WEBVTT 00:00:00.424 --> 00:00:02.286 In Oxford in the 1950s, 00:00:02.286 --> 00:00:06.054 there was a fantastic doctor, who was very unusual, 00:00:06.054 --> 00:00:08.086 named Alice Stewart. 00:00:08.086 --> 00:00:11.229 And Alice was unusual partly because, of course, 00:00:11.229 --> 00:00:14.709 she was a woman, which was pretty rare in the 1950s. 00:00:14.709 --> 00:00:16.820 And she was brilliant, she was one of the, 00:00:16.820 --> 00:00:21.636 at the time, the youngest Fellow to be elected to the Royal College of Physicians. 00:00:21.636 --> 00:00:25.393 She was unusual too because she continued to work after she got married, 00:00:25.393 --> 00:00:27.488 after she had kids, 00:00:27.488 --> 00:00:30.496 and even after she got divorced and was a single parent, 00:00:30.496 --> 00:00:32.779 she continued her medical work. NOTE Paragraph 00:00:32.779 --> 00:00:36.899 And she was unusual because she was really interested in a new science, 00:00:36.899 --> 00:00:39.523 the emerging field of epidemiology, 00:00:39.523 --> 00:00:43.011 the study of patterns in disease. 00:00:43.011 --> 00:00:45.179 But like every scientist, she appreciated 00:00:45.179 --> 00:00:47.435 that to make her mark, what she needed to do 00:00:47.435 --> 00:00:51.953 was find a hard problem and solve it. 00:00:51.953 --> 00:00:54.497 The hard problem that Alice chose 00:00:54.497 --> 00:00:57.895 was the rising incidence of childhood cancers. 00:00:57.895 --> 00:01:00.085 Most disease is correlated with poverty, 00:01:00.085 --> 00:01:02.354 but in the case of childhood cancers, 00:01:02.354 --> 00:01:04.958 the children who were dying seemed mostly to come 00:01:04.958 --> 00:01:07.403 from affluent families. 00:01:07.403 --> 00:01:09.146 So, what, she wanted to know, 00:01:09.146 --> 00:01:12.228 could explain this anomaly? NOTE Paragraph 00:01:12.228 --> 00:01:15.011 Now, Alice had trouble getting funding for her research. 00:01:15.011 --> 00:01:17.002 In the end, she got just 1,000 pounds 00:01:17.002 --> 00:01:19.257 from the Lady Tata Memorial prize. 00:01:19.257 --> 00:01:21.800 And that meant she knew she only had one shot 00:01:21.800 --> 00:01:23.842 at collecting her data. 00:01:23.842 --> 00:01:26.319 Now, she had no idea what to look for. 00:01:26.319 --> 00:01:29.435 This really was a needle in a haystack sort of search, 00:01:29.435 --> 00:01:32.057 so she asked everything she could think of. 00:01:32.057 --> 00:01:33.890 Had the children eaten boiled sweets? 00:01:33.890 --> 00:01:35.963 Had they consumed colored drinks? 00:01:35.963 --> 00:01:37.610 Did they eat fish and chips? 00:01:37.610 --> 00:01:39.618 Did they have indoor or outdoor plumbing? 00:01:39.618 --> 00:01:43.034 What time of life had they started school? NOTE Paragraph 00:01:43.034 --> 00:01:46.402 And when her carbon copied questionnaire started to come back, 00:01:46.402 --> 00:01:49.322 one thing and one thing only jumped out 00:01:49.322 --> 00:01:51.858 with the statistical clarity of a kind that 00:01:51.858 --> 00:01:54.698 most scientists can only dream of. 00:01:54.698 --> 00:01:56.618 By a rate of two to one, 00:01:56.618 --> 00:01:58.699 the children who had died 00:01:58.699 --> 00:02:04.994 had had mothers who had been X-rayed when pregnant. 00:02:04.994 --> 00:02:09.499 Now that finding flew in the face of conventional wisdom. 00:02:09.499 --> 00:02:11.406 Conventional wisdom held 00:02:11.406 --> 00:02:15.403 that everything was safe up to a point, a threshold. 00:02:15.403 --> 00:02:17.730 It flew in the face of conventional wisdom, 00:02:17.730 --> 00:02:21.188 which was huge enthusiasm for the cool new technology 00:02:21.188 --> 00:02:24.834 of that age, which was the X-ray machine. 00:02:24.834 --> 00:02:29.058 And it flew in the face of doctors' idea of themselves, 00:02:29.058 --> 00:02:32.866 which was as people who helped patients, 00:02:32.866 --> 00:02:35.562 they didn't harm them. NOTE Paragraph 00:02:35.562 --> 00:02:39.250 Nevertheless, Alice Stewart rushed to publish 00:02:39.250 --> 00:02:42.834 her preliminary findings in The Lancet in 1956. 