CCSVI – A Case Study in the Making

Some of you reading this know that I have Multiple Sclerosis. I’m pretty lucky with it, and after 10 years since my diagnosis I’m hardly any worse for wear.

I’ve been watching with a great personal interest, of course, the development/discovery of a “liberation procedure” to address Chronic Cerebrospinal Venous Insufficiency (CCSVI). It’s posited that people with MS may have restricted veins slowing the flow of blood out of the brain. In theory this could cause problems with increased cranial pressure and iron deposits in the brain. This is pretty exciting news and has offered more hope for MS sufferers than other potential treatments in the last few years. It’s also a completely different paradigm than what has conventionally defined MS.

This makes for a fascinating study in how different people react to the introduction of a fundamentally different paradigm. I would assume this idea will eventually be proven or disproven, but for now it offers a potential new way of thinking about Multiple Sclerosis and a different approach to treating, or even curing, this chronic illness. It is a game-changer or a significant derailment of the “real” efforts. How are people reacting? How should they react?

There are plenty of MS sufferers who want to start doing treatments immediately. I can’t say that I blame them. While some are actually advocating for the complete and unqualified acceptance of the theory and treatment, I think they’re in the minority. Most advocates for “rushing” the procedure simply want to act now and measure as we go. They argue for a “learn by doing” approach. As their quality of life is slipping away with every day and this relatively safe procedure may offer stark, life-changing results, they don’t have the patience for the studies that would 100% confirm or refute this theory.

There are also individuals and organizations that are calling for research and confirmation of this theory before the procedure is offered to the general population of sufferers. This would be the position of our federal government and the MS Society. This one doesn’t make quite as much sense to me, and I would like to understand it. What are the possible reasons to advocate restraint?

It draws attention from our long-term efforts

There are a lot of thoughtful people working on solving the MS riddle. They’re organized, they’re relatively well funded and they are seeing results. The availability of drugs that offer real improvements have proliferated in recent years. Having MS has a different, much better prognosis than it did when I got diagnosed. We seem well on our way to killing this thing by a thousand cuts. In fact, it seems to be just a matter of time.

Time. That’s a bit of a problem for many sufferers. Rarely – if ever – does this illness get better with age. While I’m all for researching the illness and improving our understanding, this argument doesn’t hold water for me when there’s a very promising theory that isn’t getting enough of the pie. Perhaps we can call this reluctance a “fixed cost affinity.” If you’re a bureaucrat or a politician, I think it’s a lot safer and blameless to say, “We devoted our resources to the 10 year-project that’s got millions sunk in to it. The investment ultimately didn’t pay out, but it was a smart investment” than to say, “We went with the unfounded vein theory from left field.”

It costs money and creates risk for what may turn out to be nothing.

My guess is that this argument is at the foundation of most efforts to minimize the wide-spread application of the CCSVI liberation procedure. It’s an argument that says we shouldn’t put people through this when we’re not sure it will work. Let’s spare them the hassle until we can assure them it’s good for them. I appreciate the inherent protectiveness of the position, but what if it turns out to do something profound? Was the caution and delay worth the additional suffering? If you look at the “costs” of this diagnosis and procedure, you’re looking at a set of imaging scans and a procedure similar to an angioplasty. Let’s say it’s as risky as liposuction. How much study went into that? Now factor in the fact that as we delay, people are losing their ability to walk. The math doesn’t seem to add up.

Besides, because it`s surgical, isn’t the line between trial and delivery a bit more blurred? I can see that we need to use caution when we`re experimenting with a drug with unknown side-effects, but with this procedure the surgical risk is clear, and it`s really minimal.

The science doesn’t make any sense

This is the weakest of arguments. History is filled with paradigm-shifting discoveries that didn’t make any sense. Just because it wasn’t thought of before has no bearing on it’s applicability. There seems to be some ongoing presumption that if it isn’t the model you discuss with your colleagues or the one your professor told you about, it can’t be right.  That’s not how it works. Challenges to the status quo, be it the shape of the earth or the science of multiple sclerosis, should be met with opennes and humility. We’d grow more. To say we should proceed with caution because this isn’t how we were thinking is ludicrous. That’s dragging your feet because it makes you uncomfortable. If there’s an off chance this works for MS sufferers, I`d rather take care of their discomfort and let the discomfort of admitting you didn’t see it sit for a bit.

I don’t think I’m hiding the conclusion I’ve drawn so far. I think the people that fight change or even the spectre of change are keeping us from being effective on this one. New factors are now present in this environment. Trying to sustain the old environment is entirely unhelpful.

