Book Review: ‘The Checklist Manifesto’ by Atul Gawande

The Checklist Manifesto How to Get Things Right by Atul Gawande

My rating: 5 of 5 stars


What if you heard, one day, of a simple and straightforward ‘secret’ that could halve your chances of complications after surgery, dramatically improve air travel safety even if disaster struck, and after all that make sure your order in a swanky restaurant was brought faultlessly to your table?

You’d want to be in on it, wouldn’t you?

Until, perhaps, you found out the nature of this ‘secret’.

It is no more nor less than a straightforward checklist: a written-down list of essential steps in any process – steps which may, in the heat of emergency or the lethargy of long hours, otherwise be inadvertently skipped.

Simple, right?

Er – no. Things can go horribly wrong – and in this case they did!

Who begins the process of reeling-off the items to be checked? How, if they’re not the Boss, do they command the attention of everybody present? And what effect does all this have upon the said Boss’s authority? The checklist in the workplace, we discover, has a social element as well as the obvious physical one.

In his quest for the perfect, universal checklist for surgical operations, Gawande and his team from the World Health Organisation draw from the expertise of everyone from nurses in rural Tanzanian hospitals struggling with unreliable supplies of the very basics, to Chesley Sullenberger.

But doesn’t the sheer simplicity and mundanity – banality even – of a checklist reduce every job to a mechanical routine? And make of every working person, no matter how knowledgeable or prestigious, a mindless drone? This was the wall Atul Gawande and his researchers came up against, when putting their findings to surgeons and doctors all over the world. How they overcame this, and achieved the results they did, is the best and most fascinating part of the tale.

The Checklist Manifesto is, above all, a story of human progress. It is sympathetically and enthusiastically told – parts of it read like a novel of suspense, complete with exotic locations and personality clashes. Though written ten years ago now, it has something to say to all of us.

Put it on your checklist of ‘things to read’!




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Book Review: ‘Science and Secularism’ by Dan Dana

Science and Secularism by Dan Dana

My rating: 4 of 5 stars


‘Science and Secularism’ is a journey, described three times and in three ways.

It starts with a brief life story – how the author got to the beliefs he holds now. Next come the Haiku sets, evoking his wonder at natural phenomena – a wonder which, he argues here, needs no additional thought of a ‘creator’ of any kind.

The final section sets out the most typical argument in favour of atheism: that there is no measurable evidence for a ‘creator’, nor any logical explanation of how such a thing could exist.


The opening section, with its description of the revelations about different religions, about merging into broader and broader ‘families’ of faith, is a nice sequence – representing literally a broadening of the mind.

The logic is sound: with so many religions, which in some places contradict each other but each of whose followers believe is the ‘right’ religion, which one is right? And whichever it is, the others, if they’re different, must have something wrong with them.

It is rather spoiled by an ambiguity in the third paragraph, near the beginning, in which the sentence structure implies that the adults in the culture to which he was born – or possibly adults in most cultures – had no understanding of Science. Also, to be honest, I wondered how one can breach a moat.

By taking the “there’s a huge variety of religions among people, leading to inevitable contradictions and thus the question of which one is correct” line of argument against religion as truth rather than the more traditional “There is no direct evidence of God” line, the author has also indirectly tackled the “yes but there’s no direct measurement of ‘love’ either – only of the effect it has upon people” counter-argument to the latter. After all, unlike with any ‘God’, all human beings are in agreement about what ‘love’ is, and what it does.

So: is Atheism a faith? The argument posed here is that it is not, because with no direct evidence for any god(s), it’s the most reasonable thing to believe.

The haiku sets are in two sections: Secular, and Science.

Among the Secularism Haiku (sets 1 – 10) I most appreciated the second, with its joke about ‘Not collecting foreign stamps’ bordering on the Zen. Does ‘nothing’ – i.e. the lack of things – have an existence all of its own?

The Science Haiku (sets 11 – 27) evoke the ‘sense of wonder’ the non-religious feel, without the need to invoke a ‘creating power’ of which to be in awe. Even after more than half a century of fascination with astronomy and cosmology some of us, myself included, still feel like “a wide-eyed passenger hurtling through spacetime.”

I loved the wry humour of “this haiku’s not infinite – I’ve reached the edge now.”
The penultimate haiku, in praise of water, which exists in a tiny range of temperatures and makes life possible, included a nice metaphor – Mars’ skeleton key – while the final haiku sets out our stark existential choice.

The Haiku sets are followed by the final section, dedicated to debunking Creationism, the angle taken being that Pandeism (the belief that a creator, having created everything, now becomes the things they have created and so is no longer directly detectable). This has in common with the more conventional religions, the question “where did that creator come from?” The hypothesis of non-linear time is an interesting one – that there was literally no time before the act of creation, in much the same way that you can’t travel further north than the North Pole.

My problem with this final section is that it suffers from the same shortcoming as Dawkins’ ‘The Greatest Show on Earth’, namely the desire to invoke in the reader awe of what there is in nature, while at the same time taking meticulous care to avoid any spiritual angle, religious or otherwise. This puts a severe limit on the imagery and metaphor, and neglects the observer/writer’s relationship with the world being described – and all good writing is, in one way or another, about relationships.

For an idea of what’s missing, Rachel Carson’s ‘The Sea Around Us’, for example, while a scientific and factual description of the world of the oceans, maintains a sense of beauty and awe in the reader by endowing the world described with a certain mystery – as if to say, here is what we know, but also here is our place in it; here is what we have in common with it; and finally an implication that there is always more out there that we have yet to understand. None of this can be done, it strikes me, if one adheres too strictly to the ‘material’ outlook at the expense of all else.
The narrative then turns to Supernaturalism – the mystical belief that entities exist beyond empirically observable reality, outside the laws of nature, specifically the Standard Model of particle physics. The coverage of recent advances in cosmology and other sciences is wide-ranging and thought-provoking, but to me, referring to some phenomena as ‘supernatural’ simply begs the question of what lies outside the standard model but is yet to be explained by a better scientific model.

To those who, like me, have not grown up in a religious milieu, and who’ve not had to ‘escape’ from a religious upbringing, this final section seems a bit of a sledgehammer to crack a nut.
However, the Haiku sets and philosophical sections together would make a thoughtful gift for friends who are wrestling with the contradictions between alternative world views – religious and non-religious. Or indeed with the many contradictions between and within religions.




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