Thursday, June 18, 2009

Innovation in gene use vs. technology


"We have got the same basic building blocks and plumbing [as other species], but we use it in ways that are unprecedented."

- Prof. Robert Sapolsky, at Stanford Class Day 2009.


Isn't this the same as innovation in social media? We use the same platforms (Twitter, facebook, Google), but it's the way we use them - for health care, social connection, or political dissent - that truly makes them innovative.

Sunday, April 19, 2009

Entitlement, Fear, and Cultivating the Changemaker

Americans are a very entitled bunch. Food (as much as our hearts desire), comfort ($2-million-dollar homes overlooking the sunset over SF bay), entertainment (oh, but we need that 47-inch flatscreen!), and even health care (we deserve whatever we can afford). Across the globe, Americans are being universally criticized as greedy, wasteful, self-righteous. Indeed, today I learned that the the developed world, including the U.S. and Western Europe, has 12% of the world's population but accounts for 60% of its consumer spending. The developing world, on the other hand, accounts for a mere 3.5% of such spending. The difference is enough to make anyone wince.

But I'd argue that there is an interesting psychological consequence to this chronic condition of "I deserve." For those with a more global and humanitarian inclination, it's a kind of unquestioning confidence that people have a right to certain things - clean water, adequate nutrition, safe environments. For the average American, they've grown up with these as givens. They have never worried about the tap water they drank, when they were getting their next meal, or if they were going to get raped on the way home from school. It shocks them, turns their world upside down, when they hear that such things exist elsewhere in the world. When they act, there's a conviction that propel them confidently forward to make change.

However, consider a child who grew up in the slums of Bangalore, or rural China, or the Bronx. Day after day, she's surrounded by poverty, hunger, violence, sickness, and worst of all, the resignation and fear of her elders. It's not their fault; their lives, and those of their parents, were etched out, fought for tooth and nail, against even more desperate circumstances. They've grown afraid, like anxious little mice, of losing the little they've worked so hard to gain. All they want, and all they can imagine, is for their child to be free from the desperation that plagued them. And most inherit not only poverty from their parents, but the disabling fear that snufs out any youthful hope they might have had, keeping them poor.

But as the developed world is beginning to see, people at the bottom of the pyramid have potential beyond what is often ascribed to them. With the right resources and inspiration, humans are capable of fantastic dreams. Let's say that this particular child dared to dream of a world, for herself and others, not just a life without debilitating suffering, but one with fulfillment, joy, meaning, and freedom. She longs to make this vision a reality.

What stands in her way are a number of possible obstacles - access to education, getting fed and clothed, gender discrimination, disease, economic expectations from her family. But let's just say this girl has overcome these challenges by a combination of her efforts and a good bit of luck. She now has the resources at her disposal to carry out her dreams. But there is one last barricade that stands in her way, however, and it's quite possibly the darkest of them all because it's in her head. It's the lack of a sense of entitlement.

In order to survive, she's had to adapt like her parents and grandparents. Evolution is still alive and well in the psychological ability of survivors to accept realities they cannot change, which is the first step to adaptation. To some degree, she has had to accept the dire circumstances and pain she witnessed that she couldn't change. Children's natural joy and maleable minds prevent them from experiencing true desperation. To her, dying infants and battered women were part of her childhood reality. She feels a sense of injustice, but no outrage like the entitled Americans around her. She cannot be outraged at a world that was once her own, one that offered joy along with suffering. On top of this, having feared all their lives, her elders at first frowned upon, then outright forbode her to continue pursuing her vision. To them, this was frivolousness. How dare she risk her and their lives for a mirage? How could she stick her head in the clouds while her family was hungry?

So she's caught in this impossible tug-of-war - does she answer to the dream she holds in her heart, or does she play it safe and provide for the family that gave their own lives for her? She still sees a better world in her mind's eye, but she also lives with the world's flaws that she accepted early on. Without an unshakeable sense of entitlement, she wavers. She begins to believe that maybe it's ok to take progress one step at a time -- feed the children first, dreams later. So she backs away from her vision, generations of fear and heavy sighs blinding her once bright eyes like an illness, and the world is never changed.

What kills the potential of children in poverty, children of immigrants, and children from rough-and-tumble neighborhoods who didn't grow up with the same entitlements as the middle class American? What could have altered this picture?

