Amanda Ripley Author of The Unthinkable

**UPDATE:The film is now available for purchase online here.**

Many of you have asked me how you can get a copy of the PBS documentary, Surviving Disaster, based on The Unthinkable. I am sorry it has taken so long to become available to the public… Maybe they were trying to build suspense? I don’t know, but I finally have an answer for you!

To buy a copy of the film, please email Chris Tiano at Santa Fe Productions at .(JavaScript must be enabled to view this email address). I’m told that if you are in North America and just want to watch it as an individual, then it will cost $24.95 plus $4.95 shipping & handling. If you are going to use it in a classroom, then it will cost $75 plus shipping for the public performance rights and so on and so forth.

Thank you to all who have expressed interest. I am insanely biased, but I loved the film. It captures the mystery and drama of human behavior in a disaster—and explains why our behavior matters—better than any TV show or film I’ve seen.

Economists, it turns out, can predict Olympic medal counts with uncanny accuracy. They don’t get the exact figures right, but they get weirdly close to predicting the ranking of countries worldwide—well before the Opening Ceremonies.

First let’s just acknowledge that there is something irritating about this; aren’t the Olympics supposed to be games of chance and romance? Economists do not belong in the Olympics. Is no place sacred?

And yet. In June, PricewaterhouseCoopers issued an economic briefing paper (pdf here) that modeled the performance of countries based on 4 critical characteristics:

1. Population
2. Income
3. Host country
4. Whether the country was once part of the Soviet bloc

I would have guessed the first two inputs, but the last two are more surprising—and help explain the outliers in the medal counts finalized yesterday with the closing of the London Olympics.

The model made some mistakes: the U.S. won 9 fewer medals than predicted, and Japan won 10 more. But the model did predict the ranking order, more or less, prophesying that the U.S. would come in first, followed by China, Russia and Great Britain—in that order. And that is exactly what happened.

The host country, as the model had foreshadowed, got a heady boost. Why? The economists say this is partly this is due to the greater investments that countries make in their Olympic teams when they know they are going to host. I suspect other more subtle forces are at work, too; there is a great psychological advantage to playing on the home court, after all. Imagine the thrill of having all those royals cheering for you—just a short distance from all those hooligans!

But interestingly, the home-court advantage varies depending on the country (China saw a huge bump when it hosted in 2008, winning 37 more medals than it had in Athens, but Greece only won 3 additional medals compared to its performance in Sydney).

The dominance of former Soviet bloc countries might be the most mysterious pattern of all. The economists explain this as a historical relic—a lingering Cold War respect for sports and Olympic triumph that motivates countries to invest and athletes to perform. They also see this as a victory for public policy, which is kind of adorable:

“This shows that sport is one area where state planning and intervention can produce results, which still persisted in Beijing almost two decades after the fall of the Berlin wall. However…these effects are gradually fading for the ex-Soviet countries, except for China which still has a strong state policy of promoting Olympic sport.”

Of course, try as I might, I can’t help but look at this ranking of medals and compare it to the ranking of education around the world. There is not a lot of overlap; the smartest countries in the world are not necessarily the most athletic and vice versa, as the U.S. has shown time and time again.

However, there are a few countries that perform exceptionally well—in mind and body. They are not the ones that spend the most per student (or per athlete). They are the ones that care a lot about both sports and learning, for whatever combination of reasons, and have the results to prove it:

Japan (No. 6 in the world in Olympic medals 2012; No. 6 in the world on PISA math 2009)

Australia (No. 7 in the world in medals; No. 12 in the world in math)

South Korea (No. 9 in the world in medals; No. 2 in math)

Netherlands (No. 11 in the world in medals; No. 8 in math)

Compare that to the U.S: No. 1 in the world in medals…and No. 26 in math. Something doesn’t add up; and all the king’s economists and all the king’s models can’t entirely explain it, try as they might.

 

Just finished reading Anne-Marie Slaughter’s Atlantic essay on “Why Women Still Can’t Have It All.” I read it, I should say, from home, where I was waiting in a 90-degree room for the air-conditioning repair man to come after I’d dropped my child off at “camp”—since school is, for some reason, closed all summer long.

Having it ALL!

My one fix would have been to update the headline to read, “Why Men & Women Still Can’t Have It All.” Personally, I don’t know any men with young children who don’t experience the same wrenching pull, even if (as Slaughter notes) they may not feel the same level of shame and guilt when they go on business trips. (Besides, who’s to say men don’t feel more guilt than their wives when they fail to deliver at work? Guilt is a fungible commodity.)

Anyway, I applaud Slaughter for wading into this cauldron in an honest and nuanced way—and for proposing at least a couple of tangible solutions, instead of just listing laments, which is how these things normally go.