00:02:42.834 --> 00:02:46.842 People got very excited, there was talk of the Nobel Prize, 00:02:46.842 --> 00:02:48.962 and Alice really was in a big hurry 00:02:48.962 --> 00:02:52.753 to try to study all the cases of childhood cancer she could find 00:02:52.753 --> 00:02:54.906 before they disappeared. 00:02:54.906 --> 00:02:59.250 In fact, she need not have hurried. 00:02:59.250 --> 00:03:03.441 It was fully 25 years before the British and medical -- 00:03:03.441 --> 00:03:06.313 British and American medical establishments 00:03:06.313 --> 00:03:12.417 abandoned the practice of X-raying pregnant women. 00:03:12.417 --> 00:03:17.898 The data was out there, it was open, it was freely available, 00:03:17.898 --> 00:03:22.122 but nobody wanted to know. 00:03:22.122 --> 00:03:24.806 A child a week was dying, 00:03:24.806 --> 00:03:27.539 but nothing changed. 00:03:27.539 --> 00:03:33.794 Openness alone can't drive change. NOTE Paragraph 00:03:33.794 --> 00:03:39.411 So for 25 years Alice Stewart had a very big fight on her hands. 00:03:39.411 --> 00:03:42.658 So, how did she know that she was right? 00:03:42.658 --> 00:03:46.321 Well, she had a fantastic model for thinking. 00:03:46.321 --> 00:03:48.566 She worked with a statistician named George Kneale, 00:03:48.566 --> 00:03:50.950 and George was pretty much everything that Alice wasn't. 00:03:50.950 --> 00:03:54.019 So, Alice was very outgoing and sociable, 00:03:54.019 --> 00:03:56.477 and George was a recluse. 00:03:56.477 --> 00:04:00.491 Alice was very warm, very empathetic with her patients. 00:04:00.491 --> 00:04:04.530 George frankly preferred numbers to people. 00:04:04.530 --> 00:04:08.508 But he said this fantastic thing about their working relationship. 00:04:08.508 --> 00:04:14.844 He said, "My job is to prove Dr. Stewart wrong." 00:04:14.844 --> 00:04:18.401 He actively sought disconfirmation. 00:04:18.401 --> 00:04:20.738 Different ways of looking at her models, 00:04:20.738 --> 00:04:23.995 at her statistics, different ways of crunching the data 00:04:23.995 --> 00:04:27.058 in order to disprove her. 00:04:27.058 --> 00:04:32.682 He saw his job as creating conflict around her theories. 00:04:32.682 --> 00:04:35.778 Because it was only by not being able to prove 00:04:35.778 --> 00:04:38.146 that she was wrong, 00:04:38.146 --> 00:04:41.267 that George could give Alice the confidence she needed 00:04:41.267 --> 00:04:44.249 to know that she was right. NOTE Paragraph 00:04:44.249 --> 00:04:48.924 It's a fantastic model of collaboration -- 00:04:48.924 --> 00:04:53.931 thinking partners who aren't echo chambers. 00:04:53.931 --> 00:04:56.283 I wonder how many of us have, 00:04:56.283 --> 00:05:03.202 or dare to have, such collaborators. 00:05:03.202 --> 00:05:06.979 Alice and George were very good at conflict. 00:05:06.979 --> 00:05:10.115 They saw it as thinking. NOTE Paragraph 00:05:10.115 --> 00:05:14.388 So what does that kind of constructive conflict require? 00:05:14.388 --> 00:05:17.763 Well, first of all, it requires that we find people 00:05:17.763 --> 00:05:20.411 who are very different from ourselves. 00:05:20.411 --> 00:05:24.747 That means we have to resist the neurobiological drive, 00:05:24.747 --> 00:05:29.251 which means that we really prefer people mostly like ourselves, 00:05:29.251 --> 00:05:31.475 and it means we have to seek out people 00:05:31.475 --> 00:05:33.947 with different backgrounds, different disciplines, 00:05:33.947 --> 00:05:38.098 different ways of thinking and different experience, 00:05:38.098 --> 00:05:41.963 and find ways to engage with them. 00:05:41.963 --> 00:05:46.607 That requires a lot of patience and a lot of energy. NOTE Paragraph 00:05:46.607 --> 00:05:48.418 And the more I've thought about this, 00:05:48.418 --> 00:05:53.579 the more I think, really, that that's a kind of love. 00:05:53.579 --> 00:05:56.648 Because you simply won't commit that kind of energy 00:05:56.648 --> 00:06:01.339 and time if you don't really care. 00:06:01.339 --> 00:06:05.799 And it also means that we have to be prepared to change our minds. 