I’ve spent the last two weeks shuffling around my house in a fog suffering from an MS relapse myself. I am so fortunate to have a case of MS that has proven to be very mild compared to so many of my contemporaries. I sometimes find it hard to want more and better for myself when I’m doing comparatively well. Nevertheless, my quality of life diminishes when this illness gets a grip, and when I beat it back, life gets much better (and I start blogging again). If I get the opportunity, I’ll take the liberation treatment.

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22

06 2010

The 90 Degree Rotation

Sometimes we can’t solve a problem because we’re too close to it. We work it so much that the prescribed boundaries of the problem become untouchable. What was originally established as an assumption becomes a given.

That’s dangerous thinking that we can all get caught in. Creating a deliberate practice of stepping out of that “can’t see the forest for the trees” mindset is important for our success.

You can do it in a number of ways. The list I come up with is by no means exhaustive:

  • Invite in some fresh perspective. Someone who is not familiar with the problem won’t have accepted the same restrictions as you.
  • Take a break and do something else. Take a walk, do a puzzle or listen to some music. Give you brain a breather, and a broader perspective.
  • Engage in something completely unrelated and connect it back to the problem.  How are the essential factors in growing a good wheat crop similar to your challenge? Name ten things that are green and describe how they relate to the challenge.
  • Picture your problem from above. Review it from a helicopter. Look different?
  • Redefine the timeline. What does it look like five years out? Changing the timeline can remove some barriers.

There’s another practice that I wanted to explore a little more. That’s a technique I sort of intuitively do that I’m calling the 90 degree rotation, though it’s probably more appropriately entitled “Turn it upside down.” It goes like this: take your problem and any sort of organization, hierarchies or linear processes that are part of it. Try and describe your challenge from a direction different than how you’ve been thinking about it.

Trying to complete a work process through a traditional hierarchy? What if the responsibility was given to a cross-functional team?

Trying to spread a message? What if it wasn’t through mass media, but spread through individual followers?

Coordinating a large group through rules and expectations? What happens if they’re given the outcomes they have to achieve and left to their own leadership and organization?

I don’t think my effort to name and systematize this concept has worked, but I needed to share it anyway. It’s the incorporation of a foreign (near opposite) perspective so that the givens can be laid bare. Should they really be off the table, or are they just off YOUR table?

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16

06 2010

Strategic Thinking vs. Being Strategic

Thinking strategically vs. being strategic. There’s a difference. In fact, the more you delve into it, the more they look like they might be opposites.

As a strategic thinker, you’re pretty good at nuances, reading the tea leaves and coming up with solutions that negotiate all the pitfalls. You can see what needs to happen to get things done and dispatch problems with efficiency. Strategic thinkers are intelligent, perhaps even crafty. They can think a move ahead of their opposition. I like strategic thinkers. They see issues with clarity and get closer to root causes. They think up solutions that are more sustainable and more effective. Not every strategic thinker, however, uses their knowledge for the best possible results.

Strategic thinkers don’t necessarily take the steps required to move the intiative towards the best solution. That’s not the assignment. Strategic thinkers can guarantee you efficiency and smart maneuvering within the prescribed rules of the game. It seems that sometimes strategic thinkers see what doesn’t work, but they determine that the cost of change is too great compared to the benefit of the improvement. If it’s the wrong game or if the process doesn’t create the results it used to, a strategic thinker that doesn’t want to bear the possible pain that comes with change might be the one thing holding a flawed structure together. That is short-sighted and unhelpful. 

There’s a different level to strategy, the level where you know the rules of the game are wrong and profound results will only be achieved only if the rules are broken. If you see those deeper problems, congratulations. You’ve done an exceptional job of thinking strategically. As a next step, if you act on your knowledge to improve the game, the rules or the system, in my books you’ve moved from thinking strategically to being strategic.

If you want action outside the prescribed rules, you should seek out someone who is willing to be strategic. More important than knowing some crafty next steps, you need the person who will combine altruism with a sense of the long-term to deliver action that serves best interests, not assignments.

Are they opposites? Maybe the strategic thinker and the strategic doer, but a strategic thinker that doesn’t want to take pursue change is a dangerous enemy. They can be a formidable opponent of your efforts to change. If it weren’t for change-averse smart people, I think we’d move a lot more quickly.

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A Service for his Tribe

With brilliant simplicity, Seth Godin has offered an opportunity for his readers to connect with others in their area.

Here’s his post, but don’t click away just yet. I want to impress upon you how smart I think this is.

