ORACLE

By Doug Samuelson

The midwinter party was proving to be just the antidote for the blustery, cold day outside. The fire was warm, and the two dozen or so friends and family filled the rec room with good cheer.

Paul, an O.R. analyst, had just one complaint to share with his companions. “How do I explain to my colleagues,” he lamented, “that not everything worthwhile in our profession is written up in journals?

“I just had a younger colleague ask me to review a feature article she’d written,” he explained. “And it was good, except that she’d written that this method she was presenting, a way of predicting the spread of epidemics, had never been used before. I happened to know that public health departments had been using it for something like 30 years. But it didn’t have the nice, solid mathematical derivation she had come up with, so it had never gotten into the journals. It just worked, that’s all! But to some of our journal-fixated pooh-bahs, it doesn’t exist!”

“Reminds me of a method I invented and patented some years ago,” Alan, another O.R. analyst, nodded. “My company wouldn’t let me write about it for years. By the time I did get to write it up, I had people not believing I had done it first, even though I had the key patent, because I wasn’t the first to publish in the journals. Frustrating!”

“And then there’s the national security work that takes years to get declassified or sanitized,” Jim, another analyst, added. “We wind up with lots of duplication of effort – and duplication of mistakes.”

Betty, an experienced nurse, interjected with a sly grin, “You should tell them about Spaghetti Day.” Of course this got her a round of puzzled looks.

“There’s a lot of common knowledge among practitioners in any field that doesn’t get into the research literature,” Betty said. “I remember an incident several years ago when the Framingham Heart Study group installed point-of-care computer terminals in one of their hospitals. All of a sudden they were getting accurate-to-the-minute entries of when medications were given. And this one doctor just about had kittens! He was halfway through a big research project on timing of medications, and somehow it had never occurred to him that all 24 patients in a unit could not possibly have gotten their 3 o’clock meds precisely at 3, as the nurses’ notes said. They were actually spread from about 2:40 to maybe 4:30. Any nurse would know that, but you won’t find it in the journals.”

Everyone laughed. Alan added, “Yeah, and this goes back a while. There are dozens, maybe even hundreds, of books by rabbis, going back nearly 2,000 years, about how to tell whether a chicken is kosher – but try to find a recipe for chicken soup! That was just something everyone knew. Mothers and favorite aunts passed it down to the next generation of women. Nobody saw a need to write it down until fairly recent times, maybe 200 years ago, when you could no longer count on children living their whole lives near their parents. And in our own field, there’s also a lot of essential know-how that just isn’t in the literature, and it’s misleading to ignore it.”

“Worse than misleading,” Paul growled. “You can end up suppressing innovation, which we’re supposed to be promoting, as people have to waste time and effort defending what they did against senseless, stubborn orthodoxy. Tell me, how many of the original pioneers of O.R. had O.R. degrees and publications in the O.R. journals? None, because none of those things existed, and the analysts all came from different fields. That’s why they were so successful. The more we’ve developed a standard curriculum and standard literature, the less innovative we’ve become! Now other disciplines are proceeding to eat our lunch while we try to find new ways to ‘prove’ our profession’s approach is always better. Sheesh!”

“I know what you mean,” Alan agreed. “I helped some doctors, back at the end of the Iran-Iraq war, who had done a field study of some refugees who seemed to have been victims of a chemical attack. Their first submission to a major medical journal got rejected by the statistical referee because, and I quote, ‘Your number of subjects is too small and you didn’t specify your control group.’ The guy just had his head completely stuck in clinical trials methods and wanted to apply them to everything! And the sad thing is, the statistics profession had lobbied hard to make sure that journal would have statistical reviewers, to protect against misuse. As you said, sheesh!”

“So,” Paul said, turning to Betty, “what was this about Spaghetti Day?”

“Many years ago, we had a new, enthusiastic young nurse join our unit in a hospital,” Betty recounted. “She bustled around the unit for a couple of hours in the morning, changing patients’ sheets. She noticed, though, that none of the other nurses were doing that, and she wondered whether she’d fallen into a gaggle of slackers. Finally she went to the head nurse and inquired, ‘Why isn’t anyone else changing sheets?’

“And the head nurse just pointed to the week’s meal menu, posted at the nurses’ station, and explained, ‘I guess they didn’t teach you about this in your nursing program. None of them do. Today is Spaghetti Day. Almost every sheet you change before lunch will just have to be changed again after lunch, and we all know that!’ ”

Doug Samuelson (samuelsondoug@yahoo.com) is president and chief scientist of InfoLogix, Inc., in Annandale, Va.