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INTRODUCTION Pulling the Andon Rope

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How poor are they who have not patience!What wound did ever heal but by degrees?

William Shakespeare

In a small, windowless room, in a busy clinic in south London, a familiar ritual is about to begin. Let’s call it Man with Back Pain Visits Specialist.

You may recognise the scene: the white walls are bare apart from an anatomical poster and a few smudged fingerprints. Fluorescent light falls from a bulb overhead. A faint whiff of disinfectant hangs in the air. On a trolley beside the treatment table, acupuncture needles are spread out like the tools of a medieval torturer.

Today, I am the man seeking relief from back pain. Face down on the treatment table, peering through a foam ring wrapped in tissue paper, I can see the hem of a white lab coat swishing above the floor. It belongs to Dr Woo, the acupuncturist. Though nearing retirement, he still moves with the liquid grace of a gazelle. To the hobbled masses in his waiting room, he is a poster boy for the benefits of Traditional Chinese Medicine.

Dr Woo is planting a small forest of needles along my spine. Each time he punctures the skin, he lets out a muffled grunt of triumph. And each time the sensation is the same: a prickling heat followed by an oddly pleasant contraction of the muscle. I lie still, like a butterfly yielding to a Victorian collector.

After inserting the final needle, Dr Woo dims the lights and leaves me alone in the half-darkness. Through the thin walls I can hear him chatting with another patient, a young woman, about her back trouble. Later, he returns to pull out my needles. My spirits are already lifting as we walk back to Reception. The pain has eased and my body is moving more freely, but Dr Woo remains cautious.

‘Do not get carried away,’ he says. ‘Backs are complicated and they need time to heal properly, so you must be patient.’ I nod, looking away as I hand over my credit card, knowing what is coming next. ‘You should do at least five more sessions,’ he tells me.

My response is the same as last time, the same as always: make a follow-up appointment while secretly planning to dodge it.

Two days later and, true to form, my back has improved enough that I cancel my return visit, feeling slightly smug about the time, hassle and money this will save. Who needs multiple rounds of acupuncture, anyway? One hit and I’m back in the game.

Or am I? Three months later I’m back on Dr Woo’s treatment table and this time the pain is snaking down into my legs. Even lying in bed hurts.

Now it is Dr Woo’s turn to be smug. While laying out his needles, he tells me that impatience is the enemy of good medicine, and then he gets personal. ‘Someone like you will never get better,’ he says, more in sorrow than in anger. ‘Because you are a man who wants to fix his back quickly.’

Ouch.

Talk about a diagnosis that hits where it hurts. Not only am I guilty as charged – I have been in a hurry to fix my back for 20 years – but I really should know better. After all, I travel the world lecturing on how wonderful it is to slow down, take time, do things as well, rather than as fast, as possible. I have even sung the praises of slowness at medical conferences. But though my life has been transformed by deceleration, the virus of hurry still clearly lurks in my bloodstream. With surgical precision, Dr Woo has skewered an inconvenient truth that I have ducked for years: When it comes to healing my back, I remain addicted to the quick fix.

My medical history reads like a whistle-stop tour. Over the last two decades my back has been twisted, cracked and stretched by a procession of physiotherapists, masseurs, osteopaths and chiropractors. Aromatherapists have rubbed birch, blue chamomile and black pepper oils into my lower lumbar region. Reflexologists have worked the back-related pressure points on the soles of my feet. I have worn a brace, guzzled painkillers and muscle relaxants, and spent a small fortune on ergonomic chairs, orthotic insoles and orthopedic mattresses. Hot stones, hot cupping, electric currents, heat pads and ice packs, crystals, Reiki, ultrasound, yoga, Alexander Technique, Pilates – yup, been there, done all of that. I have even visited a Brazilian witch doctor.

Yet nothing has worked. Sure, there have been moments of relief along the way, but after two decades on the treatment treadmill my back still aches – and it’s getting worse.

