Jun 6, 2022·edited Jun 6, 2022Liked by L. M. Sacasas
I'll be curious to hear your thoughts on "In Emergency, Break Glass" by Nate Anderson, if you end up snagging it. I wasn't entirely sure what to expect at first, but to say I am enjoying it is an understatement, although I cannot say I will be rushing out to read any Nietzsche as a result.
"Lewis-Kraus is also to be commended for the running acknowledgement that it may be difficult to measure and quantify the kind of effects we’re looking for. I remain skeptical that we can rely merely on social scientific data to ground our action. That may very well be a symptom of the deeper (Babel-like!) delusion of mastery and management." So true, and well-put. I work in the public health system in Canada in mental health services. There is currently an investigation into the origins of the "toxic workplace culture," following exodus en masse of huge swaths of the staff (nurses, social workers, psychologists, you name it). The cycle of disillusionment and burnout that prompted workers to quit was well underway before 2020, but the pandemic accelerated the trend exponentially. Many of us in the system feel the origins of the problem began with a mandate from the provincial government to centralizate of all the diverse health centers and hospitals into one organization. This laid waste to the local institutional cultures, each with their own organic ways of functioning, their own local sense of belonging and vibrant social fabric. Upper Management became obsessed with statistics, and blinded to the qualitative realities of the work. I was struck by a recent installment of Ezra Klien's podcast where he talked with philosopher C. Thi Nguyen about games theory and why governments and bureaucracies "love tidy packets of information." They discussed how when large institutions quantify data they take context-sensitive information that requires knowledge to understand and remove all the nuance in order to concentrate on the few factors that are invariant, and thus, can become stats and metrics. This lets information travel easily between managing bodies that have no contextual knowledge. The upper management requires these nuance-free packets of information in order to function and continue to exist. They can only “see” the kinds of information they can quantify. This drives them to attempt to transform our practices as clinicians into quantifiable metrics - more lean, more efficient, more standardized, more replicable, more people seen and discharged faster. It also blinds them to what is meaningful, and bases their decisions on factors very different than those which "help people get better." This perspective helps me understand why managing bodies destroy to what they try to improve. I see my clients build their lives back up from rock bottom, but management can't see my clients. You can't do a stat when someone re-establishes contact with an estranged child, our gets their first girlfriend, or stops experiencing suicidal ideation. People disappear when we quantify.
I'll be curious to hear your thoughts on "In Emergency, Break Glass" by Nate Anderson, if you end up snagging it. I wasn't entirely sure what to expect at first, but to say I am enjoying it is an understatement, although I cannot say I will be rushing out to read any Nietzsche as a result.
"Lewis-Kraus is also to be commended for the running acknowledgement that it may be difficult to measure and quantify the kind of effects we’re looking for. I remain skeptical that we can rely merely on social scientific data to ground our action. That may very well be a symptom of the deeper (Babel-like!) delusion of mastery and management." So true, and well-put. I work in the public health system in Canada in mental health services. There is currently an investigation into the origins of the "toxic workplace culture," following exodus en masse of huge swaths of the staff (nurses, social workers, psychologists, you name it). The cycle of disillusionment and burnout that prompted workers to quit was well underway before 2020, but the pandemic accelerated the trend exponentially. Many of us in the system feel the origins of the problem began with a mandate from the provincial government to centralizate of all the diverse health centers and hospitals into one organization. This laid waste to the local institutional cultures, each with their own organic ways of functioning, their own local sense of belonging and vibrant social fabric. Upper Management became obsessed with statistics, and blinded to the qualitative realities of the work. I was struck by a recent installment of Ezra Klien's podcast where he talked with philosopher C. Thi Nguyen about games theory and why governments and bureaucracies "love tidy packets of information." They discussed how when large institutions quantify data they take context-sensitive information that requires knowledge to understand and remove all the nuance in order to concentrate on the few factors that are invariant, and thus, can become stats and metrics. This lets information travel easily between managing bodies that have no contextual knowledge. The upper management requires these nuance-free packets of information in order to function and continue to exist. They can only “see” the kinds of information they can quantify. This drives them to attempt to transform our practices as clinicians into quantifiable metrics - more lean, more efficient, more standardized, more replicable, more people seen and discharged faster. It also blinds them to what is meaningful, and bases their decisions on factors very different than those which "help people get better." This perspective helps me understand why managing bodies destroy to what they try to improve. I see my clients build their lives back up from rock bottom, but management can't see my clients. You can't do a stat when someone re-establishes contact with an estranged child, our gets their first girlfriend, or stops experiencing suicidal ideation. People disappear when we quantify.