How to Avoid Strategy Myopia by Seth Godin: applied to stroke

 Well stroke doesn't have to worry about strategy myopia since there is NO STRATEGY ANYWHERE IN STROKE! Certainly not 100% recovery, which is what survivors want and our fucking failures of stroke associations are ignoring!

How to Avoid Strategy Myopia by Seth Godin

It just barely works from Seth Godin as applied to stroke rehab

 Stroke rehab is a complete fucking failure!

Here for your edification are most of the failure points!

All the fucking problems in stroke 

WHOM IS GOING TO CHANGE THAT? Certainly not the current stroke medical 'professionals'. None of them are working on 100% recovery! With survivors in charge, stroke would get solved.

It just barely works

This is the story of every new software innovation, and in fact, just about everything engineers have ever created.

The first Wright Bros. plane just barely flew.

The first version of VisiCalc was just barely useful.

The earliest bridges were shaky, unreliable and made of vines.

The secret of successful product development isn’t an innovation that bursts forth as a polished and finished product. Instead, it’s sticking with something that is almost useless, nurturing and sharing and improving until we can’t imagine living without it.

[Worth noting that we do the same thing when we learn to walk or to speak a new language–or even visit a new community.]

The hubris of creativity - Seth Godin

 Obviously I have a lot of hubris, thinking I might be able to offer solutions to stroke recovery. Must be true, not a single stroke medical 'professional' has ever contacted me to tell me I should just shut up and let the 'professionals' dither away and NOT SOLVE STROKE!

The hubris of creativity - Seth Godin

Where’s your permit?

Who said you could try to solve this problem?

I don’t get it…

That’s too original.

It’s not original enough.

You missed a comma.

That’s not funny.

That’s been done before.

That’s never been done before.

It’s not your best work.

None of us are authorized to solve interesting problems.

And there are no guarantees.

Do it anyway. Generous creativity is the only way things can get better.

Seth's Blog : Willfully uninformed

 What has your doctor and hospital chosen not to know about stroke? Maybe something in a bunch of these? I'm sure there would have been a lot more but I didn't index these terms my first 5+ years of writing.

• doctor competence? (145 posts to April 2023)

• doctor incompetence (132 posts to October 2016)

• doctor incompetence? (97 posts to April 2019)

• doctor irresponsibility (3 posts to December 2021)

• hospital competence? (17 posts to November 2023)

• hospital incompetence (106 posts to October 2016)

• hospital incompetence? (47 posts to August 2023)

• in-hospital strokes (7 posts to July 2015)

• don't have a functioning stroke doctor (229 posts to September 2022)

•  don't have a functioning stroke hospital (147 posts to December 2021)

I'll wait for all the doctor and hospital pushback on these and post exact replies with my opinion of the reply.

Seth's Blog : Willfully uninformed

Access to information used to be scarce. We ranked college libraries on how many books they had, and time at the microfilm reader was booked in advance.

Today, if there’s something I don’t know, it’s almost certainly because I haven’t cared enough to find out.

I don’t understand molecular biology, the history of Sardinia or much of agronomy–but that’s my choice. Now that information is widely and freely available, our sense of agency around knowledge needs to change.

It pays to acknowledge that this is a choice, and to be responsible for it. What else have we chosen not to know?

Seth's Blog : The leap

I'm sure my first thousand blog posts were barely read at all. But a few stroke survivors positively commented so I kept going, I've never had ANY communications from ANY stroke medical 'professional' so I guess they don't give a shit about what survivors think. Someday the stroke medical world will listen to me, but only after they become the 1 in 4 per WHO that has a stroke.

My journey on this blog will continue, I'm having too much fun tweaking supposedly smarter people than me. 

Oops, I'm not playing by the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 

Telling supposedly smart stroke medical persons they know nothing about stroke is a no-no even if it is true. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful, I look forward to that day.

Seth's Blog : The leap

In action movies, there’s a lot of leaping. Brave shifts in which the hero gets from here to there, all at once.