Perhaps I just haven’t found the right cure for me. After all, others have conquered back pain using techniques from my treatment plan, and even that Brazilian witch doctor came with glowing references. Or maybe, and this seems far more likely, Dr Woo is right. In other words, I treat every single cure for back pain as a quick fix, targeting the symptoms without addressing the root cause, revelling in its temporary relief, chafing when progress slows or demands more effort before moving on to the next treatment at the drop of a hat, like a chronic weight-watcher flitting from one diet to the next. The other day I spotted a web link peddling ‘Magnet Therapy’ as a panacea for back pain. My first thought was not: ‘Snake oil, anyone?’ It was: ‘Can I get that in London?’

This book is not a back pain memoir. Nothing is more tedious than listening to other people drone on about their aches and ailments. What makes my losing battle with my lumbar region worth exploring is that it points up a much bigger problem affecting every one of us. Let’s be honest: when it comes to chasing instant results, I am not alone. In every walk of life, from medicine and relationships to business and politics, we are all hooked on the quick fix.

Looking for shortcuts is nothing new. Two thousand years ago Plutarch denounced the army of quacks hawking miracle cures to the gullible citizens of Ancient Rome. At the end of the eighteenth century infertile couples queued up in hope of conceiving in London’s legendary Celestial Bed. The amorous contraption promised soft music, a ceiling-mounted mirror and a mattress stuffed with ‘sweet new wheat or oat straw, mingled with balm, rose leaves, and lavender flowers’, as well as tail hairs from the finest English stallions. An electric current allegedly generated a magnetic field ‘calculated to give the necessary degree of strength and exertion to the nerves’. The promise: instant conception. The cost for one night of fertile fumbling: £3,000 in modern money.

Today, though, the quick fix has become the standard across the board in our fast-forward, on-demand, just-add-water culture. Who has the time or patience for Aristotelian deliberation and the long view any more? Politicians need results before the next election, or the next press conference. The markets panic if wobbly businesses or wavering governments fail to serve up an instant action plan. Websites are studded with ads promising fast solutions to every problem known to Google: a herbal remedy to reboot your sex life; a video to perfect your golf swing; an app to find Mr Right. In the old days, social protest entailed stuffing envelopes, going on marches or attending meetings in town halls. Now many of us just click ‘Like’ or fire off a sympathetic tweet. All over the world, doctors are under pressure to heal patients in a hurry, which often means reaching for a pill, the quick fix par excellence. Feeling blue? Try Prozac. Struggling to concentrate? Join Team Ritalin. In the never-ending quest for instant relief the average Briton now pops, according to one estimate, 40,000 pills in a lifetime. I am certainly not the only impatient patient in Dr Woo’s waiting room. ‘The easiest way to make money today is not to heal people,’ he says. ‘It is to sell them the promise of instant healing.’

Indeed, spending money has become a quick fix in itself, with hitting the mall touted as the fastest way to lift sagging spirits. We joke about ‘retail therapy’ as we show off that new pair of Louboutins or the latest iPad case. The diet industry has turned the quick fix into an art form. ‘A bikini body by next week!’ the ads scream. ‘Lose 10 pounds … in ONLY 3 days!’

You can even buy a quick fix for your social life. If you need a workout partner at the gym, a best man for your wedding or a kindly uncle to cheer your children at sports day, or if you just want a shoulder to cry on, you can now hire any of the above from rent-a-friend agencies. The going rate for a pal to hang out with in London is £6.50 per hour.

Every quick fix whispers the same seductive promise of maximum return for minimum effort. Trouble is, that equation doesn’t add up. Think about it for a moment: is worshipping at the altar of the quick fix making us happier, healthier and more productive? Is it helping to tackle the epic challenges confronting humanity at the start of the 21st century? Is there really an app for everything? Of course not. Trying to solve problems in a hurry, sticking on a plaster when surgery is needed, might deliver temporary reprieve – but usually at the price of storing up worse trouble for later. The hard, unpalatable truth is that the quick fix never truly fixes anything at all. And sometimes it just makes things worse.

