another eye opens

The most interesting read is Atul Gawunde’s Annals of Medicine piece called “Slow Ideas,” which painstakingly lays out the evidence of how changes in medical practice (and profound social interaction) actually take place and what impedes them. The fascinating example he uses focuses on efforts to reduce infant mortality in Uttar Padesh, one of India’s poorest states. Nurses are taught a checklist of steps to take in the course of childbirth. They’re simple and commonsensical (wash your hands, keep the newborn warm by having the mother hold it against her own skin) but were often overlooked by harried, undertrained nurses.

“In the era of the iPhone, Facebook, and Twitter, we’ve become enamored of ideas that spread as effortlessly as ether. We want frictionless, ‘turnkey’ solutions to the major difficulties of the world—hunger, disease, poverty. We prefer instructional videos to teachers, drones to troops, incentives to institutions. People and institutions can feel messy and anachronistic. They introduce, as the engineers put it, uncontrolled variability.

“But technology and incentive programs are not enough. ‘Diffusion is essentially a social process through which people talking to people spread an innovation,’ wrote Everett Rogers, the great scholar of how new ideas are communicated and spread. Mass media can introduce a new idea to people. But, Rogers showed, people follow the lead of other people they know and trust when they decide whether to take it up. Every change requires effort, and the decision to make that effort is a social process.”

I also read with interest Alex Ross’s essay on Ira Aldridge, America’s first Shakespearean leading actor, and his daughter Luranah, one of the first non-white singers to appear in European productions of Wagner’s operas.