This is a celebrated book by a celebrated author. It appeared in the NY Times’ (or possibly that Atlantic’s) 100 Best books of the (1st Quarter) of the 21st Century, and was one of a handful of books (Station Eleven is another) that I decided to read this year as a consequence of seeing it there.
The book is a memoir of a year in Didion’s life following the death of her husband, John Gregory Dunne. It is, essentially, a study of profound grief, and the way in which Didion (and perhaps others) try to come to grips with it. During this period, her daughter, Quintanna, was in and out of hospital ICUs, exacerbating Didion’s difficulties. As the title suggests, Didion focuses on her disordered thinking, documenting ‘magical’ beliefs that her husband would come back to her, that discarding his effects would prevent his return, that she could have done things differently and thus avoided his (medically predictable) death.
The book is intense, and jumps around to different moments in time. Unlike other things I’ve read by Didion, I don’t find her use of language compelling. Possibly it would repay study of the structure, if one is writing a memoir, but for my purposes it does not offer a lot. Although I can’t say that I’m happy I’ve read it, due to the difficult subject matter, it was worthwhile, and I think will make me more sensitive to the ways in which grief can manifest itself.
*A Poetry Handbook:A Prose Guide to Understanding and Writing Poetry, Mary Oliver. 1994.
About the Book
Oliver is a contemporary American poet and a winner of the Pulitzer Prize and the National Book Award. I’ve dipped into a number of books that offer guidance regarding reading and/or writing poetry, but this short (~100 page) book is the first to hold my attention until the end.
The book marches through the preliminaries quickly. A short introduction takes up the question of which aspects of writing poetry can taught, and which cannot. It is followed by very brief chapters, 2–5 pages each, on preparing to write; reading poetry; and imitation as an approach to learning the craft. Then the book turns to a series of topics taken up in chapters (short, if not as short as the first) like “sound,” “the line,” “forms,” “free verse,” and so on. The strength of the book for me, besides its admirable brevity, is that it uses copious examples to illustrate its discussion. This might turn out to be my favorite book of the year, although since we are only a few weeks in that is a bit rash to say.
Unsystematic Notes
In what follows I will not attempt a tour of the book as a whole, but will just highlight what I found especially apt for my purposes (which, I will say, are not aimed at producing poetry, per se, but rather at strengthening the lyricism in the essays I write).
Sound
The first two chapters on topics are on “Sound” and “More Devices of Sound.” These, I think, are my favorite bits of the book, both because I learned a lot, and they are as applicable to lyric essays as to poems. Beginning with the observation that phrases have sonic qualities independent of their semantics (‘Hurry Up’ has a different feel from ‘Slow Down”), she then takes an analytic approach, breaking down letters (or clusters of letters) into groups: vowels and consonants; the consonants further divided into mutes (b, d, k, p, q, t, chard and ghard) and semi-vowels; and the semivowels into aspirates (c, f, g, h, j, s, x), liquids (l, m, n, r); and vocals (v, w, y, z).
All this is drawn from an 1860 grammar book that Oliver had on her shelf. The point I take away is not that all of this is hard and fast, but that it is worth paying attention to the “felt quality of sound” that words have. “Hush” (with aspirates) feels different from “Shut up” (with mutes). “Rock,” with its mute ending, feels different than “stone,” with its liquid ending. Then she goes on to look at the role these sounds play in Robert Frost’s Stopping by the Woods on a Snowy Evening. I don’t resonate with everything she says about the function of sound in this poem, but it offers, for me, a radically different lens which I hope to apply to my own work.
The next chapter, “More Devices of Sound,” take up multi-word devices. Alliteration, consonance – where both initial and concluding sounds correspond–and assonance, where the vowels echo one another, as in:
“and land so lightly / and roll back down the mound beside the hole.”
The chapter also takes up onomatopoeia, repetition, and rhythm.
The Line: Rhythm, length, etc.
After sound the book turns to rhythm, with the chapter on “The Line,” introducing the notion of feet (stress patterns) and line length. The book argues that the iambic stress patterns is most common in English (and thus other patterns sound more “composed”), and that pentameter (five feet) corresponds most naturally the patterns of speech and breathing (in English), and that use of lines longer or shorter (especially when they are breaking a norm established in a verse) have an impact on the reader/listener. They may at times emphasize particular feelings such as surprise or deliberation, or they may simply, by adding variation, make the verse livelier. But for a line’s length or rhythm to have such an effect, the writing must first establish a norm: Here is what Oliver has to say about the effect of rhythm in general:
The reader, as he or she begins to read, quickly enters the rhythmic pattern of a poem. It takes no more than two or three lines for a rhythm, and a feeling of pleasure in that rhythm, to be transferred from the poem to the reader. Rhythm is one of the most powerful of pleasures, and when we feel a pleasurable rhythm we hope it will continue. When it does, the sweet grows sweeter. When it becomes reliable, we are in a kind of body-heaven. Nursery rhymes give this pleasure in a simple and wonderful way.
—ibid., p. 42)
Oliver also considers different types of rhymes, and the effect of different types of line breaks (enjambment). These topics interest me less as they are not so applicable to essays. Still, one of Oliver’s concluding comments seems worth bearing in mind with respect to how it might apply to an essay:
Every poem has a basic measure, and a continual counterpoint of differences playing against that measure. Poems that do not offer such variations quickly become boring.
