I Can Guarantee Something That Will Never Ever Change And It’s Where To Find All The Opportunities.

There’s an old business story about a cookie factory owner.

Cookie

His company was making millions of cookies and was very profitable.  However, his board was always asking for more profits.

One day the cookie factory owner thought of a great idea!  “What if we got rid of 1 of the 13 spices we put in the cookie?  No one will probably realise and our expenses will go down!”.

He tried it out and got rid of one of the ingredients.  None of his customers realised and the boards profits and margins improved!

He went on to have another idea: “Well, no one realised that the cookie now only uses 12 spices.  Why don’t we get rid of another spice?”.

This went on for a while and at some point his cookie sales started to dwindle.  People just weren’t interested any more.  The cookie owner tried to recover, but his brand was permanently tarnished and due to the new way the cookies were being manufactured the business didn’t recover and he went out of business.

Here’s the thing.  Often things change, but really slowly.  Each small increment of change is not noticeable, but at some point when you stand back and observe, you’ll notice that the landscape has drastically changed.

The one thing I can guarantee will never change, is that everything will change.

When things change, new opportunities arise.  But the places where change occurs the most is at “the edges”, not the mainstream.

The mainstream ends up following “the edges”.

Donald Trump & Brexit

I have a confession to make.  I didn’t follow Donald Trump’s election campaign throughout 2016, which lead to his election in 2017.

I remember waking up in the morning when it was announced that he had won.  I didn’t think anything of it, but when I got to work there seemed to be some kind of mass hysteria which had overtaken everyone.  My disinterest has continued since his election and my life hasn’t changed in any way since before he was elected.

I have another confession to make.  I didn’t follow anything to do with Brexit, which resulted in the United Kingdom announcing that they would leave the European Union.  Once again, since Brexit has been announced, my life has not changed in any way.

Now, what I’m not saying is that these two events don’t matter, will never have an impact on me and on others.  But my observation is that both of these events were unpredictable and unexpected.

Election campaigns are like “The Edge” of a given field.

“The Edge”, as I define it is the place where change is rapid, where present data does not correlate with outcomes and where if you play your cards right you can gain massively from disorder by creating and innovating.

The reason why there was and is mass hysteria surrounding Trump’s election and around Brexit is because the mass population is not used to “The Edge”.  The mainstream lives in a world where change is slow, where change makes some kind of sense, where change happens to you.  

The Edge

When things hit the mainstream, the opportunities you get exposed to will be incremental in nature.

When you get to “The Edge”, opportunities aren’t incremental, they aren’t even exponential, they’re of a whole new category.

Think of a couple of the current buzzwords in the medical world at the moment: “automation” and “robotics”.

You’ll get visions of futuristic robots with lasers carrying out the work of surgeons.

ironman

I will use always every opportunity I have to stick in an Iron Man jpg into my blog posts.

To the mainstream surgeons – the typical surgeon working in small general hospitals – robotics and automation seems like several decades away, or it may be that they think robotics will never hit the mainstream.

And this is the point of this essay once again:

The one thing I can guarantee that will never change, is that everything will change.  And when change happens the people who were the main players at “The Edge” win.

Say for example that you were doing “mainstream” open heart surgery in the early 2000’s.  By the early 2000’s heart surgery was already kind of figured out.  Any further improvements since then have been incremental in nature.

“The Edge”, at this time was actually the move to minimally invasive surgery.  This is where you can operate on the heart by creating a tiny incision on a patients thigh and then introducing some instruments into the main blood vessels of the leg.  These instruments are then navigated towards the heart where you can carry out procedures such as angioplasties and valve replacement procedures.

The minimally invasive techniques have a faster recovery rate, are cheaper and increasingly have better outcomes in every respect in comparison to open heart surgery.

Being at “The Edge” at the time when minimally invasive surgery was being developed would have provided all the opportunities that people often look for – it would have allowed the innovators to have their say on how to perform procedures, to pioneer new techniques, to develop new instruments and tools which you could build a new business around etc.

