★★★★☆ Not the book I expected it to be, but better

The Checklist Manifesto

Atul Gawande

I completed my business degree in 2001. For many years thereafter I belonged to a business book club, as a way of keeping in touch with friends from biz school. I don't like business books -- most of them combine the worst aspects of the self-help literature with moral depravity -- but thanks to this book club, I have read quite a few. The Checklist Manifesto: How to Get Things Right is better than most business books.

I thought when I began it that I knew what it was about. A factoid often bandied about in both business school and medical school is that most surgeons refuse to use checklists, even though they have been proven to result in better outcomes. Atul Gawande is a surgeon, so I expected this to be a book scolding people for not using checklists. Although there is some of that, it is not the main thing I learned. When he began trying to use checklists, Atul Gawande wrote his own. And they stunk. They were awful, and not helpful to anyone. Gawande is capable of recognizing and learning from error. Therefore he tried to learn from the experts.

What he learned, and I too learned, is that designing checklists is a craft. Well-designed checklists save lives -- shopping lists pretending to be checklists don't. What should you do if you're flying a single-engine Cessna airplane and the engine fails? There's a checklist for that. Here is step one:

FLY THE AIRPLANE

I will remember that after every other detail of The Checklist Manifesto has faded from memory. As Gawande explains,

Here are the details of one of the sharpest checklists I’ve seen, a checklist for engine failure during flight in a single-engine Cessna airplane—... It is slimmed down to six key steps not to miss for restarting the engine, steps like making sure the fuel shutoff valve is in the OPEN position and putting the backup fuel pump switch ON. But step one on the list is the most fascinating. It is simply: FLY THE AIRPLANE. Because pilots sometimes become so desperate trying to restart their engine, so crushed by the cognitive overload of thinking through what could have gone wrong, they forget this most basic task. FLY THE AIRPLANE.

In the end, Gawande's concept of the checklist is broader than the word "checklist" suggests. He visits project management sites where large buildings are going up and explains how they accomplish the sorts of things a checklist is intended to help one accomplish. Not surprisingly, the answer involves software. He explains how a list of instructions for washing ones hands with soap and water (much less common pre-Covid than now) is a checklist.

The subtitle "How to Get Things Right" is a better explanation of the true subject of the book. I found it illuminating.

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