The Catalan architect Lluis Doménech I Montaner designed the entire campus, which today claims to be the largest art nouveau site in Europe. The campus is like a fairy tale – every which way you turn reveals something new and stimulating. (My photo above barely does it justice).

(The art nouveau campus was a working hospital until 2009 when it was replaced by a newer hospital – also an architectural gem – just beside it. The art nouveau campus is now a museum and cultural heritage site).

As I wandered about the campus, I thought if I were sick, this is the kind of place I would want to be. It’s beautiful and inspiring. That led me to a different question: Can the architecture of a hospital affect the health of its patients? The answer seems to be: Yes, it can.

The earliest paper I found on healing and architecture was a 1984 study by Roger Ulrich published in Science magazine. The title summarizes the findings nicely: “View Through a Window May Influence Recovery from Surgery.” Ulrich studied the records of patients who had gall bladder surgery in a Philadelphia hospital between 1972 and 1981.

Ulrich matched patients based on whether they had a view of trees out the window or a view of a brick wall. He studied only those patients who had had surgery between May and October “…because the tress have foliage during those months.” He also matched the pairs based on variables such as age, gender, smoking status, etc. As much as possible, everything was equal except the view.

And the results? Patients “…with the tree view had shorter postoperative hospital stays, had fewer negative evaluative comments from nurses, took fewer moderate and strong analgesic doses, and had slightly lower scores for minor postsurgical complications.”

Ulrich’s study (and others like it) has led to a school of thought called evidence-based design. Amber Bauer, writing in Cancer.Net, notes, “Like its cousin, evidence-based medicine, evidence-based design relies on research and data to create physical spaces that will help achieve the best possible outcome.”

Bauer cites Dr. Ellen Fisher, the Dean of the New York School of Interior Design, “An environment designed using the principles of evidence-based design can improve the patient experience and enable patients to heal faster, and better.” Among other things, Dr. Fisher suggests, “A view to the outdoors and nature is very important to healing.” It’s Ulrich redux.

I’ll write more about evidence-based design and the impact of architecture on healing in the coming weeks. In the meantime, put a vase full of fresh flowers beside your bed. You’ll feel better in the morning.

Jevons Paradox and The Future of Employment

My new teaching assistant.

My new teaching assistant.

Four years ago, I wrote a somewhat pessimistic article about Jevons paradox. A 19th-century British economist, William Jevons, noted that as energy-efficient innovations are developed and deployed, energy consumption goes up rather than down. The reason: as energy grows cheaper, we use more of it. We find more and more places to apply energy-consuming devices.

Three years ago, I wrote a somewhat pessimistic article about the future of employment. I argued that smart machines would either: 1) augment knowledge workers, making them much more productive, or; 2) replace knowledge workers altogether. Either way, we would need far fewer knowledge workers.

What if you combine these two rather pessimistic ideas? Oddly enough, the result is a rather optimistic idea.

Here’s an example drawn from a recent issue of The Economist. The process of discovery is often invoked in legal disputes between companies or between companies and government agencies. Each side has the right to inspect the other side’s documents, including e-mails, correspondence, web content, and so on. In complex cases, each side may need to inspect massive numbers of documents to decide which documents are germane and which are not. The actual inspecting and sorting has traditionally been done by highly trained paralegals – lots of them.

As you can imagine, the process is time-consuming and error-prone. It’s also fairly easy to automate through deep learning. Artificial neural networks (ANNs) can study the examples of which documents are germane and which are not and learn how to distinguish between the two. Just turn suitably trained ANNs loose on boxes and boxes of documents and you’ll have them sorted in no time, with fewer errors than humans would make.

In other words, artificial neural networks can do a better job than humans at lower cost and in less time. So this should be bad news for paralegal employment, right? The number of paralegals must be plummeting, correct? Actually no. The Economist tells us that paralegal employment has actually risen since ANNs were first deployed for discovery processes.

Why would that be? Jevons paradox. The use of ANNs has dramatically lowered the obstacles to using the discovery process. Hence, the discovery process is used in many more situations. Each discovery process uses fewer paralegals but there are many more discovery processes. The net effect is greater – not lesser – demand for paralegals.

I think of this as good news. As the cost of a useful process drops, the process itself – spam filtering, document editing, image identification, quality control, etc. – can be deployed to many more activities. That’s useful in and of itself. It also drives employment. As costs drops, demand rises. We deploy the process more widely. Each human is more productive but more humans are ultimately required because the process is far more widespread.

