Why blame culture is toxic for sport

Ed Smith in Cricinfo

Is ranting at players during team talks like bloodletting in the age of quack doctors?


Shouting at players: Satisfying? Yes. Effective? No © AFP



The subversive in me would love to whitewash over the usual clichés and catchphrases that are splashed on dressing-room walls and replace them with a more cynical message:

The six phases of a project:

1. Enthusiasm
2. Disillusionment
3. Panic
4. Search for the guilty
5. Punishment of the innocent
6. Rewards for the uninvolved

Not very cheering, I admit, but a salutary warning about our obsession with blame - a preoccupation sustained by dodgy narratives about "causes" that leads not to institutional improvement but to self-serving politics. Having pinned the blame on someone - rightly or, more likely, wrongly - the next task is "moving on". Sound familiar?

The "six phases" were attached to an office wall by an employee at the Republic Bank of New York. The story appears in Black Box Thinking, Matthew Syed's new book. Syed (a leading sports columnist and double Olympian) argues that our preoccupation with convenient blame - rather than openness to learning from failure - is a central factor holding teams and individuals back from improving. I think he is right.

Syed expresses admiration for the airline industry and its commitment to learning from failure - especially from "black boxes", the explosion-proof devices that record the conversations of pilots and other data. If the plane's wreckage is found, lessons - no matter how painful - must be learned. In the jargon, learning inside the aviation industry is an "open loop". (An "open loop" leads to progress because the feedback is rationally acted on; a "closed loop" is where failure doesn't lead to progress because weaknesses are ignored or errors are misinterpreted.) Syed presents harrowing examples from hospital operating theatres, of "closed loops" costing lives. Indeed, with its recurrent plane crashes and botched operations, the book takes the search for transferrable lessons to harrowing extremes.

One question prompted by Black Box Thinking is why is sport is not instinctively enthusiastic about evidence-based discussion. You might think that sports teams would be so keen to improve that they would rush to expose their ideas to rational and reflective scrutiny. But that's not always the case. As a player I often felt that insecure teams shrank from critical thinking, where more confident teams encouraged it.

The first problem sport has with critical thinking is the "narrative fallacy" (a concept popularised by Nassim Taleb). Consider this statement, thrown at me by a coach as I left the dressing room and walked onto the field after winning the toss and deciding to bowl first: "We need to have them five wickets down at lunch to justify the decision."

Hmm. First, even thinking about "justifying" a decision is an unnecessary distraction. Secondly, it's also irrational to think that the fact of taking five wickets, even if it happens, proves the decision was right. I might have misread the wicket, which actually suited batting first, but the opposition might have suffered a bad morning - five wickets could fall and yet the decision could still easily be wrong.

Alternatively, the wicket might suit bowling - and hence "justify" my decision - but we might bowl improbably badly and drop our catches. In other words, it could be the right decision even if they are no wickets down at lunch. What happened after the decision (especially when the sample of evidence is small or, as in this instance, solitary) does not automatically prove the rightness or wrongness of the decision.

Fancy theorising? Prefer practical realities? This kind of theorising, in fact, is bound up with very practical realities. Consider this example.

For much of medical history, bloodletting was a common and highly respected procedure. When a patient was suffering from a serious ailment and went to a leading doctor, the medical guru promptly drained significant amounts of blood from an already weak body. Madness? It happened for centuries.

And sometimes, if we don't think critically, it "works". As Syed points out, in a group of ten patients treated with bloodletting, five might die and five get better. So it worked for the five who survived, right?

Only, it didn't, of course. The five who were healed would have got better anyway (the body has great powers of self-recuperation). And some among the five who died were pushed from survival into death. Proving this fact, however, was more difficult - especially in a medical culture dominated by doctors who advocated and profited materially from bloodletting.

The challenge of demonstrating the real usefulness (or otherwise) of a procedure led to the concept of the "control group". Now imagine a group of 20 patients with serious illnesses - and split them into two groups, ten in each group. One group of ten patients gets a course of bloodletting, the other group of ten (the control group) does not. If we discover that five out of ten died in the bloodletting group and only three out of ten among the non-bloodletting group, then, at last, we have the beginnings of a proper evidence-based approach. The intervention (bloodletting) did more harm than simply doing nothing. It was iatrogenic.

Iatrogenic interventions are common in sport, too - such as when the coach tells a batsman to change his lifelong grip before making his Test debut. (Impossible? Exactly that happened to a friend of mine.) The angry team meeting is a classic iatrogenic intervention. Shouting at the team and vindictively blaming individual players, like bloodletting, provides the coach with the satisfying illusion that it works well sometimes. By "it works", we imply that the team in question played better after half-time or the following morning. Even having suffered an iatrogenic intervention, however, some teams - like some patients enduring bloodletting - inevitably play better afterwards. But on average, all taken together, teams would have playedbetter still without the distraction of a raging coach. (This insight helped win Daniel Kahneman a Nobel Prize, as I learned when I interviewed him.)

The great difficulty of sport, of course, is the challenge of conducting a proper control group experiment - because the game situation, pressures and circumstances are seldom exactly the same twice over. However, merely being open to the logic of these ideas, constantly exposing judgements and intuitions to critical thinking, takes decision-makers a good step in the direction of avoiding huge errors of conventional thinking.

That is why much of what Syed calls "black box thinking" could, I think, be filed under "critical thinking" - the desire to refine and improve one's system of thought as you are exposed to new experiences and ideas. Here is a personal rule of thumb: critical thinkers are also the best company over the long term. Critical thinkers are not only better bets professionally, they are also more interesting friends. Who wants to listen to the same set of unexamined views and sacrosanct opinions for decades? If you believe that your ideas don't ever need to evolve and adapt, can we at least skip dinner?