Mentorship and resources. A child with larger-than-life aspirations needs a light beyond the desperate world she's always known. Knowing others who have succeeded in similar struggles gives her more confidence to defy her reality. It's also a resource that she can utilize, along with economic support, education, health care, and help with other problems in her daily life. If we begin to tell disadvantage children around the world that they are entitled to life and hope, and we help them and their families achieve at least these basic rights, we would see a lot more fantastical dreams becoming reality.

New directions

I'm currently pondering about some interesting cross-sections:

- Health care
- Traditional business (organizational management, business strategy, vision, profit model)
- Leadership studies
- People-oriented design processes
- Visual arts
- Web 2.0/technology
- Communication, rhetoric, and storytelling
- Creation/seeking of new knowledge through research

...and how in the world I'm going to make sense of all these connections.
For joy banishes the darkness
If you are so lucky to hold it
A fragile, warm little bird
Sitting calmly in your hands
Its small body radiant with a strange light

Do not cage it selfishly
It does not belong to you
You are merely blessed
Set it free, roaming
Let its song soar across
Its sapphire eyes see
Barren plains
Restless seas
Tired women
Hungry children

Open your hands
It will travel the globe
Without ever leaving your outstretched palms

Friday, April 17, 2009

Practicing for a vision

Practice makes perfect. This one is the quintessential mantra that is so cliche that it can't be anything but true. Athletes, musicians, chefs, artists, and students all practice to gain proficiency, and as anyone who's ever been on a sports team or taken music lessons knows, it's not always a pretty process. As a singer in a college choir, I've had this experience time and time again. Every Tuesday night for two hours, I sat in the basement of our music building for rehearsal. There was always some paper to be written or problem set to be solved, yet there I was, tackling some obscure bit of German music that our quirky Welsh conductor had chosen. The first read-through has all 50 of us stumbling through the notes, more in a mumble than song. "He's done it again," I would always think, "What the heck is this?!"

But the vision always magically appears. As the quarter progressed, I would become more and more familiar with the individual notes, transitions, cadenzas, movements. The uncertainty was slowly replaced by confidence, then anticipation, then feeling. Inevitably, a favorite movement or phrase would emerge and lodge itself in my brain. I would, whether I admit it or not, hum it silently myself when I return from rehearsal, go to class, shower. The music, which had so shortly ago been random black dots on a page, took on a kind of life and personality with familiarity.

The magic continues on performance night. Something about being in the spotlight, joined by the non-human voices of the orchestra, facing a dark, waiting audience lends a kind of anxious energy to the music. Standing there, I would be grateful that hours of rehearsal had made it no longer necessary to concentrate on the notes; my mind was free to soak up the energy and let it reverberate through my voice.

Again and again, from the stage of our university church where we performed our quarterly concerts, to the stages of the Great People's Hall and "The Egg" in Beijing, I saw this process happen quietly, organically, this magic that emerges from chaos and doubt into a coherent, expressive whole. And when it happens, its enormity never fails to surprise and delight.

In the arts, it's easy to see the relationship between practice and vision. Practice allows you to gain mastery over the details that clog the mind and hold you back from experiencing the work as a whole. Only when the proficiency part of performance becomes automatic can the brain begin to understand the bigger picture, tease out nuiances, to offer an interpretation. But my recent thoughts on leadership makes me think that leading is not unlike mastering an art form.

Both begin from the ground up, whether it's with musical notes or organizational details. The learning process is alternately nerve-wrecking and mind-numbing, but successful people learn to charge on beyond the immediate. And they don't stop there. What separates a good musician from a great one is not proficiency; the few great ones practice because they have visions they want to carry out, but they understand this cannot be done without absolute proficiency. On top of that, a great musician needs a flair for performance and drama to communicate her vision to the audience. Similarly, a successful leader needs both the details (knowledge, skills, experience) to ground them as well as a vision for grander things to come. She also needs to convince others to join her vision. It's this talent for contradiction and multiplicity that marks success, in the arts or in organizational leadership.

Thursday, April 16, 2009

Meaning of leadership

One thing that I'm grateful about my work is that I get to sit in on meetings where executives debate future directions of the hospital. These are people, many of them doctors and surgeons, who have had a lifetime of experience in patient care and organizational leadership, who are endlessly energetic and impossibly organized thinkers. This is the kind of conversation I thrive on, the kind about vision and change that makes the numbing data analysis somehow worthwhile.

Listening to our charismatic (if a bit irratic) CMIO try to convince others in the room of his vision for information security, my mind began to drift away from the conversation itself. Instead, I thought about what I've observed about his role as a leader. Other than his title, what makes his word so influential? How did he come to that title anyway? Did he come to influence by the wealth of his experience or the boldness and succesful outcome of his ideas? What is his primary function as a leader -- is it a manager of change, utilizer of people and skills, or a grand visionary?

