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Simplicity itself
Jun. 10th, 2005 12:12 amTen years ago I got interested in complexity.
I was working for doctors, and their behavior fascinated me. Medicine is the original complex system, far too large and intricate for any one person to comprehend. To become doctors, students attack this mountain of spaghetti and spend years memorizing parts, learning formulae, repeating mnemonics. They are stretched beyond capacity; the task is impossible. In postgraduate education this is all put into action. A few years of no sleep, life-and-death decisions, and a whole new layer of complexity is introduced: clinical practice, a completely different set of information.
After this something unexpected occurs. It all becomes simple.
I don't mean to say that medicine gets any easier. Clinicians get new science projects every day, full of mysterious signs and symptoms. But the way they talk about it, it seems no more complicated than frying an egg. If you ask a physician what happens in the internal medicine ward, you'll get a breezy answer like "It's all I's and O's" or "Titrating 'lytes all day". To believe them, the entire job consists of monitoring how much fluid goes in and out and how much sodium and potassium is in the blood. Everything else is a side dish.
This sounds easy. All I'd have to do is steal some notes on electrolytes and hydration, put on a white coat, and walk back and forth in the wards telling people to put in more or less saline drip and more or less salt! Then I'd be a rich, famous doctor.
Well, no. Not going to try that. But I bet I'd do okay at least for a while. These successful physicians know that the majority of their time is spent on three or four simple tasks. Most of their education is in reserve for the exceptions. If Mrs. Patient's left leg turns red and swells up, I'm clueless, but the physician knows how to proceed next. On a typical day, Mrs. Patient's left leg does not swell up. It's all I's and O's and titrating the 'lytes on the medical floor.
From working with physicians I learned that they go through complexity into simplicity. The overwhelming detail of medical education past them, they follow the same few rules and do the same few things for most of their careers, using 1% of their expertise 99% of the time. But you can't just learn that 1% and set yourself up as a dermatologist, because you need that other 99%.
If you talk to experts in almost any field, you hear similar things. As a computer system administrator, I do three or four things all day long. The other thousand things I know how to do come up rarely. Bartenders make gin and tonics all day long; once a month someone asks for a mojito and they'd better know how to make one. I've heard similar reductive talk from aircraft pilots, engineers, cooks, and artists. Sometimes it's a couple of techniques, or a couple of formulas, or a repetitive diagnostic path. The slang in a profession is revealing of this phenomenon; as in the medical example above, the 1% knowledge turns into rhymes and mnemonics.
The progress from ignorance through complexity to simplicity recalls similar patterns in spiritual disciplines. I think of Zen Buddhist monks who, on attaining enlightenment, announce that it's all about sunlight on a block of wood or something. Or Jesus telling his fellow Jews that the entire Law is summed up as "Love God and love your neighbor".
What I wonder is this: what's this process? What about our minds reduces all this detail to a few bits of information, successfully, but only after all the complexity has been mastered?
I bet the answer is really complicated.
I was working for doctors, and their behavior fascinated me. Medicine is the original complex system, far too large and intricate for any one person to comprehend. To become doctors, students attack this mountain of spaghetti and spend years memorizing parts, learning formulae, repeating mnemonics. They are stretched beyond capacity; the task is impossible. In postgraduate education this is all put into action. A few years of no sleep, life-and-death decisions, and a whole new layer of complexity is introduced: clinical practice, a completely different set of information.
After this something unexpected occurs. It all becomes simple.
I don't mean to say that medicine gets any easier. Clinicians get new science projects every day, full of mysterious signs and symptoms. But the way they talk about it, it seems no more complicated than frying an egg. If you ask a physician what happens in the internal medicine ward, you'll get a breezy answer like "It's all I's and O's" or "Titrating 'lytes all day". To believe them, the entire job consists of monitoring how much fluid goes in and out and how much sodium and potassium is in the blood. Everything else is a side dish.
This sounds easy. All I'd have to do is steal some notes on electrolytes and hydration, put on a white coat, and walk back and forth in the wards telling people to put in more or less saline drip and more or less salt! Then I'd be a rich, famous doctor.
Well, no. Not going to try that. But I bet I'd do okay at least for a while. These successful physicians know that the majority of their time is spent on three or four simple tasks. Most of their education is in reserve for the exceptions. If Mrs. Patient's left leg turns red and swells up, I'm clueless, but the physician knows how to proceed next. On a typical day, Mrs. Patient's left leg does not swell up. It's all I's and O's and titrating the 'lytes on the medical floor.
From working with physicians I learned that they go through complexity into simplicity. The overwhelming detail of medical education past them, they follow the same few rules and do the same few things for most of their careers, using 1% of their expertise 99% of the time. But you can't just learn that 1% and set yourself up as a dermatologist, because you need that other 99%.
If you talk to experts in almost any field, you hear similar things. As a computer system administrator, I do three or four things all day long. The other thousand things I know how to do come up rarely. Bartenders make gin and tonics all day long; once a month someone asks for a mojito and they'd better know how to make one. I've heard similar reductive talk from aircraft pilots, engineers, cooks, and artists. Sometimes it's a couple of techniques, or a couple of formulas, or a repetitive diagnostic path. The slang in a profession is revealing of this phenomenon; as in the medical example above, the 1% knowledge turns into rhymes and mnemonics.
The progress from ignorance through complexity to simplicity recalls similar patterns in spiritual disciplines. I think of Zen Buddhist monks who, on attaining enlightenment, announce that it's all about sunlight on a block of wood or something. Or Jesus telling his fellow Jews that the entire Law is summed up as "Love God and love your neighbor".
What I wonder is this: what's this process? What about our minds reduces all this detail to a few bits of information, successfully, but only after all the complexity has been mastered?
I bet the answer is really complicated.
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