I was recently introduced to the following quotation:
“I wouldn’t give a fig for simplicity, this side of complexity, but I would give my right arm for simplicity the other side of complexity.”
For a long time I have been conscious that if we are to achieve the necessary transformation of the care system, then we need to stop pretending that it is a simple system, instead recognising that it is truly complex, in the meaning used in complexity science. A blog is not the place to introduce readers to complexity science – there is plenty to be read elsewehere, but suffice it to say, that one of the neatest ways of thinking about a complex system, is that it contains so many variables that even if we know everything there is to know about the system, we can never predict exactly how that system will behave. But, if we treat it properly as a complex system, then we can describe the state it is most likely to be in. It is not unlike a poor man’s quantum physics, but applied to everyday life.
Put simply, this means that we can never control a complex system, but we can influence it. Control is the stuff of centralised management, and influence is the stuff of shared leadership. Get my drift?
Back to that fabulous quotation. Pretending that a complex system can be simplified, before we have got a good understanding is worse than useless. Making sure that we understand the system, getting to grips with what is important, and then simplifying it for a given context is priceless. Facing down the complexity, allows us to simplify the system, AND know when those simplifying assumptions run out of steam, and we have to go back to the complexity to understand the new context.
So who made that profound statement? It was Oliver Wendell Holmes Senior, more than a century ago, long before anyone had conceived any of the sciences which contribute to Systems Thinking. As I read more, I got to like the man who challenged the established clinical practices with his observations about infection control before Pasteur. Amidst more controversy, he sought to admit the first black medical students and the first woman medical student to Harvard.
It seems to me that he was a man before his time – in so many ways rocking the established thought and practice. His work eventually reflected new norms in diversity and infection control. As a man of letters, he coined the new term Anaesthesia to describe the emerging practice.
Are we, even now, on the dawn of responding to his plea to stop pretending and grapple with that kind of simplicity which only emerges on the other side of complexity?
David Welbourn 