Yes, “The Edge” may sound crazy, it may be exclusive, the odds of a lot of new technologies causing a dent in the world may be random or low, but nonetheless it is still where change occurs and where opportunities live.

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Don’t Say That!

tram

“I stink, therefore I tram.”

I spent some time living in Prague, Czech Republic.  The summers would get really hot and I couldn’t help but notice that the Czechs had a strange aversion to deodorants.  This would become painfully obvious when riding the public trams.  I wasn’t the only person that noticed this, but of course if you generalise and say something along the lines of:

“Population X has characteristic Y.”

people get upset….really upset….

But what happens if it’s true?  All cultures have their own characteristics.  If you go to India and say that Indians behave – generally speaking – in a different way to people in the UK, is that controversial?

I think it’s fairly obvious that human beings get emotion and logic mixed up all the time.  We make bad choices when we’re angry or upset for example.  But I think the problem goes even deeper than this.

I think that we avoid thinking things, because it makes us uncomfortable.

It seems that ideas and thoughts fall under four categories:

 1) Wrong & Nice 4) Right & Mean
2) Right & Nice 3) Wrong & Mean

1) Wrong & Nice

Being Wrong & Nice is one of the most dangerous categories of thought.  I have seen people come to real harm as a result of this.

When a patient, for example, is very likely to have cancer should you not just be honest and tell the patient the truth?  Are you doing the patient any real favours by not telling them that they most certainly do have cancer or that their treatment is going to be painful and life altering?

How about if an employee keeps asking for a raise?  Is it fair to just keep leading them on, or is it more appropriate to explain that if said employee doesn’t bring more value to the table that they can just be replaced by someone else who will work for less.

2) Right & Nice

This is where the majority of people spend their time.  This is conventional wisdom.  It is mainstream knowledge, with mainstream thought processes.  No need to rock the boat.

Perhaps it is because we are taught from a young age that “being right” goes hand in hand with being “nice” that we conflate being “nice” with being right.

3) Wrong & Mean

Mean people are douche bags.  No one likes them.  They often have short tempers and don’t think things through.  They often only have one perspective – their own!

Again, from a young age it seems that we’re educated out of being mean.  Because being mean or being a “bully” is bad.

4) Right & Mean

The problem is that it is possible to be both right and “mean”.

When a mother tells a child off, they may be mean, but it will likely lead to a more disciplined person down the line.

When a doctor looks a patient in the eye and says “there’s nothing more we can do”, it’s often mean, but right.

I think that being mean is undervalued by society.  As a result there’s a lot of value to be found in “mean but right” thoughts.

Peter Thiel often asks the question:

“Tell me something that’s true, that almost nobody agrees with you on”

The reason he asks this question is because great businesses are built on insights which are overlooked by the majority of people. All great businesses are built on an insight or a secret which the other people in the marketplace overlooked, because if it’s not then you will face a lot of competition and your profits will be competed away.

When Uber had the idea that taxi services were corrupt, worked in cahoots with the government and were opposed to making things better despite their customers suffering, Uber could be called “mean but right”.

It is likely that there are many other successful businesses which could be built in the “right but mean” category of ideas.

But beyond business as well, there are a lot of “right but mean” thoughts which get ignored in the public discourse.  I fear that nowadays it is increasingly becoming more acceptable to be “wrong and nice” rather than “right and mean“.  It seems that society in general is moving down a more emotional, less rational trajectory.

If It Looks & Swims & Quacks Like A Duck, It Might Not Be A Duck

I was shocked at what the pyramids looked like up close when I went to Egypt.  I always thought that they’d be smooth* on the outside.  But when I got up close to them they were made of very large stones.