As a teacher, this concept makes me rather optimistic. Artificial intelligence can augment my skills, make me more productive, and help me reach more students. But that doesn’t mean that we’ll need fewer teachers. Rather, it means that we can educate many, many more students. That’s a good thing – for both students and teachers.

Politics — Lying Versus Bullshitting

You talkin' to me?

You talkin’ to me?

The presidential campaign is about to lurch into high gear and the lying is flying. Or is it? Are the candidates lying or are they bullshitting us? The two concepts are related but not the same.

Let’s take an example from Donald Trump. Trump says that he will build a wall along our southern border and make Mexico pay for it. Many neutral observers claim that it would be prohibitively expensive to build a useful (that is, impenetrable) wall along the entire border. They also suggest that it’s ludicrous to believe that Mexico would pay for it. So is Trump lying or is he bullshitting?

To answer the question, I dug out an essay by the Princeton philosopher, Harry Frankfurt. Originally published in 1986, the essay is aptly tilted, On Bullshit. * Frankfurt lays out the essential differences between lying and bullshit (with a side trip through humbug).

Frankfurt argues that both bullshit and lying are deceptive – but they’re deceptive in different ways. The liar aims to deceive us about reality and “the way things are.” A liar might say that he has a million dollars when he’s actually flat broke. A bullshitter, on the other hand, aims to deceive us about his purpose. Frankfurt writes, “His eye is not on the facts at all…. He does not care whether the things he says describe reality correctly. He just picks them out, or makes them up, to suit his purpose.”

Further, a liar knows the truth and seeks to conceal it. He opposes the truth. By contrast, a bullshitter may or may not know what the truth is – and certainly doesn’t care. Indeed, he may even be telling the truth. Making a true statement or a false statement is beside the point. As Frankfurt notes, “…the truth … of his statements is of no central interest to him.”

A liar is under numerous constraints. He knows the truth and, “…to invent an effective lie, he must design his falsehood under the guidance of that truth.” A bullshitter has no such constraints. He can make everything up, including the context and the backstory. Instead of making a statement about reality, he invents his own reality.

Indeed, the bullshitter avoids the “authority of the truth” altogether. Frankfurt writes that, “He pays no attention to [the truth] at all. By virtue of this, bullshit is a greater enemy of the truth than lies are.”

So is Trump lying or bullshitting about the wall? I’m guessing that he’s bullshitting. He doesn’t seem to care whether his statement is true or false. That’s beside the point. He just makes stuff up to suit his purpose.

So, if making a true statement (or a false one, for that matter), is beside the point, what is his hidden agenda? I think there are two:

  • To maximize attention and press coverage – every time Trump makes an outrageous statement, journalists write about it. Often times, they point out that the statement is not true. But that’s beside the point. Trump doesn’t care – nor do his followers, apparently. The point is to get elected and that requires attention and saturation coverage.
  • To soak up his opponents’ time – Trump’s opponents often make detailed rebuttals of his claims. They want to set the record straight. But as long as they’re doing that, they’re on Trump’s turf. He’s the center of attention. It’s political rope-a-dope. I’ve noticed that Trump rarely defends his points in any logical way. He simply repeats them, thus causing his opponents to redouble their efforts to prove him wrong. He gets their goat because they think he’s lying when, in fact, he’s bullshitting. Setting the record straight is useless if truth and falsity are beside the point.

So how can Trump’s opponents – Johnson and Clinton – best deal with his bullshitting? To the maximum extent possible, they should ignore him. Don’t get caught up in the trap of making him the center of attention. When a journalist asks about an outrageous Trump statement, don’t take the bait. Just say something along the lines of, “Well, we all know that he’s a world-class bullshitter. Let’s talk about something more useful.”

* Frankfurts’ essay was originally published in The Raritan Quarterly Review in 1986. It was then republished in 2005 as a small book. I’ve depended on the version that’s found here.

Corporate Culture: Counting The Uncountable

Stand by me.

You can’t measure love.

I was in a meeting not long ago with a client whose organization is undergoing a significant transformation. We were discussing what needed to change and how we might promote the appropriate change efforts. A senior executive spoke up to say, “Well, you get what you measure.” Nobody challenged the assumption behind the thought and we began to focus on how to measure change in the organization.

I had, of course, heard similar statements many times before. Business schools emphasize measurement as a key ingredient of management. As a leader, you point the way, establish some key measurements, and then harvest the results. Sounds simple, doesn’t it?