Here is my favorite tangible solution from the essay:

My longtime and invaluable assistant, who has a doctorate and juggles many balls as the mother of teenage twins, e-mailed me while I was working on this article: “You know what would help the vast majority of women with work/family balance? MAKE SCHOOL SCHEDULES MATCH WORK SCHEDULES.” The present system, she noted, is based on a society that no longer exists—one in which farming was a major occupation and stay-at-home moms were the norm. Yet the system hasn’t changed.

Want to reduce strain on families? Try, for one thing, running schools as if they operate in the real world—and as if what they do matters so much that it has to happen fairly consistently, just like work.

I just checked the calendar for the upcoming public school year in Washington, DC. Kids have 32 days off during the school year. Not counting the summer! That’s over 6 work weeks that parents somehow have to scramble to manage.

Most Americans get about half that in holiday and vacation time. The math is obvious: the tension parents feel isn’t just caused by employers not giving enough vacation time; it’s caused by education leaders who are willfully blind to the realities of families.

Every time my kid has a day off from school, I wish I had a magical Harry Potter map that could show the ripple effects being silently endured all across the city: the tense negotiations with spouses, the white lies to employers, the fingers crossed as mothers and fathers walk away from dropping off their children at dubious childcare centers where they don’t know anyone…. hoping for the best. All this for what? For “professional development” that most teachers will tell you is utterly useless.

Here’s an idea! Perhaps days off should be earned. If a given form of professional development is proven to actually make teaching more effective, then OK, it’s worth the time off. I’ll do anything to support that worthy goal.

Likewise with summer vacation: if, by the end of the year, students are all performing at levels required for young people to thrive in the modern economy, then great! Go home for the summer, kids and teachers, too. Break out the sprinkler. If not, we’ll see you back here on Monday. Which is to say, we’ll see every damn one of you here on Monday.

And now I’m off to the office. Air conditioner still broken. “Camp” ends at 3:30, at which time something called, for some reason, “aftercare” begins!

 

Medicare is starting to reimburse physicians based in part on the “quality” of their care. To incentivize better results, the theory goes, doctors whose patients’ health improved could get reimbursed at a higher rate

Ah, but how to measure quality fairly? What about all the things that doctors can’t control? Patients who are obese, patients who don’t even bother to fill their prescriptions… Surely a doctor can’t be blamed if these patients fail to thrive.

Sound familiar?

Mathematica released a new paper yesterday on whether docs could be evaluated based in part on value-added models similar to the ones designed for teachers (pdf here). Doctors everywhere shuddered, no doubt.

Here’s the part that makes theoretical sense: Doctors, like teachers, have not historically been paid based on how much they actually help their charges. In fact, doctors are often rewarded to do things that may be directly counter to patients’ interests (like administering tests they don’t need). It would make sense if doctors got a small bump if, for example, their diabetic patients’ glucose levels improved over time. That is a hard thing to do—and it should be rewarded.

The Mathematic paper suggests that Medicare could, for example, compare a patient’s glucose levels from one year to the next, and see how the change compared to the change in levels of similar patients in the same region. After that, of course, things get complicated—just as they do with teachers.

What about patients who have many doctors? What about doctors who see the same patients for many years?

The answer might be the same as the proposed fix for teachers, the paper suggests: Multiple measures!

In education, approaches to increasing the precision of performance estimates include using test scores from multiple years of classes (in other words, increasing the sample size for the estimate); combining value-added scores with other, independent measures of teacher performance, such as principals’ evaluations; and calculating scores at a higher level of aggregation (e.g., for all the teachers in a given subject or for all the teachers in a school, which, again, increases sample size). The following similar approaches could be taken in health: using multiple years of patient’s outcomes; combining value-added measures with other measures of physician performance, such as their scores on clinical process measures; and calculating value- added scores for groups of physicians in a practice.

Soon the model becomes very complex; and if most doctors do not buy in, and I suspect they will not, many will find a way to game the system. They will resent the intrusion. Some may drop low-income, low-performing patients. Others may indeed respond to the incentives—for ego or financial reasons—and actually improve their practice to lead to better outcomes.

Who knows? Maybe the value-added model could work even better with doctors than teachers. Unlike teachers, many doctors get into the profession partly to make money; they may, theoretically (again!), be more motivated by pay-for-performance schemes than teachers. They also have enough schooling that many of them may actually understand the models—unlike most people (including most teachers). And there may be more visibility into what they need to do in order to get better outcomes than there is for teachers.

Or not. So far, there’s not a lot of evidence that using value-added models to evaluate teaching actually improves outcomes for kids in the real world. There’s not a lot of evidence that it doesn’t. Time may tell.

