This book has nothing to do with design. But every designer should read it.
Michael Lewis is one of my favorite authors. I’ve read almost all of his books, starting with Liar’s Poker way back when. “Moneyball”, “The Big Short” and “The Undoing Project” (about Kahneman and Tversky!) are some of my favorite books. So when I stumbled across “The Premonition: A Pandemic Story” I was curious to see what Lewis’ take was and I had no idea of what I was in for. This book is about a group of curious people who pretty much figured out how to mitigate a pandemic and when it came, most everyone ignored them. But if you dig deeper, this book is about a bunch of smart people who act like designers — they are trying to design a way to keep people alive and healthy — even though none of them have the title “designer.” They just act that way.
Take Bob and Laura Glass, which is where the story starts. Bob is a research scientist at the Sandia National Laboratories where scientists have the privilege of exploring some pretty far out stuff. Bob’s thing is working on computer models to track how ideas spread through society. When his tween daughter Laura needs to come up with an idea for a school science fair, she sees Bob’s model and asks if he can help her create a model for how viruses spread. They both become pretty obsessed with pandemics. Ultimately the computer models they create turn traditional pandemic on its head: The experts have always said that the way to fight pandemics is to isolate the people most at risk and vaccinate them. What Bob and Laura’s model shows, on the other hand, is that it is the young people who drive the spread of viruses and to stop a pandemic, you need to isolate and vaccinate them! Laura’s school project ends up serving as the foundation for social distancing. They basically designed a completely new pandemic strategy. The big public health experts and politicians were not so happy.
The hero of the story is doctor turned California public health officer Charity Dean. Lewis describes Dean’s work in Santa Barbara. I always assumed that Santa Barbara was a Shangri-La where rich people lived in the most beautiful city with few problems. But it is actually kind of a mess. One of her first challenges on the job is to track down a weird case of TBC and figure out how to stop its spread. Charity has a unique heuristic for a public health officer: She spends time each week actually treating patients. She spends lots of time with front line nurses and other health care personnel. In order for her to create a better public health system, she gets as close to the challenges and problems faced by different people within the system. And then she comes up with a new approach and tests it. Most of the time it works. She is acting like a classic designer albeit one that actually has the power to change things on the ground in real time.
The second hero of the story is a doctor in the Veterans Administration named Carter Mescher. The Guardian described him as “a sublimely focused problem-solver with highly evolved people skills (Tom Hanks would have to play him in a movie).” Carter is really a systems designer — he works in a lot of the ways that Charity Dean works — embedding himself in problem areas, analyzing the system and developing new systems designs — but the oddly unique trait that he has is that he seemingly always puts himself in the background. He is a change agent but one that always leads from behind. This is what probably makes him so effective. By chance, Mescher gets pulled into a project at the Bush White House where he and a colleague Richard Hatchett end up designing a completely new strategy for combatting pandemics. They build a lot of it based on the Glass’ model. But they also dig in and analyze behaviors from the Spanish Flu pandemic of 1918 in a completely new way, bucking up against the status quo academics from the last 90 years.
And in the end, when the Covid-19 pandemic hits us in early 2020, this group of public health “designers” watch aghast as almost all of the politicians and public health officials around the world ignore their designs and plans, causing much more widespread pain and death than was necessary. All they can do is to support each other on Zoom calls while getting frustrated at their inability to convince national public health “experts” to change course. Their proposed changes are no challenge for the status, ego, and power of those charged with protecting human life and health. If you, as a designer, can’t recognize yourself here, I don’t know what to tell you.
Throughout “The Premonition” Michael Lewis paints us a picture of innovators: people who get as close to the people within a system so they can figure out what to change, people who never stop being curious and never stop learning about the systems and history they keep trying to change, and people who never stop acting bravely even when it puts their careers at risk. This last one might be the game-changer. All of the heroes of the book act on their designs despite clear warnings and pushback and demotions. They take personal risk for the greater good. It is a refreshing picture that is the opposite of the politicians and public health officials (in the U.S., the U.K, and Sweden, to name a few) who put their personal status and power ahead of saving people’s lives.
This book has nothing to do with design. This book has everything to do with design. If you are serious about your craft, serious about creating significant positive change, you should read this book.