Wednesday, March 4, 2009

The individual and the collective

Although not strictly a stickie "moment," this entry has been sitting on my desktop as an actual stickie for some time now. It was written on my commute home one day on a crowded caltrain, after a particularly interesting day at work. Being among strangers always seems to have its own inspirational power.

I always believed that multiple individuals operating as one (cultures, societies, businesses, economies) take on similar qualities as single individuals within that group. Take the recent credit meltdown on Wall Street, for example; even though individuals in the system, not only bank executives but also regular home owners and credit consumers, believed they were only taking a little bit of risk in the privacy of their own space. Yet these small risks began to add up and eventually caused the disaster that we're currently experiencing. Cultures work the same cumulative way, with individuals taking on the values of the collective.

This relationship between the individual and collective has always been part of my fascination -- my interest in cultural psychology (A reality -- How does the individual behave in a set cultural context? How does he/she negotiate a path between values inherited from the surrounding culture with his/her own observations and experiences? What if he/she experiences a contextual change?), the role of culture in medicine (A problem -- how cultural clashes between the individual and the collective can have dire consequences, in this case, ill health), and my own quest to find my own path between my two cultures and contexts (search for a personal solution).

But now I find that I'm discovering another part of the solution -- I'm beginning to see that it works the other way as well. Collectives shift with changes in individuals over time, if that shift is consistently in one direction. In other words, the one and the whole influence and reinforce each other, with neither ever being static. It is the magic to the never-ending complexity in both organizations (business) and individuals (psychology). After only three months on the job, I'm discovering that the new tools or tricks of the consulting trade that I'm learning are not only useful in producing success in a business, i.e. collective, organizational, sense, but they can be easily applied to bring about more personal efficacy as well. By observing and emulating successful organizations, one can discover lessons for living a fulfilling, purposeful, and principled life.

More specifically, I was seeking in this foreign profession experiences such as team work, negotiation with a win-win mentality (firmly standing one's ground but still being flexible in considering the other's perspective), conflict resolution, and even technical skills such as Excel, Word, Powerpoint, and computer programming. But little did I think I'd find more than just application of these skills in a professional context. The uses of Excel to manage due data across a variety of dimensions, for example, can be applied to project management as well as personal budgeting or managing contacts. PowerPoints aren't just "consultant-speak" -- when used aptly, they can attest to the power of visual communication in any context. Learning to deal with difficult individuals is useful whether you're with clients or with friends and family. Thinking like a programmer flexes your analytical brain, helping you understand technology as well as just about anything that has to do with logic. Being able to map an abstract problem, quickly identify its root causes, and operationize its possible solutions not only makes you a great consultant, it also provides you with the creativity in solving everyday issues. Being an effective manager of people allows your professional team to maximize its productivity and satisfaction, but also allows you to handle your personal relationships with more ease.

Business, I'm finding, is after all about the organization of people to accomplish a goal with the lowest cost and highest efficiency possible. Aren't we, as individual human beings, constantly looking for the same end? People constantly assess the value of their life by imagining what they would like to have accomplished when they're lying on their death beds. No matter what it is, we all want to leave a legacy in this world, something that stays behind externally when we're gone. Now I'm not attempting to box in what can be considered "accomplishment" -- this can range from saving dying African AIDS patients to raising a child successfully. Regardless, these are still things to accomplish, which implies that there is a process, or logical steps, one must take to achieve these ends, and some processes will be necessarily better than others. Hence application of business lessons to daily life.

At the same time, the best way for an organization to get its individuals to move in the same direction is by getting their "buy-in," or providing them motivation and a sense of meaning through their work. Even though in this case the group is bigger than its individual parts, each part still needs to be fully engaged and moving in the same direction to produce any kind of meaninful change. Similarly, we too, as individuals, seek purpose in what we spend our time doing. Again, the goals of the collective and individual align in this case.

Saturday, February 28, 2009

Jazz and the butterfly effect

I must confess that I've never understood jazz music. It's beautiful, sure, and I'm never someone who refuses to appreciate something just because I don't peronsally understand it. What we consider legitimate art today, for example, poses more and more questions about its accessibility and therefore relevancy. Contemporary "legitimate" art has increasingly trended towards the high brow and obscurely intellectual. Ever since Marcel Du Champ stuck a urinal on a pedistal and called it a fountain, the artistic establishment has been pushing us (the common class), often uncomfortably so, beyond the boundaries of our aesthetic sense and what art ought to be. I, for one, would stand up for contemporary art precisely because of its power to question. But when I stand before something especially puzzling or personally meaningless, even I find myself questioning its right to exist. But even then, even then, I'm usually able to leave behind my questions of purpose and fall back on an innate curiosity that makes the experience of the piece more about possibility rather than certainty.