00:06:05.799 --> 00:06:08.163 Alice's daughter told me 00:06:08.163 --> 00:06:11.275 that every time Alice went head-to-head with a fellow scientist, 00:06:11.275 --> 00:06:15.459 they made her think and think and think again. 00:06:15.459 --> 00:06:19.477 "My mother," she said, "My mother didn't enjoy a fight, 00:06:19.477 --> 00:06:24.619 but she was really good at them." NOTE Paragraph 00:06:24.619 --> 00:06:28.789 So it's one thing to do that in a one-to-one relationship. 00:06:28.789 --> 00:06:32.076 But it strikes me that the biggest problems we face, 00:06:32.076 --> 00:06:34.950 many of the biggest disasters that we've experienced, 00:06:34.950 --> 00:06:36.901 mostly haven't come from individuals, 00:06:36.901 --> 00:06:38.789 they've come from organizations, 00:06:38.789 --> 00:06:40.797 some of them bigger than countries, 00:06:40.797 --> 00:06:43.057 many of them capable of affecting hundreds, 00:06:43.057 --> 00:06:47.060 thousands, even millions of lives. 00:06:47.060 --> 00:06:51.498 So how do organizations think? 00:06:51.498 --> 00:06:55.524 Well, for the most part, they don't. 00:06:55.524 --> 00:06:58.517 And that isn't because they don't want to, 00:06:58.517 --> 00:07:00.922 it's really because they can't. 00:07:00.922 --> 00:07:04.269 And they can't because the people inside of them 00:07:04.269 --> 00:07:08.477 are too afraid of conflict. NOTE Paragraph 00:07:08.477 --> 00:07:11.341 In surveys of European and American executives, 00:07:11.341 --> 00:07:14.311 fully 85 percent of them acknowledged 00:07:14.311 --> 00:07:17.828 that they had issues or concerns at work 00:07:17.828 --> 00:07:21.461 that they were afraid to raise. 00:07:21.461 --> 00:07:24.620 Afraid of the conflict that that would provoke, 00:07:24.620 --> 00:07:26.988 afraid to get embroiled in arguments 00:07:26.988 --> 00:07:29.019 that they did not know how to manage, 00:07:29.019 --> 00:07:33.596 and felt that they were bound to lose. 00:07:33.596 --> 00:07:39.773 Eighty-five percent is a really big number. 00:07:39.773 --> 00:07:42.588 It means that organizations mostly can't do 00:07:42.588 --> 00:07:44.916 what George and Alice so triumphantly did. 00:07:44.916 --> 00:07:49.315 They can't think together. 00:07:49.315 --> 00:07:51.556 And it means that people like many of us, 00:07:51.556 --> 00:07:53.740 who have run organizations, 00:07:53.740 --> 00:07:57.307 and gone out of our way to try to find the very best people we can, 00:07:57.307 --> 00:08:03.580 mostly fail to get the best out of them. NOTE Paragraph 00:08:03.580 --> 00:08:06.916 So how do we develop the skills that we need? 00:08:06.916 --> 00:08:10.999 Because it does take skill and practice, too. 00:08:10.999 --> 00:08:14.413 If we aren't going to be afraid of conflict, 00:08:14.413 --> 00:08:16.572 we have to see it as thinking, 00:08:16.572 --> 00:08:20.908 and then we have to get really good at it. 00:08:20.908 --> 00:08:25.172 So, recently, I worked with an executive named Joe, 00:08:25.172 --> 00:08:28.644 and Joe worked for a medical device company. 00:08:28.644 --> 00:08:31.619 And Joe was very worried about the device that he was working on. 00:08:31.619 --> 00:08:34.644 He thought that it was too complicated 00:08:34.644 --> 00:08:36.508 and he thought that its complexity 00:08:36.508 --> 00:08:40.775 created margins of error that could really hurt people. 00:08:40.775 --> 00:08:44.915 He was afraid of doing damage to the patients he was trying to help. 00:08:44.915 --> 00:08:47.220 But when he looked around his organization, 00:08:47.220 --> 00:08:51.681 nobody else seemed to be at all worried. 00:08:51.681 --> 00:08:54.236 So, he didn't really want to say anything. 00:08:54.236 --> 00:08:56.420 After all, maybe they knew something he didn't. 00:08:56.420 --> 00:08:59.004 Maybe he'd look stupid. 00:08:59.004 --> 00:09:01.210 But he kept worrying about it, 00:09:01.210 --> 00:09:04.256 and he worried about it so much that he got to the point 00:09:04.256 --> 00:09:06.415 where he thought the only thing he could do 00:09:06.415 --> 00:09:10.545 was leave a job he loved. NOTE Paragraph 00:09:10.545 --> 00:09:14.545 In the end, Joe and I found a way 00:09:14.545 --> 00:09:16.400 for him to raise his concerns. 