Charlatan

I had an interesting conversation with a young Polish cardiologist recently. He was friendly and open to discussing views on health, without resorting to the 'Me expert, you idiot' approach of yesteryear.

I talked about some of the things I've learned about preventing heart problems and mentioned the work of Dr William Davis. The cardiologist turned to his computer, typed in Dr William Davis in the PubMed search engine and found no results. He then told me that Dr Davis must be one of those American charlatans, who are just trying to make money out of empty assertions and selling snake oil. I explained that Dr Davis has had stunning results by recommending diet and lifestyle changes in order to reduce coronary arterial plaque. The cardiologist dismissed this telling me he could claim numerous positive results and that this would prove nothing. He told me that he would need to see peer reviewed articles to convince him that Dr Davis had anything valuable to contribute to the field.

I then asked for his views on the lipid hypothesis and the idea that saturated fats contribute to heart disease. He told me that there is evidence that they do, took my email address and promised to send me links to peer reviewed articles substantiating this fact. That was at the end of November 2011 and to date I've heard nothing.

Later I typed the young cardiologist's name into PubMed and found zero results, despite the fact that this doctor routinely prescribes heart drugs and surgery to deal with various symptoms. I also checked on my GP colleagues, with whom I've worked for 20 years, and found no peer reviewed papers by any of them. I've witnessed and heard from patients testimony to their efficacy in dealing with a wide range of medical conditions. I doubt if patients need peer reviewed articles to show that their doctors aren't charlatans.

Dr Davis relies on the results of scans to show his patients' calcium scores. It's possible to challenge the cause-effect relationship between diet and heart disease that he proposes, but his results are impressive.



Dr Davis is generous with his knowledge and shares his experience freely on his blogs and in interviews. He does have a heart disease prevention programme with a membership and also sells 2 books. I don't think this automatically discounts his work.

In a previous post I mentioned the difficulty of getting research published in peer reviewed journals if it challenges orthodoxy or a sticky metaphor. Lynn Margulis persisted and made a difference to how we understand the process of evolution. The way that the Helicobacter was brought to public attention so that research was financed and appropriate antibiotics developed for the treatment of stomach ulcers is another example of this trend.

Commentators are challenging how pharmaceutical companies chase gold mine drugs and jump to conclusions about cause-effect relationships rather than correlations to research treatment for serious conditions. Some claims for drugs have been undermined by research or more detailed analysis of the initial findings on which claims for the drug were based. 'Why Science is Failing Us' is a provocative article in this vein.

$29 Billion Introduction from 29billion on Vimeo.

Another angle in this debate focuses on the trend towards senior researchers to claim credit for all breakthroughs (and to quash evidence that young juniors have found something new.) Peter Lawrence claims that the heart of research is sick. He describes the push for publication in a few high profile journals so that your papers are cited by colleagues. This means that small, obscure areas of research are overlooked and that papers on planned genetic research are favoured, an area which seems to be reaching some dead ends. The outlook for UK scientific research is depressing.

I think it's absurd to assert that a doctor can only treat people if he/she has published research in a peer reviewed journal on the subject. The history of medicine has been built on doctors and surgeons applying the results of other people's research. Some members of the field indicate that the true charlatans may be those who change the paramaters of their research AFTER the results are in or those who conceal or understate side effects and statistically insignificant results by manipulating the data.

Framework for Problem Solving

My students sometimes trip over course terminology. We define Frameworks as metaphors for creative problem solving on B822. I encourage students to do a bit of method acting and imagine the role that they inhabit when problem solving.

I think everyone tackles problems from an individual mindset or belief about how the world works and what enables problems to be solved. This view determines their choices about how to approach problems and what techniques to use.

Most people seem to be unconscious about their Framework and sort of assume that the world actually works the way they believe it does. When my students are asked to make their Framework conscious and explicit, some of them choose to change the metaphor or analogy slightly to be make it more effective and include other people.

Years ago I did a lot of consultancy and training for the rail industry. Though British Rail was derided in the media, I met a few superb managers and lots of hard working people doing their best to maintain a transport system that functioned well.

Some managers led their teams through bomb threats and sabotage by the IRA and showed great skill in outwitting the terrorists. Others took tedious, bureaucratic quality systems and boiled them down to a useful, practical essence that their staff could understand and implement with enthusiasm. As a result railway staff, who had been dismissed as old codgers, now became a powerful force for positive change.

The unconscious Framework guiding this problem solving seemed to be 'Problem Solver as Football Coach' and BR had some budding Sir Alex Fergusons in their midst.

During the early incarnations of the Crossrail project, some managers tackled the issue of 'one man train operation' with some success. They subverted the bureaucratic meetings of labour relations and drew on personal contacts and relationships based on trust to persuade unions to adopt a different work pattern. The implicit Framework seemed to be 'Problem Solver as Networker'.