It’s easy to imagine that sudden leaps are how we make our impact.

This is blog post #9000 (give or take).

When did the leap happen?

It wasn’t an external leap. The first hundred blog posts were read by fewer than a dozen people.

It was an internal one. The decision to be a blogger. And then redeciding, each day, not to stop.

Every four years, we have a worldwide holiday to celebrate this sort of leap. The leap of choice. Not to suddenly get from here to there, but to choose to go on the journey.

It’s only once every 1,460 days, you can do it.

Leap today.

Perhaps we begin by visualizing it. In the most concrete terms you can find, write it down. If you took a leap today, what would it look like? Who would benefit?

And then, share it with just one other person.

Often, the act of physically writing it down is the most difficult part.

Making change happen from Seth Godin

Obviously I'm a complete failure at this. Not one stroke 'professional' has ever contacted me.  Which is why I think stroke survivors need to be in charge of everything stroke related; hospitals, stroke associations, stroke research.

Making change happen

One way to do it is to get people to want what you want.

The other way is to help them get what they want in a way that gets you what you want.(Obviously what stroke 'professionals' want has nothing to do with getting survivors recovered!)

They’re not the same.

Changing what someone wants is very different from helping them see the story and the path that gets them what they’ve wanted all along.

“Do you have a plan?” (for stroke)

 Applied from Seth Godin: What is your hospital's plan, your doctor's plan, your therapist's plan, to get you to 100% recovery? No plan?  Then everyone in stroke for you is incompetent.

“Do you have a plan?” (for stroke)

First, let’s agree that there’s a problem.

It may be that I think we’re facing something serious, something costly, something urgent–and you don’t.

We can have an honest conversation about the problem without worrying about whether there’s an easy or certain solution.

We can also have a conversation about whether it’s a problem (problems have solutions) or whether it’s simply a situation, something like gravity that we have to live with.

Once we agree that we have a problem, the status quo will show up. It will argue with every tool it has that any variation from the current path is too risky, too expensive and too painful to consider. The status quo will stall. It will argue for studies and will amplify the pain that will be caused to some as we try to make things better for everyone.

And the status quo usually wins. That’s because the makers of change are now playing defense, forced to justify every choice and ameliorate every inconvenience.

Perhaps there’s a more useful way forward.

We begin by agreeing that there’s a problem.

And then each party, every single one, needs to put forward a plan. A plan that either addresses the problem or takes responsibility for not addressing it.

And for each plan, we can consider the likely outcomes. For each plan, we can ask, “will that work?” and follow it up with, “why?” and “how?”

Perhaps you don’t think it’s a problem worth solving. That’s important to bring up before we ask you if you have a plan.

Delay might be the best option. But then let’s be honest and announce that instead of simply stalling.

If 2% of a population takes coordinated action, it makes a difference. If 5% do, it can change everything.

 A quote from Seth Godin's latest post. So with 10 million yearly stroke survivors

, that is only 200-500 thousand people needing to speak truth to their doctors and hospitals. THAT STROKE REHAB IS A COMPLETE FUCKING FAILURE.  AND THEY ARE DOING NOTHING TO SOLVE IT! With friends and relatives(10 per survivor)we only need 20,000 survivors to speak up.   You need to shout it from the rooftops. The stroke medical world is to fossilized to move. If you didn't get 100% recovered your treatment was a failure and no amount of dissembling by your doctor changes that. If they use the excuse; 'All strokes are different, all stroke recoveries are different'. You need to scream in their faces; 'Don't try to excuse your incompetency by such a glib statement'.

I'm obviously a complete failure, not a single stroke medical person has ever contacted me.  What am I doing wrong?  So it it up to you to initiate the change because if you don't your children and grandchildren will bear the brunt of the stroke medical worlds failures.

The ones who didn’t help

If 2% of a population takes coordinated action, it makes a difference. If 5% do, it can change everything.