Pyramids of Giza

Pyramids of Giza

More recently I found out that many of the Greek and Roman architects tilted columns and spread them out unevenly to give the appearance that the columns were actually spread out evenly and absolutely straight.

parthenon-feature

The Parthenon in Greece uses a technique called “entasis” to make it appear that the columns are absolutely straight when in fact they are slightly curved

The point is that when we observe something superficially, we may be fooled into thinking a certain way.  And sometimes it takes someone to point it out and say; “Hey, look at it this way”, before we ever even notice the truth.

It strikes me that when people talk about “success” and “failure” they are often described as the opposite of one another.  People make it sound like there’s a spectrum like height, where there’s a tallest person and where there’s a shortest person.

The reality is very different.

The reality is that when you set out to accomplish something “failure” and “success” often require the same amount of effort, the same actions, the same thought processes, the same sacrifices, but one has an outcome which we call “failure” and the other has an outcome we call “success”.  Failure and success it seems are just two sides of the same coin.

“Mediocrity” is in fact the real opposite of both “success” and “failure”.  Coming somewhere in the middle, not standing out and fitting in is the path that people who are trying to accomplish something avoid at all costs.

*I am aware that the pyramids in Egypt were in fact smooth on the outside many years ago, but nonetheless they definitely aren’t smooth today.

Is Someone Getting The Best Of You?

True story.

I was once working in a hospital that was desperately short of doctors to cover the night shift.  The hospital somehow managed to find a senior doctor to cover one of the night shifts to oversee the work of the junior doctors, admit new patients and ensure patients were safe over night.

Usually the doctors that are hired in short notice get generous hourly pay because the hospital needs the doctor, but the doctor doesn’t need the hospital.

When this particular doctor arrived to start his night shift he was very angry because he was promised hot food and a place to eat.  Because the hospital didn’t organise this for him, he got up and said he was going to leave.  The nurses begged the doctor to stay, but he drove off while all the nurses looked at each other in horror, realising that there was no senior cover for the night.

What’s the lesson?

The person who has the most options always wins.

If you have no or few options in life, then by definition someone has power over you.

boss

A lot of decisions in life come disguised as logical and “safe”.  But they often bring with them hidden pitfalls and loss of optionality.

The person working in a “safe” job in an office making a steady income for example is counter intuitively a lot more vulnerable than an Uber driver.

The Uber driver can earn the same amount as most office workers.  Granted, he may have more variability in his take home pay month to month, thus making his job “unsafe”.  But when the office worker gets fired in his mid 40’s with no transferable skill set he is in a lot of trouble.

The Uber driver by contrast will be able to detect if his livelihood is at stake early and retrain / develop his skill set before getting laid off.  By working with the “safe” company the office worker gave up optionality later in life without realising.

Moral of the story:

In the majority of decisions, the decision which will provide most optionality is the correct one.

*Money is attractive to people as it represents pure optionality.  You can do anything you want with it.  But only if you own the money outright.  Money often has strings attached – either you owe it back, or someone gets a portion of your company or even worse you trade a portion of your life to get a paycheck.

In a startup this matters.  If you take a loan or you raise money, all of a sudden you’ve lost optionality as the people you took money from want it back and often with interest.  This limits your ability to innovate and explore different options.

 

How To Measure Your Life

It is unusual how when you insist on measuring something, you often end up measuring what actually doesn’t matter.  Often the thing you end up measuring is a distant relative of something meaningful.

Modern medicine is pretty incredible.  We can stick a tube down your air pipe and artificially ventilate you, we can keep your heart pumping artificially to keep the blood flowing, we can introduce an IV line and keep you hydrated by giving you fluids, we can feed you with a tube into your stomach (a PEG feed) and we can catheterise you to make sure you’re peeing properly.

By all measurable metrics we can keep you “alive”.  But by doing all of this are we really keeping the patient “alive” in any meaningful way?

 

Measure

I have a feeling that we often end up measuring things due to the mere fact that they are easy to measure.  The things which actually matter are usually difficult or impossible to measure:

  • “Likes”, “Follows” and “Shares” instead of measuring impact and engagement.
  • Money instead of measuring purpose and fulfillment.
  • Short-term growth instead of “durability”.