Regardless, thinking about this analogy made me realize that teachers have way more time to try to influence students than doctors have to affect patients. On the high end, let’s say a doctor sees a patient every two months for 15 minutes. Teachers, meanwhile, spend about 5 to 25 hours a week with their students. Over the course of two months, then, teachers have somewhere between 16,000% to 80,000% more time with students than doctors have with patients. (Granted, teachers don’t see their students one-on-one for all that time, but you get the idea: teachers spend a LOT of time with their students.) Opportunity lurks in that time….

Time is something that adults underestimate, I find. Perhaps we think it moves more swiftly because we have less of it left. Kids on the other hand know what it feels like to sit in the same room for 5 hours for 185 days. Much can happen in that time, they will tell you. (Or not.)

This year, for the first time, the U.S. Department of Homeland Security will recognize a regular, non-governmental human (or organization) for acts of superior leadership and innovation—through a new honor called the Rick Rescorla National Award for Resilience.

This is a big deal. For years, schmucks like me have been haranguing the federal government for failing to highlight the stories and wisdom of the regular people who make our country more resilient. Instead of talking about how government is going to make us safe, we ought to start listening—to the t-shirt vendors, the flight attendants, the survivors and the guy in the aisle seat, to the Rick Rescorlas of the world who have shown us how the public can prevent and respond to disasters with grace, courage and initiative.

Well, now DHS is doing it, in at least one symbolic and important way. Please send your nominations asap to .(JavaScript must be enabled to view this email address). More details and the nomination form can be found here. The deadline is June 1, 2012.

The award was named after Rick Rescorla, the head of security for Morgan Stanley Dean Witter in the World Trade Center. I wrote about Rescorla in The Unthinkable, and I’ve talked about him around the country. His story is impossible to forget once you’ve heard it. So let me share some of it here, now that we have a good excuse…

Rick Rescorla was one of those thick-necked, former soldier types who spent the second halves of their lives patrolling the perimeters of marble lobbies the way they once patrolled a battlefield. He was disciplined in everything he did, and he understood the power of the human brain to get better through practice.

After the 1993 bombing and the fiasco of an evacuation that followed, Rescorla decided that Morgan Stanley employees had to take full responsibility for their own survival— something that happened almost nowhere else in the Trade Center. He knew it was foolish to rely on first responders to save his employees. His company was the largest tenant in the World Trade Center, a village nestled in the clouds. Morgan Stanley’s employees would need to take care of one another.

From then on, Rescorla started running the entire company through frequent, surprise fire drills. He trained employees to meet in the hallway between the stairwells and, at his direction, go down the stairs, two by two, to the forty-fourth floor. He noticed they moved slowly, so he started timing them with a stopwatch—and they got faster.

The radicalism of Rescorla’s drills cannot be overstated. Remember, Morgan Stanley was an investment bank. Millionaire, high-performance bankers on the 73rd floor chafed at Rescorla’s evacuation regimen. They did not appreciate interrupting high-net-worth clients in the middle of a meeting. Each drill, which pulled the firm’s brokers off their phones and away from their computers, cost the company money. But Rescorla did it anyway. He didn’t care whether he was popular.

When guests visited Morgan Stanley for training, Rescorla made sure they all knew how to get out too. Even though the chances were slim, Rescorla wanted them ready for an evacuation.

On the morning of 9/11, Rescorla heard an explosion and saw Tower 1 burning from his office window. A Port Authority official came over the public address system and urged everyone to remain at their desks. But Rescorla grabbed his bullhorn, his walkie-talkie, and his cell phone and began systematically ordering Morgan Stanley employees to get out. They already knew what to do, even the 250 visitors who were taking a stockbroker training class and had already been shown the nearest stairway.

Rescorla had led soldiers through the Vietcong-controlled Central Highlands of Vietnam. He knew the brain responded poorly to extreme fear. Back then, he had calmed his men by singing Cornish songs from his youth. Now, in the crowded stairwell, as his sweat leached through his suit jacket, Rescorla began to sing into the bullhorn. “Men of Cornwall stand ye steady; It cannot be ever said ye for the battle were not ready; Stand and never yield!”

Moments later, Rescorla had successfully evacuated the vast majority of Morgan Stanley employees out of the burning tower. Then he turned around. He was last seen on the 10th floor, heading upward, shortly before the tower collapsed. His remains have never been found.

Rescorla taught Morgan Stanley employees to save themselves. It’s a lesson that had become, somehow, rare and precious. When the tower collapsed, only 13 Morgan Stanley colleagues—including Rescorla and four of his security officers—were inside. The other 2,687 were safe.