But think about the things that we don’t bother to measure – or that we don’t know how to measure. These include love, respect, hope, initiative, creativity, open-mindedness, ability to resolve conflicts, receptiveness to new ideas, focus, drive, and resilience. Do we really not care about these things?

We tell managers that the most important thing they can do is build a positive, engaging organizational culture. (See here and here). We also tell them they can only get what they measure. Yet many of the components of culture are simply not measureable. I have yet to hear a manager say, “In the third quarter, we increased corporate resilience by 3.2% compared with the same quarter in the previous year.”

So, how do we help managers build a positive culture even when they can’t measure it? Here are some thoughts:

  • The answer is not a number on a piece of paper. It’s OK to look at numbers but we need to remember that a number is an abstraction of a measurement that is an abstraction of reality. Looking only at numbers is like driving your car by looking only at the speedometer.
  • Trust is an unrecognized but important ingredient. We focus on measurement partially because we don’t trust our eyes, and ears, and subordinates. A measurement is supposed to give us an “objective” view of the organization. But a measurement is only as objective as the person taking the measurement – which is to say, not very. If we can create a culture built on trust, we can learn more about our organization than a measurement will ever tell us. (In this regard, it’s useful to review Edwards Deming’s 14 points of management and his red bead experiment).
  • Learning to observe is more important than learning to measure. We forget that measurement is just one form of observation. Management by walking around still works. Taking groups of employees out to dinner will teach you more than a spreadsheet will. Practice being naïve – ask questions that a rookie would ask. You may think you don’t need to ask certain questions because you already know the answer. But you’re probably wrong.
  • A good conversation is more important than a staff meeting. Staff meetings can be useful but they’re also very structured. You get the information that the structure permits. A good conversation is much more open-ended. You can wander about until you touch on the really important issues.
  • Questions are more important than answers. A number from a measurement purports to give us an answer. But it only answers the question you asked – and the answer may not be accurate. Learn how to ask probing questions that get rich and unexpected answers. Tip: a good course on critical thinking will help.

I think we obsess about measurement because we have a bad case of physics envy. We want our organization to behave like a physics experiment. If we apply Force X, we get Result Y. It doesn’t work that way and never will. Time to get over the measurement mania.

Is Critical Thinking The Ultimate Job Skill?

Interesting syllogism. But the premise is unsound. That's why I get the big bucks.

Interesting syllogism. But the premise is unsound. That’s why I get the big bucks.

When I went off to college, my mother told me, “Now remember … you’re going to college to learn how to think. Don’t miss that lesson.”

I wonder what she would say if she were sending me off to college today. It might be more along the lines of, “Now remember … you’re going to college to get a good job. Don’t blow it.”

We can only judge programs and processes based on their goals. If the goal of government is to provide good services at a reasonable cost, we might give it a fairly low grade. However, if the goal of government is to increase employment, then we might evaluate it more positively. The same is true of higher education. So what is the goal of higher education? Is it to teach students how to think? Or is it to provide them skills to get a job?

I would argue that the goal of higher education – indeed of any education – is to improve the students’ ability to think. Good thinking can certainly help you get a job. In fact, it may be the ultimate job skill. But good thinking can take you much farther than a good job. Here’s my thinking on the issue:

1) Thinking is foundational — the essence of running a business (or a government) is to make decisions about the future. To make effective decisions, we need to understand how we think, how our thinking can be biased, and how to evaluate evidence and arguments. If we know everything about finance, for instance, but don’t know how to think effectively, we will make decisions based on faulty evidence, weak arguments, and unconscious biases. By chance, we might still make some good decisions. But we should remember Louis Pasteur’s thought, “Chance favors the prepared mind.”

2) The future is unknowable — our niece, Amelia, will graduate from college next May. If she works until she’s 65, she’ll retire in the year 2060. What skills will employers need in 2060? Who knows? As I reflect on my own education, the content I learned in college is largely useless today. The processes I learned, however, are still very relevant. Thinking is the ultimate process. Amelia will still need to think effectively in 2060.

3) Thinking promotes freedom – if we can’t think for ourselves, we will forever be buffeted by other people’s agendas, desires, ambitions, and rhetorical excesses. Critical thinking allows us to assess ideas and social movements and make effective decisions on our own. We can frame our thinking as we wish and not allow others to create frames for us. We can identify the truth rather than relying on others to tell us what is true. Critical thinking, allows us to take control of our own destiny, which is the essence of freedom. I don’t know of any other discipline that can make the same claim.

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