It is hard to imagine how anyone who is interested in leadership, innovation or self-improvement could fail to find something new and challenging in this book. Rather than presenting a simplistic catch-all solution, Syed takes us on a modern and personal walk through the scientific method. The book makes an interesting contrast with Syed's first book,Bounce, which proposed that talent is a myth - an argument that can be summed up in a single, seductive phrase: genius is a question of practice.

Rather than presenting a single idea, Black Box Thinking circles around a main theme - illustrating and illuminating it by drawing on a dizzyingly wide and eclectic series of ideas, case studies and lines of philosophical enquiry. The reader finishes the book with a deeper understanding of how he might improve and grow over the long term, rather than the transient feeling of having all his problems solved. The author, we sense, has experienced a similar journey while writing the book. Syed doesn't just preach black-box thinking, he practises it.

Artificially prolonged old age is the new iatrogenic malady. - When it's time to go, let me go, with a nice glass of whisky and a pleasing pill

Advances in science are keeping us alive for longer and longer, but we are denied the right to die with dignity. It is grotesque

• 
• • Margaret Drabble
  • The Guardian, Thursday 2 January 2014

'Don't blame us if we are cluttering up the system. What we want and need is simple: a change in the law concerning assisted dying and voluntary euthanasia.' Illustration: Matt Kenyon

Back in the mid-70s, we were introduced to the notion of "medical nemesis" by the Austrian philosopher Ivan Illich. He warned us that doctors may do more harm than good, and that some diseases (which he labelled iatrogenic) were caused, not cured, by medical interventions. This doctrine has been widely accepted – we all know about the dangers of overprescribing antibiotics, about the risks of over-zealous or misinterpreted scans, about the creeping medicalisation of childbirth – but its application to old age and death is what interests me here. One of Illich's arguments in those days was that medicine, despite its apparent successes, was not notably increasing life expectancy. Alas, he was wrong. Artificially prolonged old age is the new iatrogenic malady.

We can't switch on the news without being told we will live longer, work longer, and survive on diminishing pensions or overpriced annuities. Newspaper columnists tell us we are selfish and that the young are suffering from our claiming an unfair share of state support. They begrudge us our bus passes, one of the few well-earned consolations of age. As we move into our unwanted last decade, we will, entirely predictably, become lonelier and lonelier and more and more likely to suffer from dementia and more and more expensive to maintain.

It would be unfair to blame doctors or health professionals for our longevity, which may be attributed to causes other than surgical ingenuity and pharmacological innovations and deadly life support machines, but it is not surprising that many of us feel gravely disappointed by the help and relief on offer to us at the end of life.

We look in vain for compassion, dignity, even common sense. We look in vain, despite what we are told, for adequate pain relief. Medical professionals seem far more interested in keeping alive barely viable premature "miracle" babies with a poor long-term prognosis than in offering reassurance to the growing and ageing multitudes who long to depart peacefully. They keep the babies alive because it's challenging, and very few people dare argue that it's not a good thing to do. They keep us alive because they are forbidden to give us what we want and need, and they are too frightened to question the law. There's something wrong there.

Don't blame us if we are cluttering up the system. What we want and need is simple. We want a change in the law concerning assisted dying and voluntary euthanasia, and help, if need be, to die with dignity.

The groundswell of opinion in favour of change is unmistakable. How often do you hear phrases like "you wouldn't let your dog suffer like that"? Three-quarters of the population backed Lord Falconer's assisted dying bill on its first reading in parliament. The bill would allow people who are terminally ill to receive the help they need to die, if that is what they choose. But can we have what we want? No. The politicians won't let us, the bishops won't let us, the health professionals aren't allowed to let us. It's grotesque.

Those suffering from incurable diseases need to be able to choose without penalty the help which they are at the moment denied. The elderly need to be able to plan ahead clearly, and to make their own choices about when their lives are no longer worth living. There seems to be some conspiracy to stop us thinking about the end game we all shall play. So we shuffle on, until it's too late to make any decisions at all, and we become helpless pawns in the politics of deferral, and utterly dependent on the humiliating procedures that for all our rational life we so wished to avoid.

It is my hope that in my lifetime the law will change, taking with it the fears that add so much terror to death. How wonderful it would be, if we knew that we would not be obliged to contemplate the bodily and mental decay that threatens us all. That we could opt out, and make our quietus, not with a bare bodkin or a plastic bag, or by jumping off the top of a multistorey car park, but with a nice glass of whisky and a pleasing pill – and so good night. How the heart would lift with joy at the good news. I don't go for Martin Amis's suicide booths, but I'm with Will Self all the way about the right to die when and how we want. When it's time to go, let's just go.

At the moment, it's not that easy. My husband, Michael Holroyd, fondly believes that as the longest serving patron of the Dignity in Dying campaigning organisation, he will be allowed to die in peace, but no, the doctors, in mortal fear of parliament, the law, the press and the General Medical Council, will be slavishly working to rule and obeying orders and striving officiously to keep him alive as they observe their archaic Hippocratic oath. It will be just like it was in the old days, when Simone de Beauvoir described her mother's death, in the ironically titled A Very Easy Death. If a woman of her intellect and clout couldn't prevent her mother from being hacked about by surgeons on her deathbed, what hope have we?

The best new year's gift an ageing population could receive is the right to die. As the philosopher Joseph Raz argues "The right to life protects people from the time and manner of their death being determined by others, and the right to euthanasia grants each person the power to choose themselves that time and manner." The right to die is the right to live.