This simple math also means that most people rarely do anything. Perhaps they don’t care. Perhaps they’re afraid to speak up and commit. And perhaps it’s simply easier to go along for a free ride.

Of course it hurts when friends and colleagues we thought we could count on shirk and hide. But everyone has their own narrative, their own issues, their own fears. We can say, “if I were you,” but we’re not them, they are.

When we focus on the ones who didn’t help, we’re undermining our work. It’s a distraction and a disservice.

Shun the non-believers. Ignore the well-meaning but unmoved. Instead, we have the chance to find and connect and celebrate the people who care enough to make a difference.

Toward better.

 

Difficult problems as applied to stroke by Seth Godin

Si9nce we have NO leadership in stroke, every problem in stroke is being avoided.

Try having your doctor explain why these haven't been solved. NO EXCUSES ALLOWED!

Look at all these problems in stroke needing solutions but none exist and no one seems to be working on them.

 

Difficult problems 

The easy problems are often an illusion. If they were real and they were easy, they’d be solved already.

Difficult problems, on the other hand, stick around until someone with insight, dedication and commitment shows up and gets to work.

Seeking out difficult problems is far more effective than avoiding them.

 

Under the circumstances from Seth Godin

 Trying to beak the complete failure of the status quo in stroke is nigh impossible.

Under the circumstances from Seth Godin

The circumstances are heavy indeed. Systems work hard to maintain the status quo.

The teacher is doing the best they can. But the principal and the board and the regents and the parents…

The board member got elected with great intentions. But the state and the unions and the parents…

The textbook publishers want to do better, but the boards and…

You get the idea.

The circumstances conspire to put us under them.

The option is to start small, as small as possible. Small enough to work, big enough to put you on the hook. Build something that works.

And then, the challenging task begins: Get someone else to do it too.

All at once vs. chronic by Seth Godin applied to stroke

 Stroke is chronic and has totally been overtaken by dementia/Alzheimers. Stroke needs to get to the tipping point  where every piece of research is breathlessly reported on. But that won't occur with current stroke leadership who in some la-la land think nothing needs to be done for stroke, it's already solved.

The whole problem is the stroke world thinks nothing needs to be done as proven by this meme on World Stroke Day a few years ago. Whomever approved that is a complete blithering idiot.

What a lying piece of shit

All at once vs. chronic by Seth Godin applied to stroke 

The emergency wins every time.

The newspaper, social media, dinner time conversation, the principal’s office, sportscasters, the weather, the boardroom–the conversation is almost always about the emergency of the moment. The thing that’s happening all at once.

We have a volunteer fire department in town, but we don’t often have a volunteer corps dedicated to long-term culture change. Even typing that out seems odd.

But the chronic problems define our future, and the persistent changes over time brought us to where we are. Evolution of species is a chronic process. And most of us die from chronic illnesses.

What would it take for us to spend even a fraction of our time and energy and attention on the chronic instead of the urgent? Drip by drip.

 

Knowing it can be done; A Seth Godin blog as applied to stroke

 I know and have documented thousands of research pieces that if just followed up can get stroke solved. The whole problem is the stroke world thinks nothing needs to be done as proven by this meme on World Stroke Day a few years ago. Whomever approved that is a complete blithering idiot.

What a lying piece of shit

Knowing it can be done 

We can improve and magnify things in very short order.

Light bulbs, elevators, website technology–give it some time, and people will pile on and all of the important metrics will be sharpened, made more efficient and more powerful as well.

That’s not really the hard part. The hard part is doing it when people aren’t sure it can be done.

And in that stage of development, taking notes isn’t nearly as important as taking leaps.(Their will be no leaping until survivors are in charge.)

If you do it once, we’ll figure out how to do it again

Your big idea by Seth Godin

 

Your big idea by Seth Godin 

 

It’s probably not completely original. (Actually I think it is. 100% stroke recovery for all.)

