Practice

I have begun reading "Complications" by Atul Gawande, a discourse on the fear and confusion inherent in learning to practice medicine, written by a surgical resident near the end of his eight years of training in general surgery.  He describes the agonizing process of learning to insert a central line, something the more experienced residents made look easy:
Surgeons, as a group, adhere to a curious egalitarianism.  They believe in practice, not talent.  People often assume that you have to have great hands to become a surgeon, but it's not true.  When I interviewed to get into surgery programs, no one made me sew or take a dexterity test or checked if my hands were steady.  You do not even need all ten fingers to be accepted.  To be sure, talent helps.   Professors say every two or three years they'll see someone truly gifted come through a program -- someone who picks up complex manual skills unusally quickly, sees the operative field as a whole, notices trouble before it happens.  Nonetheless, attending surgeons say that what's most important to them is finding people who are conscientious, industrious, and boneheaded enough to stick at practicing this one difficult thing day and night for years on end.  As one professor of surgery put it to me, given a choice betwen a Ph. D. who had painstakingly cloned a gene and a talented sculptor, he'd pick the Ph. D. every time.  Sure, he said, he'd bet on the sculptor being more physically talented; but he'd bet on the Ph. D. being less "flaky."   And in the end that matters more.   Skill, surgeons believe, can be taught; tenacity cannot. It's an odd approach to recruitment, but it continues all the way up the ranks, even in top surgery departments.  They take minions with no experience in surgery, spend years training them, and then take most of their faculty from these same homegrown ranks. 
And it works.  There have now been many studies of elite performers -- international violinists, chess grand masters, professional ice-skaters, mathematicians, and so forth -- and the biggest difference researchers find between them and lesser performers is the cumulative amount of deliberate practice they've had.  Indeed, the most important talent may be the talent for practice itself.   K. Anders Ericsson, a cognitive psychologist and expert on performance, notes that the most important way in which innate factors play a role may be in one's willingness to engage in sustained training.  He's found, for example, that top performers dislike practicing just as much as others do.  (That's why, for example, athletes and musicians usually quit practicing when they retire.)  But more than others, they have the will to keep at it anyway.

8 comments:

E Hines said...

I think there's room for both--although perhaps not in the hospital's abattoir.

The flaky intuitionist comes up with innovations that the steadily practising engineer cannot. And the latter develops innovations through his incremental practice that the intuitionist--the artist--misses with his leaps.

Both sets of innovations are important.

Eric Hines

Grim said...

Joesph W. has been missing for a week or so, but I'd be interested in his thoughts on how this 'talent for practice' works out with that "G" (general intelligence) factor that he sometimes discusses. Does general intelligence inform self-discipline, or give rise to it, or are these competing models of how you get to practical competence?

E Hines said...

Does general intelligence inform self-discipline, or give rise to it....

And what's the relationship, if any, of all of that with OCD?

Eric Hines

james said...

I'm not at all sure that mathematicians fit in the same boat. A subset large enough to be noticed have brilliant early careers and flame out in their 20's. And there's a threshold level of skill: below that you never become a mathematician. So I don't quite see where the dull gruntwork comes it.

In addition, mathematicians seem to do a lot of "playing around" with ideas--creativity is important. You need discipline to stick to an idea long enough to work out the details, of course.

When they write their papers, they make it sound as though they started at point X and worked the way to point Y from sheer logic. In reality they often were looking at something else, considered a few examples and noticed something interesting, and tried to see if it was generally true. If so: bingo, a paper. If they lucked out, the topic is one they can discover new things in for a few years.

E Hines said...

Or this path. I once was called to work out a homework calculus problem in class. I had been unsuccessful the previous night, but as I walked to the chalkboard, I flashed on the answer. My problem then was to work out the path from the problem to the answer.

A real mathematician might have a similar problem, but with far more important leaps.

Eric Hines

Texan99 said...

I agree, I doubt high achievement in mathematics has much to do with dogged tenacity. Apparently surgery does, though. You need considerable smarts, certainly, to learn everything a surgeon needs to know, but sheer brilliance isn't enough to get good at it.

E Hines said...

I think a mechanic can make a fine surgeon, and I'd have no trouble submitting to one, were the surgery necessary in the first place. And so long as I can stay awake and watch.

But the innovations, even in what is essentially an engineering problem like surgery, I think can also come from intuitive leaps, followed by, "How do I do that?"

Eric Hines

douglas said...

The flaky intuitionist comes up with innovations that the steadily practising engineer cannot. And the latter develops innovations through his incremental practice that the intuitionist--the artist--misses with his leaps.

Both sets of innovations are important.


I dare say both are necessary. The intuitionists tend to come up with the conceptual leaps, but often leave some or many of the technical details hanging as loose ends. The dogged engineers tend to work those things out, making them practicable. Edison has been criticizes for not inventing the light bulb, which is true- but worked it out to make it useful and practical. Is that any less important that the original idea, or even prototype with less than practical use? Clearly, no, and perhaps his is the more valuable end of the deal.

Sometimes, the dogged engineer also stumbles on the conceptual leap by having worked on something so long and so deeply and having gained so much knowledge of it in the process. I'll take dogged over talented any day, if I must choose.

A little 'Silent Cal' for you:

“Nothing in the world can take the place of persistence. Talent will not; nothing is more common than unsuccessful men with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent. The slogan Press On! has solved and always will solve the problems of the human race.”

― Calvin Coolidge