Presumably, Seth Godin’s readers are everywhere.  One of the problems, however, is that the ideas and concepts he’s sharing create short-term discomfort when you practice them. Being a Linchpin or leading a Tribe (his two most recent books) require you to buck convention, speak truth to power and stand up for change. In my experience, the large majority of people in your off-line world are going to react negatively to this behaviour. The ones that agree with you are hard to find and you can’t identify them. If only we had special hats or t-shirts. 

I humbly suggest that Regina, Saskatchewan, my location, is worse off than most. We’re a government town in a resource-based province. A new reality hasn’t really hit here yet.

Seth Godin just put his hand out to me. He said, “I know it’s hard. You’re not alone.” For one glorious evening, I’ll be able to see the people in Regina that are having a similar experience. If you’re in Regina and buy this stuff, I hope to see you there.

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25

05 2010

Working Without…

 

There’s a certain boost of adrenaline that comes with the phrase, “working without a net.” When the trapeze artist performs without a net, there is no backup if the performer fails. The show gets better for the audience. People straighten up in their seats. The tension goes up. Breath is baited.

There’s the work equivalent, too. It’s working without deniability. What if there’s no fallback if your plan fails? If the initiative doesn’t make your numbers? What if ultimate responsibility lies with you and only you. That would be disastrous, wouldn’t it? Enter deniability, the practice of getting prior approval, consent or direction from someone else. This safety harness allows you to undertake initiatives without fear of reprisal. You’ve got all the CYA you need, so go forth and give it a shot. If it doesn’t work, that’s OK. You were following directions.

Deniability, however, really eats into your ability to create the kinds of change we need. Solutions that would really provide the kind of transformational thinking we need. The process of seeking deniability requires that you first anticipate the interests of the approver and mitigate the scary parts of the initiative by rounding the corners. Essentially, you propose something that’s got the scary parts removed to make it more palatable. The consequences of not doing the scary parts are where the real disastrous consequences sit. Not doing the thoughtful, scary parts is a subtle way of supporting the old model… the one you’re trying to change.

The alternative is to work without deniability, which is to say you would take initiative you think serves interests without checking for the go-ahead, first.

Do you need deniability? Is it all that important? If you fail, do you land in the middle ring of the big top, never to get up? Unlikely. Instead, you sheepishly admit your mistake, you get some amazing life experience and, as an added bonus, the people who really matter take note of the fact that you’re willing and able to work in an environment without deniability.

There’s an excellent audio lecture available right now. So excellent, in fact, I can’t believe it’s free. Seth Godin shares the main concepts of his latest book, Linchpin in a highly engaging presentation. He’s not actually talking about his book, though.  He’s providing advice about work and life that is spot on, relevant and very accessible.  Naturally, it inspired this post. By all means, read the book, but here’s an easy way to get your head around the concepts. Enjoy!

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30

04 2010

Seeking Depth

The Internet is such a firehose. The information comes fast. The marketing comes fast. The new ideas, the new products, the next thing… fast, fast, fast.

I find myself getting pretty frustrated with the skimming it induces. A full night of superficial snippets can leave me with a lot of trivia and nothing of substance. I find it more important than ever to make sure I pull away from the bells and whistles every once in a while and actually go deep, immersing myself in something that engages my brain.  Deliberately exploring a topic to a new level of understanding makes a lot more meaning for me than the skim.

In fact, if we were to collect all the things we hear and see each day and somehow conduct an audit to figure out what actually made it into our brain, we’d realize we can do without a lot of the barrage that occupies us.

So, why do we often choose to consume so much at a superficial level? I think it’s because choosing to actively ignore information that’s coming at you is like the problem with not buying a  lottery ticket. How can you possibly not buy a ticket? This may be THE ONE.  What if this ticket is the one that makes you rich? What if that next phone call is the President? What if the next big Internet sensation needs my investment immediately? What if a once in a lifetime announcement is just around the corner? All that hope, all those what-ifs… they cause a lot of attention to be directed to areas that rarely, if ever, have a payoff.

Here’s why some can do without lottery tickets: They get the math. They understand that one in 14,000,000 means you’ll typically spend $14,000,000 on tickets before you hit THE ONE. There’s an equivalent logic for understanding the information barrage, too. It may be less tangible, but intuitively, we know it’s there. If you step away from the constant flow and deliberately pursue and immerse yourself in what you want to see, you get more, you learn more. It’s more relevant. It’s more applicable to your life because you have selected, not received.

We’re now in a world where it’s easier for each of us to be our own program director. There’s unlimited information. It’s accessible at the click of a button. It comes on our time and on our terms.

It’s time to break an old habit – technology now allows you near complete control of the firehose. Don’t let others choose the messages for you.

