Why We Fail - According to Atul Gawande

In the "Checklist Manifesto - How to Get Things Right", Atul Gawande talks about the complexity of our lives and how we can deal with it. One of the themes of the book that spoke to me most is why we fail. The book traces the reasons for our failures back to two philosophers, Samuel Gorovitz and Alasdair MacIntyre, whose essay mentions three ways through which we can fail: necessary fallibility, ignorance, and ineptitude.

Necessary fallibility concerns situations in which what we want to do simply lies beyond the purview of our capabilities and control. As human beings, we are limited, and some things are just beyond our control. As the book argues "some things we want to do are simply beyond our capacity. We are not omniscient or all-powerful. Even enhanced by technology, our physical and mental powers are limited. Much of the world and universe is—and will remain—outside our understanding and control." In such situations, nothing can be done to avert failures.

However, there are domains in which we may have the capabilities, and still fail. Both the essay and the book argue that this failure can stem from two reasons. The first reason we fail is ignorance. Ignorance, in this sense and according to the original essay (1975), is construed to be a precondition for scientific progress. The essay goes on to assert that "This ignorance of what is not yet known is the permanent state of all science and a source of error even when all the internal norms of science have been fully respected (page 14). Thus, as the book (The Checklist Manifesto) puts it, "there are skyscrapers we do not yet know how to build, snowstorms we cannot predict, heart attacks we still haven’t learned how to stop."  

The second reason we may fail is ineptitude. Failure from ineptitude refers to situations or domains where knowledge exists but we fail to apply it correctly. Following the book's analogy, "This is the skyscraper that is built wrong and collapses, the snowstorm whose signs the meteorologist just plain missed, the stab wound from a weapon the doctors forgot to ask about." The good news is that in these situations, failures can be prevented. How? That's the main theme of the book.