The evidence is all around us. Even as we drop billions of pounds on diet products promising Hollywood thighs and Men’s Health abs in time for summer, waistlines are ballooning all over the world. Why? Because there is no such thing as One Tip to a Flat Stomach. Academic studies show that most people who lose weight on diets regain it all, and often more, within five years. Even liposuction, the nuclear option in the slimming arms race, can backfire. Fat sucked from a woman’s thighs and abdomen usually resurfaces within a year elsewhere on her body, as bingo wings, say, or shoulder flab.

Sometimes, the quick fix can be worse than no fix at all. Look at ‘retail therapy’. Buying the latest Louis Vuitton bag may lift your mood, but the effect is usually transient. Before long you’re back online or in the mall hunting for the next thrill – while unopened bills pile up like snowdrifts by the front door.

Look at the damage wrought by our penchant for pills. Surveys suggest that nearly two million Americans now abuse prescription drugs, with more than a million hospitalised every year by the side effects of medication. Overdosing on legal pills is now a leading cause of accidental death in the US, where the black market in hard-to-get medication has fuelled a sharp rise in armed robberies at pharmacies. Even neonatal units are reporting a spike in the number of babies born to mothers with painkiller addictions. And it’s not a pretty sight: newborns suffering from withdrawal scream, spasm and vomit, rub their noses raw and struggle to eat and breathe.

You certainly cannot solve hard problems by just throwing money at them. To mend its ailing public schools, New York City began linking teacher pay to pupil performance in 2008. After forking out more than $55 million over three years, officials scrapped the programme because it was making no difference to test scores or teaching methods. It turns out that fixing a floundering school, as we will see later in the book, is a lot more complicated than just doling out cash bonuses.

Even in business, where speed is usually an advantage, our fondness for the quick fix is backfiring badly. When firms hit choppy waters, or come under pressure to goose the bottom line or jack up a sagging stock price, the knee-jerk response is often to downsize. But shedding staff in a hurry seldom pays off. It can hollow out a company, demoralise the remaining workforce and spook customers and suppliers. Often it leaves deeper problems untouched. After sifting through 30 years’ worth of longitudinal and cross-sectional studies, Franco Gandolfi, a professor of management, came to a stark conclusion: ‘The overall picture of the financial effects of downsizing is negative.’

The rise and fall of Toyota is a cautionary tale. The Japanese car-maker conquered the world by obsessively tackling problems at their source. When something went wrong on the assembly line, even the lowliest worker could pull a cord, known as the Andon rope, which would cause a buzzer to ring and a light bulb to flash overhead (‘andon’ means ‘paper lantern’ in Japanese). Like a toddler, staff would ask ‘Why, why, why?’ over and over again, until they reached the root cause of the problem. If it turned out to be serious, they might stop the entire production line. In every case, they would devise a permanent solution.

But everything changed when Toyota embarked on a headlong dash to become the number one car-maker in the world. Management overreached, lost control of the supply chain and ignored warnings from the factory floor. They started putting out fires without asking why those fires were breaking out in the first place.

Result: a recall of more than 10 million faulty vehicles that shredded the firm’s reputation, wiped out billions of dollars in revenue and unleashed a barrage of lawsuits. In 2010 Akio Toyoda, the company’s chastened president, explained to the US Congress how Toyota fell from grace: ‘We pursued growth over the speed at which we were able to develop our people and our organisation.’ Translation: we stopped pulling the Andon rope and fell for the quick fix.

You see the same folly in professional sports. When a team hits a slump, and the clamour for a turnaround reaches fever pitch in the stands and the media, owners reach for the oldest fix in the playbook: fire the coach and hire a new one. As the world has grown more impatient, the scramble for results on the field has turned more frantic. Since 1992 the average tenure of a manager in professional football in England has fallen from 3.5 years to 1.5 years. In the lower leagues six months to a year is now the norm. Yet turning management into a revolving door is a bad way to run a team. Academic research shows that most new managers deliver no more than a short honeymoon period of better results. After a dozen games the team’s performance is usually the same, or worse, than it was before the regime change. Just like a weight-watcher piling the pounds back on after a crash diet.

You see the same mistakes in war and diplomacy. The US-led coalition failed to back up the shock-and-awe invasion of Iraq in 2003 with proper long-term plans for rebuilding the country. As Western troops amassed on the border, Donald Rumsfeld, then the US Secretary of Defense, put a modern spin on the old chestnut that the soldiers would be ‘home for Christmas’. The war in Iraq, he declared, ‘could last six days, six weeks. I doubt six months.’ What followed was years of chaos, carnage and insurgency, capped by an ignoble retreat from a job half done. In the salty argot of the US military, the brass ignored the golden rule of the seven Ps: Prior Planning and Preparation Prevents Piss-Poor Performance.

Even the technology industry, that great engine of speed, is learning that you cannot solve every problem by simply crunching more data and writing better algorithms. A team of IT specialists recently rode into the World Health Organisation headquarters in Geneva on a mission to eradicate tropical diseases such as malaria and Guinea worm. A culture clash ensued. The Tropical Diseases department is a million miles from the hip working spaces of Silicon Valley. Grey filing cabinets and in-trays piled high with folders line a dimly lit corridor. A yellow, hand-written note saying ‘Hors Service’ (out of order) is taped to the coin slot of the drinks machine. Sandal-wearing academic types work quietly in offices with tropical fans on the ceiling. It feels like the sociology department of an underfunded university, or a bureaucratic outpost in the developing world. Like many of the experts here, Pierre Boucher was stunned and amused by the can-do swagger of the IT interlopers. ‘These tech guys arrived with their laptops and said, “Give us the data and the maps and we’ll fix this for you,” and I just thought, “Will you now?”’ he says, with a wry smile. ‘Tropical diseases are an immensely complex problem that you can never just solve on a keyboard.’

‘Did the uber-nerds make any inroads?’ I ask.

‘No, nothing at all,’ says Boucher. ‘Eventually they left and we never heard from them again.’

Bill Gates, the high priest of high-speed problem-solving, has learned the same lesson. In 2005 he challenged the world’s scientists to come up with solutions to the biggest problems in global health in double-quick time. The Bill and Melinda Gates Foundation awarded $458 million in grants to 45 of the more than 1,500 proposals that flooded in. There was giddy talk of creating, for instance, vaccines that needed no refrigeration within five years. But five years later the mood was sober. Even the most promising projects were still a long way from delivering real solutions. ‘We were naïve when we began,’ Gates conceded.

The bottom line here is clear: the quick fix is the wrong horse to back. On its own, no algorithm has ever solved a global health problem. No impulse buy has ever turned around a life. No drug has ever cured a chronic illness. No box of chocolates has ever mended a broken relationship. No educational DVD has ever transformed a child into a baby Einstein. No TED Talk has ever changed the world. No drone strike has ever killed off a terrorist group. It’s always more complicated than that.

Everywhere you look – health, politics, education, relationships, business, diplomacy, finance, the environment – the problems we face are more complex and more pressing than ever before. Piss-poor performance is no longer an option. The time has come to resist the siren call of half-baked solutions and short-term palliatives and start fixing things properly. We need to find a new and better way to tackle every kind of problem. We need to learn the art of the Slow Fix. Now is the moment to define our terms. Not all problems are created equal. Some can be fixed with a quick and simple solution. Inserting a single line of code can stop a misfiring webpage from inflicting mayhem on a company. When someone is choking on a morsel of food, the Heimlich manoeuvre can dislodge the offending object from the windpipe and save the victim’s life. My focus in this book is on a very different kind of problem, where the parameters are unclear and shifting, where human behaviour comes into play, where there may not even be a right answer. Think climate change, the obesity epidemic, or a company grown too big for its own good.

When dealing with such problems, the quick fix addresses the symptoms rather than the root cause. It puts short-term relief before long-term cure. It makes no provision for unwelcome side effects. Every culture has a tradition of skin-deep fixes. The French call it a ‘solution de fortune’. The Argentines ‘tie it all up with wire’. In English we talk of ‘band-aid cures’ and ‘duct-tape solutions’. The Finns joke about mending a puncture with chewing-gum. The Hindi word ‘jugaad’ means solving problems – from building cars to repairing water pumps – by throwing together whatever scraps are to hand. My favourite metaphor for the folly of the quick fix is the Korean expression ‘peeing on a frozen leg’: warm urine delivers instant relief, followed by worse misery as the liquid freezes solid on the skin.

So what is the Slow Fix? That is the question we will answer in the coming pages. But already it seems clear that it rests on a virtue that is in short supply nowadays: patience.

Sam Micklus knows that better than most. He is the founder of Odyssey of the Mind, the closest thing we have to an Olympics of problem-solving. Every year, pupils in 5,000 schools around the world set out to tackle one of six problems set by Micklus himself. They might have to build a weight-bearing structure from balsa wood, stage a play where a food defends itself in a mock court from charges of being unhealthy, or depict the discovery of archaeological treasures from the past and the future. Teams square off in regional and then national competitions to win a place at the annual World Finals. NASA is the chief sponsor of Odyssey of the Mind, and sends staff along to scout for talent.

I catch up with Micklus at the 2010 World Finals in East Lansing, Michigan. A retired professor of industrial design from New Jersey, he now lives in Florida, and looks every inch the American pensioner, with his comfortable shoes, silver hair and light tan. At the World Finals, however, surrounded by the hubbub of children pulling on costumes and fine-tuning their presentations for the judges, he is buzzing like a kid on Christmas morning. Everyone refers to him fondly as Dr Sam.

During 30 years at the helm of Odyssey of the Mind, Micklus has watched the cult of the quick fix tighten its grip on popular culture. ‘The real trouble nowadays is that no one wants to wait for anything any more,’ he says. ‘When I ask people to think about a problem even for just a minute or two, they are already looking at their watches after ten seconds.’

He takes a sip of water from a plastic bottle and looks around the enormous gymnasium where we are chatting. It feels like backstage at a West End musical, with children scurrying to and fro, bellowing instructions, assembling stage props and testing surprisingly elaborate floats. Micklus’s eyes come to rest on a clutch of 11-year-old girls struggling to fix a faulty chain on their homemade camper van.

‘Even here at the World Finals, where you’re talking about the best problem-solvers of the future, a lot of the kids still want to pounce on the first idea that comes along and make it work immediately,’ he says. ‘But your first idea is usually not your best, and it may take weeks or even longer to find the right solution to a problem and then make it come to fruition.’

No one, not even Micklus, believes we have to solve every problem slowly. There are times – patching up a soldier on the battlefield, for instance, or cooling a damaged nuclear reactor in Japan – when sitting back to stroke your chin and ponder the big picture and the long term is not an option. You have to channel MacGyver, reach for the duct tape and cobble together a solution that works right now. When the astronauts on the Apollo 13 radioed Houston about their ‘problem’ back in 1970, the boffins at NASA mission control did not launch a full inquiry into what caused the space craft’s oxygen tanks to explode. Instead, they rolled up their sleeves and toiled round the clock to devise a quick-and-dirty workaround that would modify the carbon dioxide filters so the astronauts could use the lunar module as a lifeboat. Inside 40 hours the crack problem-solvers in Houston came up with an ingenious solution using materials on board the ship: cardboard, suit hoses, plastic stowage bags, even duct tape. It was not a permanent fix, but it brought the Apollo 13 crew home safely. Afterwards NASA pulled the Andon rope, spending thousands of hours working out exactly what went wrong with those oxygen tanks and devising a Slow Fix to make sure they never exploded again.