During and after privatisation, a lot of fuss was made about the new broom sweeping through the rail industry, with the appointment of senior managers from the commercial sector. The cynical view (in common with privatised electricity companies) was that failed managers from the oil industry found a safe haven in deregulated transport and utility companies.

I didn't work with the newly appointed titans of the rail industry, but certainly witnessed interactions between them and their staff as well as external consultants. They seemed to share a tendency to view people as problems. The Framework that comes to mind when I recall this era is 'Problem solver as Neanderthal'. These high testosterone managers seemed to have a very small toolkit for problem solving and most often used a large rock to try and crush the problem (or verbally bludgeoning their people.) This might work in the short term, but did nothing for long term cooperation and motivation.

In recent consultancy work in organisations that have driven down the demographic of supervisors and managers, I am seeing youngsters managing people who are older and more experienced than them. I witness a lot of 'Problem Solver as Dalek', where some of the youngsters seem scared and rigid, expecting their staff to carry out work exactly as they used to do it. Part of my task is to help them let go of their robotic approach so that they relax and set goals, freeing staff to find their own way of reaching them. Increasingly strident and fixed commands and reproaches cut no ice with people who believe they could do the same job better, faster and with less friction.

Dr Who may be brainy and have centuries of wisdom on which to draw, but he does involve his team in finding ways to get the job done.

Sticky Metaphors

I encourage my students to include metaphors and analogies in creative problem solving. One of the reasons is that a good metaphor can be sticky and stay in the minds of colleagues much longer than wordy powerpoint presentations or reams of data.

One example of how this works in society is the notion, now shared by most primary school aged kids, that saturated fat clogs our arteries (like chip fat poured down the drain) and makes us fat. If this were so, then it should follow that all our cars would become clogged by the oil we regularly pour in their engines.

Here's an eminent endocrinologist, Dr Robert Lustig, explaining what actually causes obesity:



If you stop someone on the street and ask them to explain evolution, they're likely to describe it as survival of the fittest an evocative description of how random mutation works in evolution championed by biologists such as Richard Dawkins.

The biologist Lynn Margulis died in November. It took nearly a decade and 15 rejections before the Journal of Theoretical Biology published her paper presenting the process known as symbiogenesis, by which organisms cooperate in development rather than always competing. One of the examples she cited was mitochondria, which are organelles within cells that generate most of the chemical energy needed by the cell. Mitochondria have many properties characteristic of bacteria (including reproduction by binary fission) and their DNA resembles that of bacteria.

One example in the human body is the appendix, which was thought to be a vestigial organ from the days when we ate rabbit food. Bill Parker, Professor of surgery and Duke University School of Medicine, is undertaking research that indicates the appendix may be a reserve of beneficial bacteria for the gut (symbiosis in action.)

Sticky metaphors can block fresh thinking and become orthodoxy that resists new research presenting contrary evidence.

In creative problem solving, sticky metaphors can lure colleagues away from rigid thinking to consider the status quo from a new, more dynamic angle that leads to critical thinking and action. In a previous post I mentioned the power of animal metaphors in describing the state of the company. The animal can help us talk about company problems without personalising them.

During a creative problem solving workshop a comic analogy (such as the above Gary Larson cartoon) may arise that seems to have no benefit or use in the process. If it persists, I encourage the group to revisit it and consider how it might contribute to the challenge at hand.

If it sticks, run with it.

David and Goliath

A small club gets knocked out of the Premier League. Problems continue and the club teeters on the edge of bankruptcy until a consortium buys it out. Negotiations stall over a move to the old Crystal Palace site from Selhurst Park. A new manager joins.

Every year Crystal Palace FC start the season well and then seem to falter. Fans begin to reconsider the idea of renewing their season ticket, given that the rewards seem to be outweighed by the costs.

At the other end of the scale, Manchester United go from strength to strength. Sir Alex Ferguson has managed the club for 25 years and the cupboards are full of silverware. Despite the buyout by the Glazer family and subsequent financial transactions that left the club with significant debt, Ferguson has ensured the security of ManU for the forseeable future through his long run of success.

On 30 November Palace played ManU and won 2-1 by Glenn Murray's goal in extra time, strengthening their chance of a place in the final of the Carling Cup. ManU may well have played the B,C or D team, because of more important fixtures coming up, but they still had substantial financial assets on the pitch in the form of overseas signings, and still lost.

This is a great boost to Palace and their dispirited fans and encourages people to trust in Dougie Freeman, the new manager.

Denmark showed how minimal expectations and determination can produce results, when they won the European Championship in 1992 (replacing Yugoslavia, who couldn't play because of the Bosnian conflict.) If you have nothing much to lose and everything to gain, then it's possible to beat impressive opponents, if you shift mindsets and persist. The psychological battle is the hardest to win, the rest is down to persistence, effort, skill and luck.

Congratulations Palace.

Someone had some fun with this spoof:

Rapper Fat Joe says "Educate yourself to weight loss"

Here's how he used to look:

In this video he talks about how he lost 100lbs by educating himself on the science of food and metabolism. Basically Rapper Fat Joe cut out most starch and sugar.

