James is Trying

The ultimate goal is to create a better world, or at least that’s how I like to approach life. Making a positive change requires identifying problems and working to solve them. It’s trying and failing then adjusting and trying, again and again until you start finding your way. It also helps to take a look at how other problems were solved. How brilliant minds approached making positive changes. Or how they totally messed it up.

Doctors didn’t always disinfect their hands between patients. This resulted in a significant spread of infection. A lot of people died. In 1847, an incredible thinker started to put this together and found a solution. I can’t even comprehend his genius. It’s incredible to even think about.

And I view him as one of the most profound failures I’ve ever heard of. He died in disgrace. Because he thought that simply knowing the answer was enough. It’s not even the start.

Dr. Ignaz Semmelweis worked in a hospital where women were dying at a high rate of what was called puerperal fever. No one could figure out why the mortality rate at this hospital was so high. He hypothesized that it was coming from the cadaver lab.

He found that using chlorinated lime could remove the horrible cadaver smell and proposed that if everyone used this solution to wash their hands when leaving the cadaver lab, maybe they could stop transporting puerperal fever to patients.

The hospital tried it and it worked. The mortality rate plummeted. He told everyone he could. No one listened. He died at age 47. His incredible contribution to medicine was mostly ignored.

It’s easy to blame everyone else for not adopting his hand washing practice. It’s an all-too-common explanation for a lack of success. Everyone is stuck in their ways or they think they know everything or the ultimate classic – people are SO stupid. That last one is particularly toxic and I hear it far too often. And it’s just plain wrong. 

If you share this opinion – that you can’t get your ideas heard or no one will listen to you because “people are dumb” – then I can almost guarantee that regardless of how brilliant you are or how much you have it figured out, you’re not going to accomplish much of anything in your life.

No one listened to Semmelweis because he was an asshole. He was arrogant. He diluted his solid, clearly effective solution with a really wild explanation – that “cadaverous particles” were the cause. It was the beginning stages of what became the widely accepted “germ theory” but, at the time, it was an incomplete hypothesis at best, and not a unique idea. The attitude of his colleagues was probably something like, “It’s interesting but we’ve heard this before. Where’s the proof?”

When he wasn’t making an impact he decided to go with another approach. Telling doctors that they have to wash their hands and if they don’t, they will continue needlessly killing patients. Now he turned it into a fight. Me versus you. The basis of this new argument was accusatory and fanatical. Unsurprisingly, it still didn’t work.

In my opinion, he made a few gigantic mistakes that prevented his idea from being widely adopted.

Mistake 1: He mixed the thing he absolutely knew (washing hands with an antiseptic solution saved lives at his hospital) with stuff he didn’t totally know (germ theory). It discredited his message entirely. His rather simple solution revealed a much bigger and far more complicated issue that wouldn’t be fully explained for another 25 years or so. Like any good scientist, he explored this new issue. But he presented his solution and incomplete theory together, didn’t admit that he lacked a complete understanding of the issue, didn’t emphasize his evidenced-based solution, and, maybe worst of all, he didn’t ask for any help or input from anyone else.

Mistake 2: He needed to be right. Because of this, he grew angry and began placing blame. He arrogantly and desperately told doctors they were killing patients, have been all along, and needed to implement his hand washing method in order to stop. This turned it into a fight which would have a winner and a loser. And now, anyone implementing his solution was not only saying he was right and they were wrong, an already difficult obstacle, but they were also, by default, admitting they were responsible for the deaths of countless patients. Creating system-wide change is always difficult but getting a doctor to experiment with a new hygiene method is probably a lot easier than getting them to accept that they’re wrong and they’ve been killing people their entire career.

I can’t personally say I’ve successfully communicated or implemented a life-altering idea – I’ve never even had an life-altering idea. And while I can’t outline the path to changing the world, I have a good handle on how to avoid definite, guaranteed failure.

Since I’m not currently brilliant enough to come up with my own genius solution, I’ll pretend I was hired to give advice to Dr. Semmelweis. This is EXACTLY what I would’ve said to him in 1847.

Alright Semmie, if you want to have a shot at changing the world, here’s what you gotta do:

First, and absolutely most importantly, make sure you have your facts straight and actually propose a realistic, evidence-based solution.

It won’t be helpful if you start arguments, point out problems, and come up with theories without knowing the subject matter or without offering any tangible ideas to solve the problem. Everyone is trying their best here. Attacking people, sharing memes and grainy YouTube videos, and constantly criticizing anyone with a differing opinion is already a terrible way to spread your ideas or start a meaningful conversation but if you don’t even have a tangible solution or anything constructive to offer, you’re going nowhere. 1847 is a crazy year.

Be very clear and completely honest about what you know and what you don’t know.

“Women are dying at a much lower rate of puerperal fever at my hospital when we use this specific hand washing method between patients and especially after leaving the cadaver lab. I need more hospitals to try this method to see if it might be worth implementing as a standard practice or if I’m completely wrong. I have a theory about what might be happening but, honestly, it is way out there and I don’t think I have it all figured out. I need help with this because there might be something really significant happening and it could give us an opportunity to practice better medicine. Is your hospital willing to experiment with my hygiene practices and share your outcomes?”

Focus on the solution.

“We are all trying to fight disease and save lives. I’m honored to be in this profession. I believe I may have found a fairly small change we can all make which could save a lot more people. At my hospital, it has radically decreased the mortality rate. It might’ve been a fluke and I might be way off base but I can’t sleep without exploring the possibility that we might be able to save more lives. Could you experiment with this to see if the mortality rate of your hospital also decreases?”

Don’t be an asshole.

You are not an all-knowing savior. Your theory is incomplete and you have so much to learn. Don’t work to destroy an idea in hopes that it will be replaced with yours. Share your ideas, share your evidence. Ask for help, collaborate. Try. Fail. Then ask people why you failed and ask if they will help you succeed the next time. Assume others have ideas that can enhance your theories. Work with them. Give up ownership of your idea and use it as a means to bring people together to collectively find a solution that works.

People are not stupid. Everyone wants life to be better. Act with compassion. With empathy. Change the world. Let’s wash our hands. Together.