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26

04 2010

How to Generate an Epiphany

The myth of epiphanies is that they strike you when you’re not expecting it.  You’re sitting in your bathtub and suddenly you shout “Eureka!” because you’ve realized that water displacement can measure volume.

Well, OK. I think that one actually did happen.

I don’t think that’s always the case.

Often, epiphanies come from a systematic effort to think about a problem differently. I propose that the key is actually that you open your mind to approach the problem from different angles. You have to deliberately steer your mind to make wander or make connections between seemingly unrelated concepts.

The reason epiphanies sometimes happen when you’re not trying to solve the problem is that we allow our minds out of the restrictions we were imposing on it. That doesn’t have to be by accident.

In 1990, Frank Lynn Meshberger, M.D., saw that Michelangelo’s “Creation of Adam” on the Sistine Chapel was actually a side profile of the human brain. The fact had been overlooked for centuries. I remeber hearing this back in the day, and it has always stuck with me. I find it pretty cool, not because of what Michelangelo did (it’s debated), but that Dr. Meshberger saw what so many others had not.

He had been in medical school at the time and happened to look at picture of the fresco shortly after dissecting and drawing a human brain – here’s the story.

That discovery, I would suggest, was a very happy coincidence (if you indeed believe Michelangelo was drawing a human brain). Regardless, this kind of a discovery offers a glimpse, into how we can synthesize and find solutions.  Sometimes, problem-solving comes when we add in lots of influences, not when we buckle down and “work the problem.”

If you’re stuck or things aren’t coming together, it might be time to pick up a book, look through the funny pages or listen to a symphony. You might need to invite in some other opinions, or draw the problem as a picture, or write a short story about it.

Putting in some extra hours at the office is likely counter-productive.

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23

04 2010

Post-Olympic Dissonance

It appears I had a different sort of experience than many of my friends and colleagues through the Vancouver Olympics.

I enjoyed the competition, I definitely enjoyed the stories of triumph and tragedy, but I’m not left feeling I’m better off after I had this intense blitz of melodramatic reality broadcast to me.

I keep hearing that the Olympics are a treasured experience for my fellow Canadians. That the gold medal count, the hockey victory and the splendid performance of the City of Vancouver were a fantastic, even memorable experience for them.

I’m sitting here wondering how the Olympic viewing experience is anything more than a brief break from reality. Cynical, no?

Like many of us, I’ve given in to the allure of a large bag of  potato chips in just one sitting, or a second bowl of ice cream when one would suffice. I’ve honked my horn or shook an angry fist at a fellow driver and I’ve said something hurtful to a friend so that I’d feel better. All of these actions share a common thread – they offer a respite from my own hurt or sadness. They give reprieve, just for a moment.

After each of these events, I think you’re quite likely going to experience a hard landing back to reality. Those reprieves don’t last forever, and when they end, you’re actually a step back from where you started.

I’m trying not to make a negative post here, and I know I’m failing. I’m trying to say that “vacations” from reality don’t help us, they momentarily sidetrack us. They trick us into sitting on the couch for two weeks or gaining weight instead of losing. They withdraw deposits from the emotional bank account or they coax us into engaging with a road-rager in a no-win situation.

One of the things I’m personally working on is not wasting time in front of the TV. If I am in front of it, it’s programming I’ve carefully selected with the commercials removed.

My clear-headed, relentless pursuit of this objective was sidetracked by the Olympics. I sat in front of the TV indiscriminately. I didn’t know what was coming next. There was lots of interesting stuff, but I also watched uninteresting, unfulfilling blather and watched more commercials in that two week period than I do in an entire year. Those two weeks of excessive couch potato-ing were a backslide.

Damn you, Olympics and your heartwarming stories.

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21

03 2010

The Jungle Analogy

In the 7 Habits of Highly Effective People, Dr. Stephen Covey illustrates the role of a leader with the Jungle Analogy.  He talks about a group, an organization, committed to swathing a path through the jungle.  In this organization, he identifies three roles – the machete-wielding worker, the manager and the leader.

While the worker is cutting down the undergrowth, the manager is behind the action making sure the worker is well supported – sharpening machetes, providing training, nutrition, strength building, you could even imagine this manager providing supportive words of encouragement… “Great slash! A couple more like that and you’ll be up for hacker of the year!”

The leader is perched atop a tall tree ensuring direction, and if necessary, yelling “Wrong jungle!”

The lesson Dr. Covey is conveying is about the importance of having someone that is at the highest of high levels thinking about purpose and direction. Another great example he uses is talking about climbing a ladder and the importance of having the ladder up against the correct wall. I’m in wholehearted agreement with the sentiment.

