Posted by: knightbird | October 26, 2010

The New Normal

It’s hard to believe that the syndicated Doonesbury is 40 years old. Started in 1970 by Garry Trudeau while he was a Junior at Yale during the height of the Viet Nam war, the strip has been a part of all of my adult life. Joanie Caucus entered law school when I started my Senior year at College, and graduated from law school one year before I did. I read Walden while the cast was living in Walden. I have lots of great memories of Doonesbury.

While being interviewed on NPR, Mr. Trudeau talked about BD’s loss of his leg during the war in Iraq in 2004. When BD lost his leg, he also lost his ubiquitous headgear (which changed as BD changed from football player to soldier). Mr. Trudeau said this about the moment:

“Many found it moving to see his graying, matted, sweaty hair revealed for the first time,” Trudeau explains. “It conveyed a kind of vulnerability. It sent the message that for him, life would never be quite the same. That he had to struggle to move into the life of a wounded warrior and find out what that new normal looked like.”

Mr. Trudeau’s statement about “The New Normal” made me think. What is Normal? And what is a New Normal? In researching what “The New Normal” is, a few commentators said that “The New Normal” is change. Meryl Streep is quoted from a commencement speech at Barnard saying: “There’s no normal. There’s only change, and resistance to it, and then more change.” [i]

Change is a subject I have written about. It’s hard to achieve, but necessary. As Charles Darwin said “It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change.”

Normal in  the typical workplace, in my mind, is controlled chaos. Employees work hard to ensure that their job gets done. They will invent workarounds, form alliances, beg, cajole and get angry in order to accomplish their task. They will hide mistakes, deflect blame off to other employees and at times will lie to avoid the punishment they think is coming. When their efforts fail, Managers will step in to rescue the situation by requiring the change they believe should happen (fighting fires). If they think the employee is not doing enough, they terminate the employee. They will bring in consultants that have successfully tackled similar problems, adopt their solution, then require employees to implement it.

In contrast, the New Normal in health care management is, in my opinion (in case you haven’t noticed) Lean Healthcare. However, there are many who are heavily invested in the current healthcare system, and they are very resistant to the change coming. What will it take to recognize the New Normal in healthcare management? For BD, his New Normal was introduced through the loss of his leg. In healthcare, at least for the Anesthesiologists I wrote about yesterday, their New Normal was introduced by the incredible losses of life under their watch. When they stopped protecting the status quo, began working together, with data, the Anesthesiologists created their New Normal, and we benefitted from it.

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