Voices: Dr. Atul Gawande on maintaining humanism in a world of AI and checklists.
Part 2 of a 3-part series.
Here’s the link to Part 2 of my interview with Dr. Atul Gawande, the best-selling author, public health researcher, surgeon, and current lead for global health at the United States Agency for International Development (USAID). (For Part 1 of our interview, click here).
In this part of our conversation we covered one of my favorite passages of Atul’s writing: his description of the Miracle on the Hudson, in which Chesley Sullenberger and Jeff Skiles safely landed an A320 (US Airways Flight 1549) in the Hudson River after it lost power to both of its engines on initial ascent in 2009.
Remember where you were that day? I do. The basement at Mount Sinai Hospital (this was during medical school). It was nice to see the CNN Breaking News banner with something so uplifting—if you will.
Atul describes the checklist like the one that Sullenberger and Skiles pulled out for the scenario they found themselves in. The first item on the list was surprisingly simple: “Fly the airplane.”
I’ve always found this so satisfying. The checklist has several technical maneuvers. But that first directive—steer—came from experience gained in flight simulators. Apparently, pilots in simulators frequently did so much futzing around with switches and levers that they forgot the big picture.
Watching a real-time animation of the flight path of UA 1549 synced to the air traffic control comms, what strikes me is how much flying had to happen in the 3 minutes and 30 seconds between the loss of power and making contact with the water of the Hudson River. Sully has to stay left to avoid running into the George Washington Bridge, which he’s just 600 feet above. Then he angles to the right, as they briefly considered landing at Teterboro airport in New Jersey. Realizing they won’t make it that far, they open the flaps—and the rest is history. Everyone survived.
I asked Atul about this, and how the lessons from that day apply to medicine. I also asked whether in the age of medical checklists and AI, we are at risk of losing the humanistic aspects of the practice of medicine. Are we at risk of becoming too protocol-driven?
Ever the optimist, Atul points out that a computer can beat the world’s best chess champion—but no computer can beat a human assisted by AI. That, he argues, is where we are headed: collaboration with AI and technology that frees us to do the “important thinking.”
Can checklists and technology make us better physicians? Do they save lives? Yes, Atul says.
I hope you enjoy the conversation as much as I did.
Here again are the links to Part 1 and Part 2 of our interview over at Medpage Today.
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Dr. Faust, Recently, I’ve been bummed about my own health care oversight, but following the two parts of your interview with Dr. Gawande has improved my attitude without resorting to meds, guru mediation or going to a therapist. Thank you. You helped a patient/subscriber today.