But there was always something about my lack of a structured understanding of jazz that bothered me. I felt like it wasn't enough to just appreciate and experience jazz. I needed to know how this kind of music was made, the purpose for which it was made, two crucial components to reaching a higher appreciation of jazz that remained frustratingly inaccessible to me.

These were the thoughts that were in my mind when I first sat down at Yoshi's in San Francisco tonight. And as is the case whenever I listen to jazz, I also thought about two jazz pianists I knew in college. When they played, especially during those 3am nights in the dorm where I was their only audience, I would feel simultaneously haunted and captivated. These two people came from very different paths. One is a Japanese-Italian who was born and raised in Texas, and had such thorough training that it spoke for itself when he set his fingers down to play the first few chords. The other is an Arabian (some sort of royal, I suspect) with an untamed head of tight curls who stumbled upon the piano and had almost no training whatsoever. But they had something in common - when they played, there was a rawness about the sounds they produced that made you feel like you were somehow directly interacting with them without needing contact or words. I also remember being drawn to their almost mystical energy, a deep sense of wonder that they always seemed to exude, and a tolerance for uncertainty that was refreshing in our elite institution where we were constantly pushed to pursue clarity. Somehow, I thought, if I understood their music better, I would be able to tap into that energy that was so irresistable about them. But the more I continued to search for that answer, the more frustrated I got with not finding it.

I was thinking about them as I sat at Yoshi's tonight and pondered their vastly different paths (one had gone on to pursue her music in ways some would consider eccentric, others odd, and the other one killed himself in a tragic railway incident). Meanwhile, on stage, the pianist had switched the trio from a frantic tune to something more mellow, more resounding of the natural sounds of rain and animal steps and owls in a dark forest. But even in this peace, there was still constant movement. I felt the familiar frustration of still not being able to anticipate where his chord progressions were going; I could only desperately hold on to the underlying rhythm, itself shifting and barely audiable beneath the erratic notes, by lightly bobbing my head to it. Normally, I would attribute this to my lack of understanding of jazz and music theory, and my ignorance would infuriate me. But tonight, together with the memory of my two friends, it all made sense.

The butterfly effect has recently become a popular concept (partly thanks to, or in spite of, a movie of this title starring Ashton Kutcher). It has been employed to explain everything from weather patterns to complex phenomena in math and physics. The theory states, very simply, that one small change (a butterfly flapping its wings in, say, the rainforests of Brazil) can initiate a chain of events that leads to a devastating hurricane on the Gulf coast. This means that in our quest to perfectly know and predict our environment, unless we can account for every last atom, completely comprehend its pattern of movement infinitely into the future, and understand how it will be impacted by every other atom that surrounds it, we will become very wrong, very fast. It's why weather predictions are never very accurate beyond a few days, and stock markets rise and fall contrary to our best estimates (too soon?). There are simply too many factors and relationships to take into account. But in spite of the erratic appearance of these events, some have proposed that in the long run, meta-patterns do emerge; we're just too microscopic to observe them clearly. For example, while we've never been able to predict the exact dates of major recessions, they have occurred in roughly 20-year cycles since the beginning of the last century. Ultimately, things return themselves towards an equilibrium, even exhibit a general pattern in doing so, but we just fail miserably at predicting the minute-to-minute specifics of these patterns.

So we're left stuck between the possibility for prediction, and thus control, and a deep resignation that we'll never be able to get it perfectly right. Somewhere along the way, someone must have figured out that not only do the physical components of our environment reflect the butterfly effect at play, but indeed, our own lives reflect the same. A professor of mine, who received a MacArthur "genius" award for his work with baboons and stress, argues that stress, to higher-order animals with self-awareness like baboons and humans, is the struggle they have against factors in their external environment in order to gain the control that is crucial to their well-being. In the field of psychology, stress is defined as our physical and emotional response to "stressors" (I've always loved this circular definition), or things that throw us off balance. Even in my own life, when I think about it carefully enough, stress most often manifests itself as a feeling of losing control, whereas I've felt the best when I sensed everything was in its rightful place.