So the question becomes; “Are you measuring your life in a meaningful way?”, or are you measuring out of convenience.  Maybe it’s time to buckle down and figure out what actually matters.

It All Starts With An Idea

Two fish swam past one another. One turns to the other and says:

“The water’s nice today isn’t it?”

After a few minutes the second fish thought to himself:

“What’s water???”

Ideas are valuable. Ideas are the birthplace of innovation, entrepreneurship and value creation.

The problem in today’s world is that many ideas go unquestioned for so long that we forget that we can even question them. The fact is that opportunity surrounds us all if we only take a closer look and examine things a bit deeper.

In this respect we’re all swimming in opportunity, but just like that fish we may be blind to it.

There’s another problem. New ideas, heterodox ideas, the ones that at first instance seem a bit weird are often dismissed too quickly. They aren’t allowed to grow and mature, because just like anything else, ideas change over time and often get better.

So the key is to not only question what already is, but allow new ideas a chance by not interrogating them too much, but exploring them fully.

Ideas Come First

For some reason there is a notion that “science” generates ideas, that science provides the means to bring about spectacular new innovations.

But, it isn’t and never will be.  Science is a method to prove or disprove a theory.  The theory or idea itself came from a person who had a hunch.

I sometimes tell my patients a story about stomach ulcers.  It used to be thought that ulcers could never be caused by bacteria living in the stomach.  The whole scientific community found it preposterous that an organism would be able to live in the stomach and cause ulcers to form.

An Australian doctor had the complete opposite idea.  He had the idea that a bug* could indeed cause stomach ulcers and that a simple course of antibiotics could prevent people needing more invasive operations and reduce the chances of people developing stomach cancer if promptly treated.

“everyone was against me, but I knew I was right.” – Dr Barry Marshall

He used the scientific method to prove himself right – by infecting himself with the bacteria and treating himself.  He went on to win the Nobel Prize in medicine for his work.

How To Know If You’ve Got A Good Idea

I can’t figure out how to develop ideas.  Phrases such as “solve a problem”, don’t quite seem to do the job.

The reason is that “problems” aren’t clearly defined.  Problems – the type that actually matter and are therefore the most valuable are fuzzy and yet to be defined.  So framing a problem in and of itself is very difficult.

The other thing is that to really solve a problem requires you to have an opinion, a view of how things are or should be.  Like Dr Barry Marshall, you need to develop a point of view and then have the balls to stick by it and see it through to the end.

This is very rare indeed.

It is very rare to meet someone who has thought deeply about an issue and come to a conclusion which is unique and well thought out.  Most people not only allow others to define the discussion or the problem, but they rely on other people to provide the solution and thought process behind the reasoning.

I have noticed that if you do have an idea, the best way to figure out if it is a good one, is to put it to the test.  Implement it in the real world and see what happens.  It won’t be perfect and it will get altered, modified and changed** as time goes on and as it comes into contact with resistance.  But if all the signs point to the idea being robust then you owe it to yourself and the world to see it through.

*Helicobacter pylori

** There is an idea called “Hegelian Aufheben” which says that when some ideas come into contact with an opposing idea it is not destroyed.  Nor does the original idea destroy the opposing idea.  There are situations where the opposing ideas enrich each other and they both get better, stronger and more robust.

Are You Stupid, Mature Or Brave?

The only thing between where you are now and where you want to be are a series of hurdles.

Few people overcome these hurdles to reach the goal. Few people push through to become the person they want to become.

Stupid people start something while full well knowing, from the very beginning, that they’re never going to push through to the end.

Mature people realise that there are too many hurdles and don’t even start.

Brave people, the very few, decide that they’re going to fight to the end and reach the goal.

When you started your project, your business, your university course, your fitness regime you signed up for a series of hurdles.

Being mature is fine.

Being brave is fine.

Being stupid is inexcusable.