This morning, when I went out for my first walk of the day, it was pretty quiet on the road so I did what I usually do which is to use that time to pace out the first few paragraphs of a post and it’s working title. This post was originally just going to run under the single letter title R. : the R standing for the R in SMART which I always read as Realistic which I also always thought of as being a bit out of place. I figured that if a part of the plan wasn’t realistic, and you could sense that right at the start then what was it doing there in the first place.
Then when I got home what I realized I was still thinking about was the various forms of failure mode that happen frequently with new exercise and/or dietary regimes : of course I was wondering what my personal failure mode might be. I am, somewhat unfortunately, at either week 13 of my first cycle or just week one of my second cycle and in today’s first walk I had a bit of an aha moment when I realized what my form of failure mode might be and it has merely one word : complexity – that iv’e now got so many things to individually think about that I can’t hold them all in my mind at the same time.
I also happened to be reading Adam Savage’s book ‘Every Tool’s a Hammer’ and it suddenly came to me that I didn’t have even the most basic checklist to help me get this plane off the ground so it was more than likely to crash and burn. If that makes zero sense whatsoever then I should explain that one of the places and times formal checklists came along was after the fatal crash of Boeing’s new uber-bomber the B 17 later known as the Flying Fortress. The story goes that when the new airplane was to be demonstrated alongside it’s rivals for the contract the plane crashed on takeoff and killed it’s pilots. The reason, soon worked out, was that the new aircraft was so radically new that it needed new procedures that couldn’t be easily remembered by the crew : what was needed was a formal checklist of things that had to be worked through before firewalling the engines and giving it large on the runway.
If you were able to listen in on the pilots of any large commercial aircraft today then you would most likely hear the pilot and co pilot talking through several lists before even taxiing out to the runway : one of the problems with something that has a take off weight of 500 tons and is carrying maybe 300 passengers is that it has to take off and land first time every time – there is no room for error which is why the commercial aerospace sector has a no holds barred attitude to safety.
As a side note I came across the concept of patient safety in the NHS because it became my job to read through all of the hospital’s incident and error forms (Datix forms) to find out what our team was maybe getting wrong and I was, for a while, the only person in the hospital that had a helicopter view of the entire hospital for the time that I did the job. I came across checklists at that time and for a while I was even developing ones for our team to help us get everything right when we were called in to escort and move critically ill patients around the hospital.
A part of that was sometimes to go help with an emergency procedure first : the one that comes to mind is endotracheal intubation which is normally only carried out in the operating theater or the intensive care unit. The important feature of both is that the procedure is carried out, as usual, by a senior anaesthetist but in theater with the help of a skilled technician (ODA) and in the ICU by a nurse that is at least experienced in assisting with intubation. The time that it goes wrong is often when performing the procedure on a general ward without expert help as most ward nurses don’t have that experience. It’s also one of those procedures that pans out like an aeroplane committing to take off but with a plane end crew that aren’t ready. What it really needs on the ward is a quick checklist : I won’t detail the whole procedure but it’s things like ‘have we pre-oxygenated the patient ?’. is the suction working ?, is the patient on a monitor and if so what are the O2 sats ?. do we have a selection of tubes and does the laryngoscope work ?……and so on. Like many practical checklists it’s best spoken out loud and a question and response verbal format used.
Checklists don’t have to be that immediately serious, for example when we traveled to Yosemite (California) for several weeks of back country mountain hiking I would lay out all of my personal kit and our shared camp kit on a groundsheet and kinda/sorta tell myself a story about using them while my partner would write out a checklist for her kit and then put all of that together, Today i’m not a great one for creating lists which is one of the reasons that I have difficulty getting stuff done : rather I try and reduce things to as simple as possible such that I can hold in mind what it is that i’m trying to do. With my first cycle of diet and exercise that was only three or four main things : with my exercise I determined that I needed to go for a couple of medium distance walks per day that had some cardio element and on the dietary side I had to stop eating biscuits and ditch as much extraneous sugar out of my diet as possible.
It wasn’t a bad start and at that time I figured to only make one small change at a time – maybe one minor change per fortnight and get used to that one thing : for instance I added body weight squats about halfway through and i’m still trying to perfect the routine of making that a daily practice. My big problem is that I dived back in to learning and re learning everything I could about diet, exercise, health and particularly metabolic related disease. What I ended up with was a head so full of stuff that not only could I not remember it all but I was even at risk of total project failure due to the nearest thing to analysis paralysis : I almost got there when I wrote my companion piece about failure modes.
What I needed was some way of keeping what i’m doing functionally simple such that I keep up with the basic stuff while making small changes but at the same time having a way of referring to the nuances and complexities of all the new stuff that I had learned or re learned. The obvious answer was to write a check list although not a standard single list but more like what professional model and props maker does with his many projects and that includes not just a check list but check boxes to denote the level of progress with each listed project stage.
It’s somewhat calming to look at the short list of things that iv’e already done because that tells me that i’m on the right road even if it’s a long and twisty one. I already have a shorter list of what things would constitute total and partial failure while the longer list is a work in progress that I need to look at frequently and which tells me in return what stage of completion (or not) i’m at with each thing from the primary check list – the list of all things. Finally there is a smaller list written for future Steve rather than now Steve and those things I can deliberately set aside until cycle three.
Best wished Y’awl
Dirty Wet Dog, the great adventure. 