012-Dare-to-disagree-(Margaret-Heffernan)-2012

013Daretodisagree(MargaretHeffernan)2012InOxfordinthe1950s,therewasafantasticdoctor,whowasveryunusual,namedAliceStewart.AndAlicewasunusualpartlybecause,ofcourse,shewasawoman,whichwasprettyrareinthe1950s.Andshewasbrilliant,shewasoneofthe,atthetime,theyoungestFellowtobeelectedtotheRoyalCollegeofPhysicians.Shewasunusualtoobecauseshecontinuedtoworkaftershegotmarried,aftershehadkids,andevenaftershegotdivorcedandwasasingleparent,shecontinuedhermedicalwork.Andshewasunusualbecauseshewasreallyinterestedinanewscience,theemergingfieldofepidemiology,thestudyofpatternsindisease.Butlikeeveryscientist,sheappreciatedthattomakehermark,whatsheneededtodowasfindahardproblemandsolveit.ThehardproblemthatAlicechosewastherisingincidenceofchildhoodcancers.Mostdiseaseiscorrelatedwithpoverty,butinthecaseofchildhoodcancers,thechildrenwhoweredyingseemedmostlytocomefromaffluentfamilies.So,what,shewantedtoknow,couldexplainthisanomaly?1:23Now,Alicehadtroublegettingfundingforherresearch.Intheend,shegotjust1,000poundsfromtheLadyTataMemorialprize.Andthatmeantsheknewsheonlyhadoneshotatcollectingherdata.Now,shehadnoideawhattolookfor.Thisreallywasaneedleinahaystacksortofsearch,sosheaskedeverythingshecouldthinkof.Hadthechildreneatenboiledsweets?Hadtheyconsumedcoloreddrinks?Didtheyeatfishandchips?Didtheyhaveindoororoutdoorplumbing?Whattimeoflifehadtheystartedschool?Andwhenhercarboncopiedquestionnairestartedtocomeback,onethingandonethingonlyjumpedoutwiththestatisticalclarityofakindthatmostscientistscanonlydreamof.Byarateoftwotoone,thechildrenwhohaddiedhadhadmotherswhohadbeenX-rayedwhenpregnant.Nowthatfindingflewinthefaceofconventionalwisdom.Conventionalwisdomheldthateverythingwassafeuptoapoint,athreshold.Itflewinthefaceofconventionalwisdom,whichwashugeenthusiasmforthecoolnewtechnologyofthatage,whichwastheX-raymachine.Anditflewinthefaceofdoctors'ideaofthemselves,whichwasaspeoplewhohelpedpatients,theydidn'tharmthem.Nevertheless,AliceStewartrushedtopublishherpreliminaryfindingsinTheLancetin1956.Peoplegotveryexcited,therewastalkoftheNobelPrize,andAlicereallywasinabighurrytotrytostudyallthecasesofchildhoodcancershecouldfindbeforetheydisappeared.Infact,sheneednothavehurried.Itwasfully25yearsbeforetheBritishandmedical--BritishandAmericanmedicalestablishmentsabandonedthepracticeofX-rayingpregnantwomen.Thedatawasoutthere,itwasopen,itwasfreelyavailable,butnobodywantedtoknow.Achildaweekwasdying,butnothingchanged.Opennessalonecan'tdrivechange.3:44Sofor25yearsAliceStewarthadaverybigfightonherhands.So,howdidsheknowthatshewasright?Well,shehadafantasticmodelforthinking.SheworkedwithastatisticiannamedGeorgeKneale,andGeorgewasprettymucheverythingthatAlicewasn't.So,Alicewasveryoutgoingandsociable,andGeorgewasarecluse.Alicewasverywarm,veryempatheticwithherpatients.Georgefranklypreferrednumberstopeople.Buthesaidthisfantasticthingabouttheirworkingrelationship.Hesaid,MyjobistoproveDr.Stewartwrong.Heactivelysoughtdisconfirmation.Differentwaysoflookingathermodels,atherstatistics,differentwaysofcrunchingthedatainordertodisproveher.Hesawhisjobascreatingconflictaroundhertheories.Becauseitwasonlybynotbeingabletoprovethatshewaswrong,thatGeorgecouldgiveAlicetheconfidencesheneededtoknowthatshewasright.4:55It'safantasticmodelofcollaboration--thinkingpartnerswhoaren'techochambers.Iwonderhowmanyofushave,ordaretohave,suchcollaborators.AliceandGeorgewereverygoodatconflict.Theysawitasthinking.Sowhatdoesthatkindofconstructiveconflictrequire?Well,firstofall,itrequiresthatwefindpeoplewhoareverydifferentfromourselves.Thatmeanswehavetoresisttheneurobiologicaldrive,whichmeansthatwereallypreferpeoplemostlylikeourselves,anditmeanswehavetoseekoutpeoplewithdifferentbackgrounds,differentdisciplines,differentwaysofthinkinganddifferentexperience,andfindwaystoengagewiththem.Thatrequiresalotofpatienceandalotofenergy.5:57AndthemoreI'vethoughtaboutthis,themoreIthink,really,thatthat'sakindoflove.Becauseyousimplywon'tcommitthatkindofenergyandtimeifyoudon'treallycare.Anditalsomeansthatwehavetobepreparedtochangeourminds.Alice'sdaughtertoldmethateverytimeAlicewenthead-to-headwithafellowscientist,theymadeherthinkandthinkandthinkagain.Mymother,shesaid,Mymotherdidn'tenjoyafight,butshewasreallygoodatthem.6:35Soit'sonethingtodothatinaone-to-onerelationship.Butitstrikesmethatthebiggestproblemsweface,manyofthebiggestdisastersthatwe'veexperienced,mostlyhaven'tcomefromindividuals,they'vecomefromorganizations,someofthembiggerthancountries,manyofthemcapableofaffectinghundreds,thousands,evenmillionsoflives.Sohowdoorganizationsthink?Well,forthemostpart,theydon't.Andthatisn'tbecausetheydon'twantto,it'sreallybecausetheycan't.Andtheycan'tbecausethepeopleinsideofthemaretooafraidofconflict.InsurveysofEuropeanandAmericanexecutives,fully85percentofthemacknowledgedthattheyhadissuesorconcernsatworkthattheywereafraidtoraise.Afraidoftheconflictthatthatwouldprovoke,afraidtogetembroiledinargumentsthattheydidnotknowhowtomanage,andfeltthattheywereboundtolose.Eighty-fivepercentisareallybignumber.Itmeansthatorganizationsmostlycan'tdowhatGeorgeandAlicesotrium