'Super crack head level with sugar...... and then we wonder how we caught diabetes...'



'I lost 6 friends last year to heart attacks..... all younger than me...'

'We're not superheroes, we're human beings. I'm being a realist. That's going to happen to me if I don't switch it up.'

'Not only do I feel better, I'm not missing nothing. I still eat chicken, steak, lobster, with sauteed vegetables or salad. I don't eat it with that pasta, rice or bread.'

In breaking news, Denmark has levied a tax on saturated fat and Norway is running out of butter from the increasing popularity of high fat/low carb ways of eating.. 2 neighbouring countries with diametrically opposed views on diet and obesity.

Listen to da man. Rapper Thin Joe tells it like it is.

Respect.

You must be crazy!

As a boy, Jørn helped his father build and sail small boats.

In Denmark he observed the intricacies of the natural world and marvelled at interlocking fish scales and the mechanics of a bird's wing in flight.

When he travelled abroad as an architectural student, he noticed how these details sometimes appeared in building design, such as intricate interlocking roof tiles on a grand mosque. His observations went into the melting pot and culminated in a visionary design for an important building, which he submitted in open competition.

Jørn's drawings were discarded by the panel early on in the weekend. The Finnish architect, Eero Saarinen, turned up late to participate in judging entries. He worked through all of the entries, including those that had been eliminated, and decided that Jørn's ideas were the most outstanding of the bunch. Saarinen championed Jørn's design until it was finally chosen.

Building was a major challenge. Jørn had not included any engineering slant on how his vision might be turned into reality. Danish Engineers, Ove Aarup and Partners, were brought in to find a solution. However, Jørn had included detailed consideration of elements to enhance sound and performance as well as facilities for the audience, which would take the project way over budget if included. The project was finished without Jørn, as he was thrown off the project in the middle, refushing to compromise on the detail. The building has become an iconic landmark and is famous worldwide to tourists and musicians alike. Much later the authorities began to admit that some of the additional details could be retrofitted, as they would make a significant difference to the quality of the experience.

That is the story of how Jørn Utzon designed the Sydney Opera House.

I thought about Utzon when a young Georgian architect friend told me he plans to build a financial district in his country - the City of Tbilisi. There is a long history of visionary architects and planners being thrown off their own projects mid way, so the risks of the undertaking are huge.

Meredith Belbin devised a way of considering how people work together in drawing up his Team Role Inventory. He encourages us to look at the range of functions that must be fulfilled in order to complete a project. Each of us can fulfill one or more roles. We may have functions that are strong, moderate or weak, so it makes sense to work to our strengths and find others who are strong at our weak functions.

Utzon holds the visionary or Plant function. He clearly also thinks through to the consequences of his designs down to the smallest detail, which covers the Completer Finisher function. He probably also carries out the Specialist function, in that he shows little interest aptitude for the areas outside of his own narrow field (including finance and engineering.)

Ove Aarup and Partners were brought in by the government to make Utzon's design work and held the Implementer or Company Worker function. Others sorted out the finance, when the project went well over deadline and budget and held the Resource Investigator role. There was also a driving force to ensure that the project maintained momentum and was completed (Shaper). The Chairperson or Co-ordinator role was also carried out, but seemed unable to manage the external pressures effectively.

Neglected areas seem to be those who detached themselves to check out what was happening in the team to ensure that appropriate decisions were taken (Monitor Evaluator); and those who kept the peace and ensured constructive relations in the team throughout the crises (Teamworker).

Other notable architects manage to stay the course and avoid being kicked off their projects. I suspect that, in some cases, the named star takes the role of Co-ordinator and delegates the Plant and Implementer roles to underlings, who don't ususally share the glory. This seems to be common practice in architectural firms, but Ken Shuttleworth is the most notable example of the mismatch between fame and quality of output. His former boss, Norman Foster, built the company's reputation by tackling small industrial projects in the early days.

Survivors also include engineering expertise in their designs, so they can demonstrate the HOW of the building and not just the WHAT to prospective customers. Bringing the Implementer role in-house or under their own control ensures that projects don't slip out of their grasp so easily.

Utzon's story also reminds me of how much innovation may depend on luck or serendipity. If he had not found a champion in Saarinen, then we might have a functional, but pedestrian building in Sydney harbour.

As Pinchot reminds us 'Go to work each day ready to be fired.' That seems sober and realistic advice for young visionary innovators starting out.

Doers versus Dreamers

Books offering home spun philosophy, such as 'Chicken Soup for the Soul' do well in the best seller lists, but don't seem to draw on life experience in a useful way.

Here are 2 excerpts from an interview with Steve Jobs, where he offers 2 concepts that helped him.

The first relates to change and the power of ordinary people to make a difference:



The second gives us an insight into how he made progress in his career, mainly by asking for help: