On Not Fitting In

imageWhen I was in Columbus for the iCKM conference last week, I went to see a doctor. I had been traveling for almost a week with a bad sinus problem that had started relatively benignly in Singapore and then worsened rapidly as I travelled.

For those of you who’ve had it, sinusitis + air travel = exploding head every time you make a descent. And I had been making a lot of descents. The other interesting effect was that it appeared to send jetlag effects into hyperdrive. So for the curious the formula looks something like this:

Sinusitis + airtravel = (Exploding head x # descents) + (jetlag effects x # hours time difference)2

I wasn’t keen to repeat the experience on the journey back to Singapore. The hotel suggested the nearby public hospital, but the only way to get attention as a walk-in patient was to go to Emergency and I couldn’t in conscience warrant that. The hospital suggested an “urgent care” centre at a local health centre, which does take walk-ins. So I walked in.

I was taken in hand by a grandmotherly lady named Madonna who told me “We’re not set up for international visitors but don’t you worry honey, we’ll get you seen”. She was right. The patient registration system had us both crouched in front of it as we figured out together how to trick it past US zip codes and phone numbers as validated required fields, missing US social security numbers, and no local emergency contact person in case I keeled over in the midst of being treated there (we gave that doubtful privilege to a person called Hyatt Regency).

And Madonna, bless her, did get me seen, though it took an age (a whole afternoon out of the conference) to do so.

Later on, as I waited in the local supermarket pharmacy to get my prescription filled, I spotted a front page story in the local Columbus newspaper. It said that local police were complaining that their (Federal) crime reporting system had no category for murder-suicides.

They either had to capture it as one thing or the other, but cases where someone killed another person then turned the gun on himself couldn’t be captured. In consequence they were having difficulty figuring out how bad the problem was, or whether there were any distinctive patterns or predictors in such cases.

So what started out as a simple medical expedition turned out to generate several taxonomic insights:

absent categories can impair your ability to manage – if your taxonomy fails to predict the categories you need (eg short term visitors who are non-US citizens, combination crimes) then it’s very difficult to put formal management processes in place around those categories – they are technically invisible

attitude matters – if Madonna hadn’t had the customer focus she had, I might easily have been excluded from her treatment world because technically, in the registration system, I could not exist

improvisation around “invisibles” often happens but it is always provisional and depends on the attitudes and capabilities of the staff confronted by the problem. Even where the improvisation becomes habitual it tends to remain a tacit practice not captured in formal processes, so it remains invisible, and the fact that staff make the problems go away means that the formal managerial process is never confronted with the problem and therefore does not recognise or accommodate it – ie people who are forced to use poor taxonomies develop improvisation strategies that very quickly conceal the shortcomings of the taxonomy and hinder its correction.

I guess this is why the first rollout phase of a taxonomy or any management system built around fixed category structures, needs to be extremely responsive to mismatches and failed categorizations, so that improvisations don’t get enough time to bed down and conceal the problem. Secondly, when new category needs become apparent (eg we need to examine the phenomenon of murder-suicides), all systems need a way of alerting their taxonomy manager with the requirement.

The murder-suicide phenomenon by the way is a very good example of why single hierarchical taxonomies, where there is a single place for every entity, simply do not work in human systems. The Ohio police need facets. But that’s another story.

1 Comment so far

Luke Naismith

Of course, you could have used a Neti Bowl in the first instance of when you felt your sinus condition coming on.  That would have flushed your sinuses and cleared any infection before it took hold.  But then, you would not have been able to tell such an interesting story!

Posted on October 27, 2008 at 04:03 PM | Comment permalink

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