—ibid., p. 56
Other Topics, mainly poetic
The next four chapters discuss, respectively, verse; free verse; diction, tone and voice; and imagery. I found these chapters interesting, but not particularly applicable to my ends. The final three chapters return to process – revision; and workshops vs. solitude – and offer a concluding chapter offering Oliver’s thoughts on how to write and live as a poet. Mostly these did not speak to me, though her comment that poems may suffer from having too much – brilliance, or metaphor, or detail, or… – is worth noting. Pictures need frames; gemstones need settings.
The book discusses the use of checklists, both in the author’s domain of surgery, and in other domains such as aircraft piloting and construction management. It makes and documents claims about the ability of checklists to significantly, and sometimes radically, reduce errors and increase success rates.
I see three main lessons in the book, one obvious, and the other two less obvious.
The Obvious Lesson
The first and obvious lesson is that checklists can serve as a powerful tool for buttressing unaided human cognition. Even experts are prone to forgetting or overlooking steps in task, and using checklists can make a massive difference in the quality and valence of a task’s outcome.
But on the other hand, as example after example in the book showed, the items on the checklists that are making such a difference are obvious. For example, in the pilot’s checklist for what to do during “Engine Failure,” the second item – in large print – is “Fly the airplane.” Similarly, in checklists used in hospital, checklist items are things like “Confirm that the patient has verified his identity,” and “Confirm that all team members have introduced themselves by name and role.” Checklists are not being used to keep track of complicated things, or hard to remember things, or things that their users don’t know well.
The Important and Easily-missed Lessons
Instead, checklists are being used to ensure a group is working together in an effective way. Checklists are being used as scaffolding to support group processes, not so much individual cognition. This brings us to the second and third lessons I took from the book (lessons which I do not think were emphasized nearly enough): checklists are used as part of a shared, social practice rather than as a solitary tool.
The second lesson is that going through a checklist was a group activity, and it is this collective activity that leads the group to reflect on and prepare for the group’s task; it also facilitated (“activated”) later communication within the group and appears to have increased group affinity and commitment. This effect is explicitly invoked in checklists that highlight communicative activities (“the submittal schedule” — who should talk with whom about what and by when) rather than instrumental activities.
The third lesson is that when a checklist is adopted as an organizationally-sanctioned activity, it has a side effect of requiring that the organization’s infrastructure, on-hand resources, and staffing be configured to enable the checklist to be successfully executed. This function was facilitated, in one deployment of checklists, by making an on-site executive part of the team responsible for deploying checklists. The executive was able to reconfigure the organization’s supply base so that needed materials were on hand, and further was able to persuade a supplier to package materials needed to execute the checklist together. Thus, ultimately, the checklist worked to reconfigure the organization and its supply chain.
Details
page 7-10. Philosophers essay on errors distinguishes between errors of ignorance and errors of ineptitude. The first seem more forgivable than the second, but in the context of performance of complex activities under time pressure. the latter seem inevitable.
page x. A patient in an intensive care unit undergoes 178 procedures a day.
page 38. Using a checklist to make sure 4 steps were carried out reduced the 10-day line infection rate from 11% to 0. Other examples showed reductions from 41% to 3% for untreated pain, and 70% to 4% in improper procedures for those on mechanical ventilators (resulting in a 25% decrease in cases of pneumonia).
page 43-44. In the Keystone initiative, getting project manager and executive participation in checklist roll out was key. Executives made sure that the required chlorhexidine soap was available (previously it was available in only 1/3 of the ICUs), and that required sterile drapes were stocked. After a while, the supplier of lines was persuaded to produce a kit that had both the soap and drapes in it.
page 46. In a checklist deployment to hospitals to reduce cardiac arrest fatalities, checklists were deployed to first responders (rescue squad personnel) and first coordinators (hospital operators) even though they were the least powerful. This enabled the organization to prepare by being alerted ahead of time and mustering the needed skills.
pages 65-68. The building construction checklist of both instrumental tasks (put together by 16 disciplines and looked over by subcontractors), and communications activities (“the submittal list” – who talks to whom when about what). By ensuring that the right people are charged with talking at the right time, you radically lower the need for a single person to understand all the details of what is going on.
pages 76-80. Walmart and Katrina and empowering store owners. And Van Halen and brown M&M story as a procedural integrity check.
pages 95-97. The Proctor and Gamble soap in India study. The use of soap was made more systematic, and more pleasant.
pages 99-100: “Cleared for Takeoff” checklist for ensuring timely administration of pre-operative antibiotics. A mechanical forcing function (a metal tent stenciled with “cleared for takeoff over the scalpel that served as both a prompt and a legitimation of the nurse’s role in the process. Increase in proper antibiotic administration went from 60% to 89% (3 months) to 100% (10 months).
page 103. “‘That’s not my problem,’ is probably the worst thing people can think, whether they are starting an operation, taxiing an airplane full of passengers down the runway, or building a thousand-Foot skyscraper. But in medicine, we see it all the time.”
pages 107-110. Introductions among team members increase team affinity and empower lower status members to speak up. “When nurses were given a chance to say their names and mention concerns at the beginning of an operation, they were more likely to note problems and mention solutions.” Employee satisfaction rose 19% and OR nurse turnover went from 23% to 7%
page 120. Good vs. bad checklists. Would be nice to know more about this, rather than the obvious and rather sloganish comments in the book. …Nice point about getting leadership to adopt checklists first.
pages 154-155: WHO Safe Surgery Checklist results. Double-digit reductions.
page 177. Item 1 on the checklist: “Fly the airplane.” … “The checklist gets the dumb stuff out of the way, the routines your brain shouldn’t have to occupy itself with.”