by J. Carl Laney
I was visiting my daughter and son-in-law last week in Yakima, Washington. Besides being the fruit capital of eastern Washington, Yakima is one of the hottest regions of the state. Cooling down in the air conditioned comfort of their house I picked up a book by Atul Gawande, The Checklist Manifesto. Gawande is a surgeon at the Brigham and Women’s Hospital in Boston and an associate professor at Harvard Medical School. He also leads the World Health Organization’s Safe Surgery Saves Lives program.
It wasn’t the title or the author that got me hooked on the book. It was the opening story of chapter 2, “The Checklist.” Gawande told the story of an event that took place on October 30, 1935 at Wright Airfield in Dayton, Ohio. The U.S. Army Air Corps held a flight competition for airplane manufacturers vying to build the military’s next-generation long-range bomber. It wasn’t suppose to be much of a competition since Boeing’s gleaming aluminum-alloy Model 299 had trounced the designs of Martin and Douglas. Boeing’s plane could carry five times as many bombs as the army had requested and it could fly faster than previous bombers and almost twice as far. The army planned to order at least sixty-five of the aircraft.
A crowd of army brass and manufacturing executives watched as the Model 299 test plane taxied onto the runway. The sleek plane with four engines, rather than the usual two, roared down the tarmac, lifted off smoothly and climbed sharply to three hundred feet. Then it stalled, turned on one wing, and crashed in a fiery explosion. Two of the five crew members died, including the pilot.
An investigation into the crash revealed that nothing mechanical had gone wrong. The crash was due to “pilot error.” The new plane was substantially more complex than previous aircrafts, requiring the pilot to attend to all four engines, each with its own oil-fuel mix in addition to the retractable landing gear, wing flaps, and electric trim tabs needing constant adjustment at different airspeeds. While doing all this, the pilot had forgotten to release the new locking mechanism on the elevator and rudder controls. The new Boeing aircraft was deemed “to much airplane for one man to fly.” The Army Air Corp declared Douglas’s smaller design the winner and Boeing nearly went bankrupt.
In spite of the crash, some insiders in the Air Corp were convinced that the aircraft was flyable and several were purchased. A group of test pilots got together to determine what to do. It was not a lack of experience that led to the crash. It was the human failure–a failure of the memory. The test pilots came up with an ingenious solution, they created a pilot’s checklist. In the early years of flight, getting an aircraft into the air was a rather simple procedure. But the new plane was too complicated to be left to the memory of any one person, no matter how well qualified and experienced.
The test pilots created a list of simple, brief, and to the point checklists for takeoff, flight, landing and taxiing. The list reminded the pilots to do the things they knew to do–simple stuff, dumb stuff. The test pilots went on to fly the Model 299 a total of 1.8 million miles without one accident. Ultimately, the army ordered 13,000 of the aircraft, now dubbed the B-17, and popularly known as “the flying fortress.” Because the checklist enabled pilots to fly the B-17 safely, the allies gained a decisive air advantage in the Second World War, enabling its devastating bombing campaigns across Nazi Germany, and today a pilot’s checklist is standard protocol for the airline industry.
In his research of successful and unsuccessful operations Dr. Gawande discovered that surgeries that failed were often due, not to a lack of knowledge or surgical expertise, but to a failure to do what the surgeons knew to do. But the complexity of modern medical procedures with the monitors, tubes and electronic equipment, the surgeon’s mind is overloaded and the memory can sometimes fail. Forgetting or missing the proper timing on antibiotic can result in infection and even loss of life. Gawande believed that a surgeon’s checklist could help.
Gawande does not believe the checklist should tell the doctor what to do. But the checklist helps him be as smart as possible every step of the way, not overlooking anything necessary to the successful outcome of the surgery. When surgeons make sure to wash their hands or talk over the planned procedure before beginning, they improve their outcomes with no increase in skill.
The research cited in The Checklist Manifesto demonstrates that many lives have been saved and unnecessary complications avoided through the use of checklists by surgeons in the operating room.
As I read this intriguing book last week I kept thinking, “How can the checklist help me as a minister and seminary professor? Are there things I know to do, but with the complexity and confusion of a busy day, I sometimes forget? Absolutely! I remember not that long ago when I was putting the finishing touches on a sermon and realized that I had completed the exegesis and exposition without seeking God’s help through prayer. Do I believe in prayer? Do I believe in praying before sermon preparation? Do I believe that through the Holy Spirit God’s Word will be illuminated to my mind and heart? Yes, yes and yes! But I forgot to pray.
I am toying with the idea of a check list for sermon preparation. I wonder if a checklist could improve my sermon preparation and my preaching? My proposed checklist has the following: Pray for guidance; read the original text; outline the passage; identify key words or phrases; identify what needs clarification; exegete the text; prepare the exposition; check the commentaries; list the biblical principles; show the relevance of the principles for life (application); prepare an introduction; prepare the conclusion and challenge.
Perhaps a weekly checklist would be helpful as well: Send visitor letters; send out appreciation notes cards; visit the shut-ins; prepare the church bulletin; allow time for a crisis.
I believe that a checklist for ministry can empower pastors and teachers to be the very best they can be in the pulpit, the classroom and in pastoral ministry. It worked for the airlines, the surgeons, and maybe it will work for the ministry. Do you think it’s worth a try?