Yet how many of us follow NASA’s lead? When a quick fix eases the symptoms of a problem, as that acupuncture session did for my back, our appetite for pulling the Andon rope tends to fade. After a tidal wave of bad debt threatened to torpedo the world economy in 2008, governments around the world swiftly put together bail-outs totalling over $5 trillion dollars. That was the necessary quick fix. Once the threat of global meltdown receded, however, so too did the will to follow up with a deeper fix. Everywhere, politicians failed to push through the sort of root and branch reform that would guard against Financial Armageddon 2: The Sequel.

Too often, when a quick fix goes wrong, we wring our hands, promise to turn over a new leaf and then go back to making the same mistakes all over again. ‘Even when a more fundamental change is required, people still go into quick-fix mode,’ says Ranjay Gulati, a professor of business administration at Harvard Business School. ‘They appear to make the right noises and take the right steps, but ultimately they fail to follow through, so that what starts out as a slow fix ends up being just another quick fix. This is a common problem.’

BP is a textbook example. In 2005 the company’s refinery in Texas exploded, killing 15 workers and injuring 180 more. Less than a year later, oil was twice found to be leaking from a 25-kilometre stretch of corroded BP pipeline off the coast of Alaska. Coming so close together, these two incidents should have been a wake-up call, a warning that years of cutting corners had started to backfire. In 2006 John Browne, then BP’s chief executive, seemed to agree the time for quick fixes was over. ‘We have to get the priorities right,’ he announced. ‘And job one is to get to these things that have happened, get them fixed and get them sorted out. We don’t just sort them out on the surface, we get them fixed deeply.’

Only that never happened. Instead, BP carried on much as before, earning a slew of official reprimands and a hefty fine for failing to live up to Browne’s pledge. In April 2010 the company paid the price for its cavalier approach when an explosion ripped through its Deepwater Horizon rig, killing 11 workers, injuring 17 others and eventually spewing more than 200 million gallons of crude oil into the Gulf of Mexico, making it the worst environmental disaster in US history.

The BP fiasco is a reminder of just how perniciously addictive the quick fix can be. Even when lives and large sums of money are at stake, when everything from our health and relationships to our work and the environment is suffering, even when bombarded by evidence that the road to calamity is paved with band-aid solutions, we still gravitate towards the quick fix, like moths to a flame.

The good news is we can beat this addiction. In every walk of life, more and more of us are starting to accept that when tackling hard problems faster is not always better, that the best solutions take flight when we invest enough time, effort and resources. When we slow down, in other words.

There are many questions to answer in this book. What is the Slow Fix? Is it the same recipe for every problem? How do we know when a problem has been properly solved? Above all, how can we put the Slow Fix into practice in a world addicted to speed?

To answer those questions, I have been travelling the planet, meeting people who are taking a fresh approach to solving tough problems. We will visit the mayor who revolutionised public transport in Bogotá, Colombia; hang out with the warden and inmates at a state-of-the-art prison in Norway; explore how Icelanders are reinventing democracy. Some solutions we encounter may work in your own life, organisation or community, but my goal is to go much deeper. It is to draw some universal lessons about how to find the best solution when anything goes wrong. That means spotting the common ground between problems that on the surface seem completely unrelated. What lessons can peace negotiators in the Middle East, for instance, take from the organ donor system in Spain? How can a community regeneration programme in Vietnam help boost productivity in a company in Canada? What insights can French researchers trying to reinvent the water-bottle take from the rehabilitation of a failing school in Los Angeles? What can we all learn from the troubleshooters at NASA, the young problem-solvers in Odyssey of the Mind, or gamers who spend billions of hours tackling problems online?

This book is also a personal quest. After years of false dawns and half-measures, of shortcuts and red herrings, I want to work out what is wrong with my back. Is it my diet? My posture? My lifestyle? Is there an emotional or psychological root to all this spinal misery? I am finally ready to slow down and do the hard work needed to repair my back once and for all. No more duct tape, band-aid or chewing-gum cures. No more peeing on frozen legs.

The time has come for the Slow Fix.

The Slow Fix: Solve Problems, Work Smarter and Live Better in a Fast World

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