Charles Lindberg, The Checklist Manifesto, and Overcoming That Goldarned Overhead Luggage Compartment

In 1927, Charles Lindberg, a.k.a. Lucky Lindy, took off from Long Island on the first successful nonstop Atlantic flight in history.  In 2010, I flew about 140,000 miles aboard various beat-up Delta aircrafts. Since the distance around the entire earth is about 25,000 miles, you can see I put in just a couple more hours than Mr. Ticker Tape Parade.

Not only that, but Lindy never had to compete for overhead luggage space, or sit next to obese folks whose preponderance of pounds is not contained by the flimsy excuse of an armrest. To be fair, Slim also made the voyage sans biscotti and small hermetically sealed bags of peanuts. And if you believe the movie (Lindberg was played by an aging Jimmy Stewart), his only in-flight companion was a housefly. Which, I can tell you, are horrible conversationalists.

But even though Lindy turned out to be a racist, and his fabled flight is no longer so impressive when stacked up against the punishment of modern air travel, he did manage to do something quite remarkable.

Lindy was the first to use a checklist for commercial air travel.  That list, now utilized by pilots everywhere, helps guarantee that prior to flight all the flippity jibs and flapperdoodles are properly aligned for take-off.  Statistics show that, in part thanks to Lindberg, your chances of dying in an airplane crash are something like 1 in 5 million (about the same as finding room for your suitcase in the overhead compartment).

In The Checklist Manifesto: How to Get Things Done Right, Atul Gawande cites multiple examples of where the simple idea of employing a checklist has seen remarkable results.

In 2001, a critical care specialist at Johns Hopkins Hospital named Peter Pronovost came up with the following checklist for surgery:
  • Doctors should wash hands with soap
  • Clean patient’s skin with chlorhexidine antiseptic
  • Put sterile drapes over the entire patient
  • Wear a mask, hat, sterile gown, and gloves
  • Put a sterile dressing over the insertion site
Even without a medical degree, it seems like pretty basic stuff.

After a trial period of just over two years, calculations showed that Pronovost’s list prevented 43 infections, eight deaths, and saved the hospital 2 million dollars. Now you might be shocked to discover that a surgeon could need a reminder to wash his or her hands, but neuroscientists know the working memory is remarkably unreliable and prone to errors.

We tend to flit about like we have unlimited storage capacity, when in actuality there’s barely a thimbleful of free room in our overtaxed pre-frontal cortexes. That overhead bin requires a burly flight attendant to jam the door closed.

According to Gawande, despite the fact that hospital checklists have proven repeatedly to save lives and money, people are reluctant to use them. It makes them feel inadequate, the implication that they can’t remember the simplest of tasks.

Just last week, I showed up to give a seminar to a large crowd in Baltimore only to discover I’d forgotten to pack a belt.

“Was it on your checklist?” you might ask.

“...What checklist?” I would be forced to reply.

I’ve learned my lesson. From now on, any time I head out, I’ll be checking and rechecking my new travel checklist. I am not too proud to admit I have the working memory of a hummingbird, albeit a well-intentioned one.

Socks, check
        belt, check
             pants, check
                 birdseed, check
                         checklist, check…

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