00:09:16.400 --> 00:09:19.271 And what happened then is what almost always 00:09:19.271 --> 00:09:20.865 happens in this situation. 00:09:20.865 --> 00:09:24.086 It turned out everybody had exactly the same 00:09:24.086 --> 00:09:25.832 questions and doubts. 00:09:25.832 --> 00:09:29.864 So now Joe had allies. They could think together. 00:09:29.864 --> 00:09:33.128 And yes, there was a lot of conflict and debate 00:09:33.128 --> 00:09:37.432 and argument, but that allowed everyone around the table 00:09:37.432 --> 00:09:41.512 to be creative, to solve the problem, 00:09:41.512 --> 00:09:45.840 and to change the device. NOTE Paragraph 00:09:45.840 --> 00:09:49.216 Joe was what a lot of people might think of 00:09:49.216 --> 00:09:51.488 as a whistle-blower, 00:09:51.488 --> 00:09:54.203 except that like almost all whistle-blowers, 00:09:54.203 --> 00:09:56.576 he wasn't a crank at all, 00:09:56.576 --> 00:10:00.024 he was passionately devoted to the organization 00:10:00.024 --> 00:10:03.472 and the higher purposes that that organization served. 00:10:03.472 --> 00:10:07.288 But he had been so afraid of conflict, 00:10:07.288 --> 00:10:12.368 until finally he became more afraid of the silence. 00:10:12.368 --> 00:10:14.227 And when he dared to speak, 00:10:14.227 --> 00:10:17.625 he discovered much more inside himself 00:10:17.625 --> 00:10:22.867 and much more give in the system than he had ever imagined. 00:10:22.867 --> 00:10:26.198 And his colleagues don't think of him as a crank. 00:10:26.198 --> 00:10:31.326 They think of him as a leader. NOTE Paragraph 00:10:31.326 --> 00:10:35.694 So, how do we have these conversations more easily 00:10:35.694 --> 00:10:37.607 and more often? 00:10:37.607 --> 00:10:39.593 Well, the University of Delft 00:10:39.593 --> 00:10:41.990 requires that its PhD students 00:10:41.990 --> 00:10:45.903 have to submit five statements that they're prepared to defend. 00:10:45.903 --> 00:10:49.287 It doesn't really matter what the statements are about, 00:10:49.287 --> 00:10:53.079 what matters is that the candidates are willing and able 00:10:53.079 --> 00:10:55.682 to stand up to authority. 00:10:55.682 --> 00:10:58.046 I think it's a fantastic system, 00:10:58.046 --> 00:11:00.559 but I think leaving it to PhD candidates 00:11:00.559 --> 00:11:04.864 is far too few people, and way too late in life. 00:11:04.864 --> 00:11:08.030 I think we need to be teaching these skills 00:11:08.030 --> 00:11:12.110 to kids and adults at every stage of their development, 00:11:12.110 --> 00:11:14.559 if we want to have thinking organizations 00:11:14.559 --> 00:11:18.206 and a thinking society. NOTE Paragraph 00:11:18.206 --> 00:11:23.824 The fact is that most of the biggest catastrophes that we've witnessed 00:11:23.824 --> 00:11:30.215 rarely come from information that is secret or hidden. 00:11:30.215 --> 00:11:34.519 It comes from information that is freely available and out there, 00:11:34.519 --> 00:11:36.903 but that we are willfully blind to, 00:11:36.903 --> 00:11:40.031 because we can't handle, don't want to handle, 00:11:40.031 --> 00:11:44.438 the conflict that it provokes. 00:11:44.438 --> 00:11:47.367 But when we dare to break that silence, 00:11:47.367 --> 00:11:50.024 or when we dare to see, 00:11:50.024 --> 00:11:52.279 and we create conflict, 00:11:52.279 --> 00:11:54.904 we enable ourselves and the people around us 00:11:54.904 --> 00:11:59.150 to do our very best thinking. NOTE Paragraph 00:11:59.150 --> 00:12:02.526 Open information is fantastic, 00:12:02.526 --> 00:12:05.710 open networks are essential. 00:12:05.710 --> 00:12:07.687 But the truth won't set us free 00:12:07.687 --> 00:12:11.451 until we develop the skills and the habit and the talent 00:12:11.451 --> 00:12:15.588 and the moral courage to use it. 00:12:15.588 --> 00:12:19.348 Openness isn't the end. 00:12:19.348 --> 00:12:21.990 It's the beginning. NOTE Paragraph 00:12:21.990 --> 00:12:33.469 (Applause)