It’s probably not breathtaking in scope. (It certainly is. A BHAG(Big Hairy Assed Goal))

It’s probably not immediately popular. (It is amongst the 10 million yearly stroke survivors. Not so much among the stroke medical world because it means a lot of extremely hard work to get there.)

But… it’s definitely worth pursuing, consistently and persistently for years and years. (I've only been at this for 10+ years. Not stopping any time soon.)

If you care. If it’s generous and helpful and worth the journey.

All the big ideas that made a difference follow this pattern.

Dr. Watson for stroke

Since no human is actively trying to solve stroke we should enlist Dr. Watson to analyze all the stroke research out there and create a strategy on running research that will lead to 100% recovery. 

Other Dr. Watson medical uses in here.

• Dr. Watson (48 posts)

 

Seth Godin has a good take on this in here:

Commercial vulnerability 

The paragraph I am focusing on;

What if the work you do is:

compliance-based

standardized

repetitive

not based on innovative or flexible customer interaction…

If it is, it’s pretty likely that you’ll be replaced by a combination of robots, AI and outsourcing.

Everything in stroke should become standardized.  Using the crapola quotation; 'All strokes are different, all stroke recoveries are different.' That requires laughing in their face, stating; 'You know absolutely NOTHING ABOUT STROKE, do you?'

1. First there is the objective diagnosis which points you to the intervention protocols to be used to fix that diagnosis.

2.  The rehab protocols contain EXACT instructions and EXACT NUMBER OF REPETITIONS.  None of this guideline crapola or clinician's expertise . 

3. Doing the first two steps correctly leads to the intended result; Recovery from the disability.

 

Stuck on enormity - but what about stroke?

Yep, solving stroke is a BHAG(Big Hairy Audacious Goal.

Which is why you break it down into smaller parts. Choose one of the 5 causes of the neuronal cascade of death in the first week and just focus on that. Or tackle one of these 13 problems in stroke. This is so fucking simple, it is called creating a strategy to solve stroke. We can't allow researchers to willy nilly choose their stroke research, it has to be directed to the goal of 100% recovery. Which is why biomarkers and recovery prediction should never be researched, they assume the status quo will not change.  The status quo in stroke needs to be destroyed. Another great blog post by Seth Godin.

Stuck on enormity 

When a problem appears too large, too intractable and too unspeakable to deal with, it’s easy to give up.
There never seems to be enough time, enough resources or enough money to make the big problems go away.
Perhaps we can start with a very small part of it. One person, one opportunity, one connection.
Drip by drip, with commitment.
Those are the two hard parts. The insight to do it drip by drip and the persistence to commit to it.

Of course stroke is a difficult problem

Another great Seth Godin blog post. Ask your doctor why they are running away from solving 100% stroke recovery. 'It's hard' needs to maniacally laughed at. 

Of course it’s a difficult problem 

All the easy ones are already solved.
Difficult problems are precisely what we signed up for, right?
Or, at the very least, the only problems that are left.
Difficult problems are rarely solved immediately, and sometimes they’re not solved the way we might have imagined, but with effort, they often yield.

“Where does this bus go?” - 100% recovery is the only destination

If your stroke medical professionals are not on the bus to 100% recovery, shove them off the bus.  THE ONLY GOAL IN STROKE IS 100% RECOVERY, anyone not ok with that needs to get out of stroke.  

More fantastic stuff from Seth Godin.

“Where does this bus go?” 

One approach, which is tempting in the short run, is to wait until people are on the bus and then ask each person where they want to go. Seek to build consensus. Try not to leave anyone out.
The other approach, which works far better if you have a fleet of available buses, is to announce in advance where the bus is going. That way, anyone who wants to go where you’re headed can get onboard.
Enrollment is critical. Enrollment allows leaders to lead. Not by endlessly querying those that they seek to serve, but by announcing their destination and then heading there, with all deliberate speed

Two buttons on offer; One button says, “I don’t care.” The other button says, “I’d like to help.”

Which button is your stroke medical professional wearing?   Like to help is vastly different that actually being able to help. Do you have protocols available to get you 100% recovered? 