I really like this jungle analogy. When I talk about it, I always attribute more lessons to it than Dr. Covey did. I think this analogy is fantastic for helping us understand our organizations. It simplifies the playing field and allows for a very direct examination and discussion about roles in the workplace.

Here’s my addition to the analogy. I think the Manager feels tremendously inadequate in their role. They’re on the field. They’re in a position to assess and actually provide criticism on the actions of others, however they don’t cut. They don’t participate in the direct purpose of the organization. Seen from the perspective of a hotshot machete worker, they’re a gofer. A waterboy.

For managers, that can weigh heavy, especially since most of them used to be hotshot machete workers. I think these managers have a tremendous internal pressure to pick up a machete and impressively lead the way. Especially consider when one of their machete workers pleadingly looks back at them. “This is a very difficult patch,” they say. What manager could resist the opportunity to show their skill at getting the job done? It’s a moment that allows them to be a hero, is it not?

The moment a manager puts down their clipboard and starts hacking, the organization is gravely injured. When a manager takes on that role on the front lines, all other machete workers are without support. It’s so simple to see in the analogy, so seemingly difficult to see in the office. In the manager’s (selfish) effort to show their ability and see immediate progress, they reduce the capability of everyone else. I’m not sure that’s even the worse part, though. They also teach one machete wielder a very unhelpful lesson – if you find yourself in a challenging spot, look backwards. Rather than taking the time to figure it out, you can count on someone else to do the really hard stuff.

If a manager does their very difficult, emotionally demanding job of not jumping in, they build capability of staff.  They build a more sustainable and healthy organization.

Here’s the assignment. Don’t look for validation through the social mirror, look for it in your own principles. The majority of your colleagues likely won’t be with you, but that’s not the objective. You’re looking for personal satisfaction for a job effectively done. For what it’s worth, I will also be celebrating your courageous choice.

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The Examined Life of the Sellout

I’ve been a sellout many times in my life. For definition, let’s say that sellouts are when you apply your ability and talent to something that isn’t for your purpose in life, it’s for somebody else’s. The theory of the sellout is that they happen because selling out is practical, it’s prudent and it seems like a good, secure, long-term choice. However, they’re called sellouts because they go against your very fibre. You give up (sell) a piece of your soul for comfort. You pursue someone else’s interest in return for compensation.

I’d like to take a look at some of my sellouts, in the order that they have happened:

* I trusted the educational system with too much of my maturation and development of knowledge and pursued all manner of academic success in highschool. I devoted excessive time that could have been spent pursuing my own interests to learning how to differentiate between chemical oxidation and reduction, a sonnet and iambic pentameter and a circle’s radius versus its diameter.
* I chose to take Commerce (business school) in University, not because of some overwhelming passion for business, but because it was the path to secure, well-paid employment.
* I accepted positions of employment because of title and pay, not because of my personal affinity for the topic.
* I engaged, interacted and gave respect to undeserving individuals who held influence. I shared ideas not for innovation and effectiveness, but to impress.

A couple of weak defenses of my actions might help me feel better here. First is the fact that this is what I was advised to do. I followed the path that was laid out for me. That’s weak, because I was sentient when all these sellouts took place. I always had a choice… I just didn’t acknowledge it. My second defense – I could have done more selling out, or I could have done it for an entire career. I think it could easily be argued that I continue to sell out, but I’m happy to say I’ve recognized it and am taking steps to repair the damage.

The damage, however, is quite interesting and hard to repair. To start with, sellouts aren’t exactly natural, so they’re hard to sustain. When we’re doing something contrary to our being routinely each day, we’re ultimately stealing days we won’t get back that could be happier. That’s a hard pill to swallow.

There’s the damage of how being a sellout seems to tie our hands, too. It comes in the shape of established levels of comfort and expectation that are extremely hard to dismiss. They come in the form of a mortgage that was accepted in headier times and a lifestyle best described as a hedonic treadmill.

The damage is a reluctance to try new things, to depart from this game’s “winning strategy” even as the rules of the game are changing.

The damage is a fear of the actions that could address our mistakes but haven’t received acceptance from family, parents, peers, friends, teachers or bosses.

The damage is the fear of ending up living in a van down by the river.

All that is strong, but it doesn’t quite overpower the knowledge that there are ways to add value and be true to your passion. Even when all the comforts of being a sellout are calling me to stop, relax and be enveloped in their charms, I can’t help but remember that those sellout actions aren’t my agenda. They’re just the choices I’ve made.

I guess I’m saying that the one thing more powerful than all the comforts of the life of the sellout is the peace that comes with pursuing my own agenda.

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05

03 2010