How do we achieve this sense of well-being? We think, analyze, reason, justify, and plan. The process of logical analysis, when it's boiled down, is really to take into account as many factors as we can, understand their interactions, and arrive at an end state that we think has the highest likelihood of occurring. We do this (essentially predicting the future) in order to influence the future to the outcome we desire. Being able to do so gives us a sense of control; failing to do so makes us feel like we're losing control and stressed out. Our lives, in one sense, is a constant pursuit of perfect knowledge and a feeling of being in the driver's seat. We love it when we're "on top of our game," when we've "got it covered," and when things are "falling into place."

In fact, we love it so much that we perhaps forget how, according to the butterfly effect, we can never truly be on top of it. No matter how much we analyze our lives and make our decisions based on logical thought, we can't turn out right all the time. Thus enter the uncertainties, the ups and downs, the grey areas, the tough decisions that stress us out and drive us in hordes to Hawaiian vacations and therapists' chairs. We're being blind to the fact that beyond a certain equilibrium point, the more things we try to tame, the more they go out of wack; the more we try to retain control, the more we're likely to lose it.

How Zen of you, you must be thinking at this point. No, I'm not talking about becoming a Zen master or a buddhist monk to restore your sense of equilibrium and achieve balance. I'm talking about jazz. As a form of music that evolved from both classical and African folk music, jazz was in a way a reaction against the rules and theories that governed tradition (much like postmodern and contemporary art - see earlier in this entry). As such, it rejected a world view that things can be neatly categorized and explained by definable principles. The musicians on stage, and my two friends, get this. Listening to the erratic ebbs and flows of the music (which probably had some components of improv that the musicians themselves didn't even understand), all the while searching for that underlying steadiness, I realized I was listening to a world view being communicated in music. In this act of listening, I was also enacting a microscopic version of living, struggling to search for some consistent pattern in a confusing blur of random events, all the while trying to make peace with the fact that I can never get it exactly right. Suddenly, it didn't matter that I didn't know the makeup of the jazz chord, or why he was playing two notes that jarred against each other in classical theory. All that mattered was that it was...there, and it spoke a kind of truth.

Friday, February 27, 2009

When moments are stickie...

I'm sitting at Yoshi's in San Francisco. It's dark and warm; soft beams of light scattered throughout the room fall on small bar tables and silouettes seated around them. My tea is getting cold, the plate of sweets half eaten. Instead, I'm mesmorized by the hands of the bass guitarist on stage. They're not just strumming or plucking, but literally flying on and off the strings in a blurry rush, his fingers hitting, slapping, pounding them with a fanatic energy. Attacked by this madness, his guitar becomes a percussion instrument that produces a sound I've never heard before. In this moment, I disappear -- just utterly melt into the blurry dark warmth...and the sound. For this one moment, this is all there was. It's a moment that makes you realize that something as basic as a sound repeated in a pattern can shake you to the core, like when you suddenly glimpse the bay as you're coming over one of San Francisco's hilly streets, or catch the eyes of a stranger on the street and a million possibilities flash before your eyes, or realize that you've fallen in love without knowing it. And most of all, you realize that you're sharing this moment with every single person in the room, who is sharing it with every other person across the boundaries of time and distance. It doesn't matter that this beat comes from a tradition, philosophy, and way of life entirely different from my own. In this moment, something in me vibrates to the same frequency as the frantic sounds coming from guitar strings.

Then the moment passes, as hurriedly as it washed over me. It leaves behind ripples, to be sure, but I feel these also fading fast. What to do, then, with these earth-shattering moments that sometimes last only a few seconds? How do we hold on to the flittering moments that define us more than the long stretches of time in between, those that hold our lives together?

I look down into my bag, and there is my solution.

We all know and love these (in secret, if not professed publically) -- they come in seemingly endless packets, are a delightful (and trademarked) canary yellow, and are the perfect size to scribble down just about anything on, from one-line self-reminders to words of pure inspiration.

They're stickie notes.

There I see them, a packet of ordinary post-it stickie notes, its light color somehow more inviting than the spotless white of stationary that we're used to, and its small size more forgiving of the imperfection that too often gets brushed aside by lengthy and careful thought. I quickly grab one and scramble to put down a few clumsy words. It doesn't matter if I get it perfectly right; I will never be able to. But there's a freedom in this knowledge, as well as the simple act of the attempt. Stickie notes are how I'm to hold on to this experience, and to similar ones from now on. I will grow these as a body of evidence that attest to moments that move me, to my having the capacity to be moved. This blog, then, will record the "stickie moments" that would otherwise slip through the cracks of a mind too accustomed to expectations of logic and pragmatism.