I'm 100% positive that our fucking failures of stroke associations are wearing the 'I don't care' button.

 A great Seth Godin discussion.

Two buttons on offer;One button says, “I don’t care.” The other button says, “I’d like to help.”

“I was wrong” from Seth Godin

At what point do our stroke leaders say, 'I was wrong', and let stroke survivors run the stroke world? They have been doing it wrong for at least 50 years and haven't solved stroke. No more chances for them. 

“I was wrong” from Seth Godin 

That’s a hard sell.
It’s difficult to get someone (a client, a boss, a voter, a partner) to say those three words. Difficult to say on our own behalf, too.
Which is why we so easily get stuck.
We get stuck defending what we already decided. Because it feels easier to defend than it does to be wrong.
In 1993, in my role as founder of an internet company, I rejected the idea of the world wide web. I saw Mosaic (and then Netscape) and decided it was stupid, a dead end, a technology not worthy of our tiny company’s time.
That decision cost me a billion dollars.
Within nine months, I saw what others were seeing. I saw the power of widespread connectivity and how it was more powerful than a centralized host.
It still wasn’t easy to say, “I was wrong.”
The alternative is, “based on new information, I can make a new decision.”
We can make a new decision on what’s happening to our environment, based on new data and new science. We can make a new decision on corporate governance or on a recent political referendum.
“Why didn’t you tell me that it would lead to all these bad outcomes?”
Not wrong, simply underinformed.
The cost of a do-over is often less than the cost of sticking with a decision that was made in good faith, on insufficient information.
We don’t have to be wrong. But we regularly get a chance to make things more right.

Justifying mediocre work

Another great post from Seth Godin. How does your doctor and stroke hospital justify even less than mediocre work? Or complete failure like the following?

Full recovery using tPA is only 12%.

Full recovery after stroke rehab is only 10%.

1. 30% get spasticity NOTHING THAT WILL CURE IT.

2. At least half of all stroke survivors experience fatigue Or is it 70%?

Or is it 40%?

NOTHING THAT WILL CURE IT.

3. Over half of stroke patients have attention problems.

NOTHING THAT WILL CURE IT.

4.  The incidence of constipation was 48%.

NO PROTOCOLS THAT WILL CURE IT.

5. No EXACT stroke protocols that address any of your muscle limitations.

6. Poststroke depression(33% chance)

NO PROTOCOLS THAT WILL ADDRESS IT. 

7.  Poststroke anxiety(20% chance) NO PROTOCOLS THAT WILL ADDRESS IT. 

8. Posttraumatic stress disorder(23% chance)  NO PROTOCOLS THAT WILL ADDRESS IT.

  9.  12% tPA efficacy for full recovery NO ONE IS WORKING ON SOMETHING BETTER.

10.  10% seizures post stroke NO PROTOCOLS THAT WILL ADDRESS IT. 

11. 21% of patients had developed cachexia NO PROTOCOLS THAT WILL ADDRESS IT. 

 

12. You lost 5 cognitive years from your stroke  NO PROTOCOLS THAT WILL ADDRESS IT.

13.  33% dementia chance post-stroke from an Australian study?

       Or is it 17-66%?

       Or is it 20% chance in this research?

NO PROTOCOLS THAT WILL ADDRESS THIS

 

 

 

 

Justifying mediocre work

The list of reasons is nearly endless.
We need all of them to explain the shortcuts, phone-ins and half-work that we’re surrounded by.
All of them are pretty good reasons too. We’re in a hurry, the system is unfair, the market demands it, no one will notice, it’s not my job, I was handed a lousy spec, the materials are second-rate, the market won’t pay for quality, competition is cutthroat, my boss is a jerk, it’s actually pretty good, no one appreciates the good stuff anyway…
On the other hand, there’s only one way to justify work that’s better than it needs to be: Because you cared enough.  Obviously our stroke associations don't care enough to solve stroke.