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June 10, 2009

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Why Is Gawande So Good?

There’s been lots of Atul Gawande love here and elsewhere… so I am a bit embarrassed to admit I only read his latest New Yorker piece yesterday.

And now I can confidently agree, it’s great. But why is it so great?

Here’s my theory:

  • It’s a first person narrative — and not tentatively so. There are I’s everywhere in this piece, and it’s wonderful.

    New rule: The more abstract and complex the subject matter, the more important it is to anchor it to an identifiable human point-of-view.

  • The use of place in this piece is also really important. Yes, the piece focuses on different health-care costs in different parts of the country, so it makes sense. But, even absent that connection, I think anchoring ideas to places is generally a good idea. Think of a memory palace. Our brains have super-powerful circuitry for thinking about and remembering places, and when you connect ideas to places (even imaginary places) you co-opt some of that power. It’s like a computer scientist finding a way to do a calculation on the GPU to take advantage of that crazy speed and parallelism.

    New idea: Use place in narrative as a hack to engage the 3D-sensing-mapping brain.

  • It’s a hero’s quest. Really! In this piece, Atul Gawande is Luke Skywalker leaving Tatooine. Frodo going to Mordor. He has an urgent quest (to solve this health-care puzzle); he enters new, unexplored territory (McAllen, Texas); he meets friends and foes along the way. It’s Joseph Campbell meets Peter Orszag. Near the two-thirds mark he literally mentions flying home; that’s important. It gives the piece a familiar, satisfying arc.

    New venture: Policy think-tank co-founded by George Lucas and Peter Jackson?

So there you go.

Posted June 10, 2009 at 3:39 | Comments (4) | Permasnark
File under: Briefly Noted


It is also, like most NYer stories, mostly chronological. It's a story, not a "piece" or an "article" or a collection of facts held together by bits of narrative.

I got into this in the earlier thread, but I think there's something about his style of argument/reasoning that's analytic without being abstract.

He writes and reports like a surgeon -- he has some idea of what he's looking for, but investigates with an open mind. He quickly anticipates and rules out alternative explanations (but always addresses them), makes his diagnosis, ..., and then elegantly sutures everything together again.

There is something about this mode of thinking that is inherently appealing. He lets you watch his mind at work. And he doesn't hesitate in his decisions, but also is never afraid to admit when he's made a mistake. Both of those things make his conclusions more appealing than they would be otherwise.

So, it's not just a narrative -- it's an epistemological narrative. He's showing you what he now knows, HOW he knows what he knows, on what grounds he evaluates that, and teaches you how to make similar evaluations. It's an imitatio of thought itself.

I'd be slow to derive general rules from this, admittedly-terrific, piece.

The "story" form has notable limitations. First, it lends itself to demonstrating the process of thinking through a problem, but unless done very well it resists ending up at anything other than tentative ideas. Even in Gawande's case, he ends up with a hypothesis, not with a conclusion. If he wanted to present a solid case for some set of conclusions, I think he'd chose a different form/genre.

Second, one has to be very smart and knowledgeable to pull this off. This sort of discovery narrative tends to be the stuff of first drafts. We write out the process by which we discovered what we think we discovered. (This tends to be most interesting to the author, b/c who doesn't like reading about their own experiences?) In later drafts, we begin with the conclusions we ended our first draft with and make certain we have evidence to support those conclusions. I would contend that to ensure a piece like this holds up, it probably makes sense to go through that entire process before going back and re-writing the chronological discovery story, with the benefit of all the clarity won by the earlier re-writing. Gawande probably gets away w/o this cumbersome process b/c he has spent a long time thinking through this material already.

Posted by: Dan on June 10, 2009 at 06:59 PM

Tim just beat me.

But in response: I agree Gawande pulls this off. But I think that is because he has so many interesting insights and pulls off his analysis well. I maintain that this is a risky form: I have read many, many research paper drafts that emulate this move to very boring effect.

Posted by: Dan on June 10, 2009 at 07:04 PM
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