Pandemic As A Fractal Disaster

A clipart image of a woman running with her hair on fire, tormented by various demands that she can't respond to effectively. They include email, Re:Re:Re:, 90, 17,Hey! Nobody told me that, How was I supposed to know that, Who has it?, and a polycom talking nonsense.

Making Choices in an Ocean of Uncertainty (Part 1)

The pandemic resulting from the spread of a novel virus, Covid-19, has pointed out many of the failures of not thinking, planning, or acting with an awareness of large systems and how they dynamically change over time. These failures occur every day in every system of support for people with disabilities, and they occur throughout the larger global complex adaptive system (CAS) that is our world. But we don’t normally see the failures except as small drops of irony. That is, we don’t see the ocean of uncertainty that is the reality of living out our lives in a Complex, Adaptive, System.

I don’t believe that any event in my life (over 7 decades) has shoved our collective face into these realities the way this virus has.

And in less than 3 months.

Much of this “in your face” quality of the pandemic is due to our “connected” world if connected is the right descriptor for experiences that can’t be avoided except in a sensory deprivation chamber, in a deep valley, underground, in Antarctica, with a face mask.

Pandemics always end, but while they are going on, they act like slow motion volcano eruptions, raining down ash on the just and unjust, rich and poor, and every other distinction we make among ourselves about our personal and social worth. Social, financial, and political choices that are usually buried or disguised become obvious. In the disability community, devaluing and destructive choices and matters of life and death become far more obvious and less hidden behind the walls of institutions and programs.

Everything we do before a pandemic will seem alarmist. Everything we do after a pandemic will seem inadequate. This is the dilemma we face, but it should not stop us from doing what we can to prepare. We need to reach out to everyone with words that inform, but not inflame. We need to encourage everyone to prepare, but not panic.” — Michael O. Leavitt, 2007 From Telliamed Revisited

The dilemma that Leavitt describes is certainly a real one, but it is also a dilemma not just because of the impact of a pandemic, but also because those who have taken on the authority for telling us about an appropriate response have long-standing, deeply political, and financial reasons to pretend that they are in control of the pandemic and that their simple, mechanical (maybe these days data-driven), operational policies will win the day. Messaging to communities that have always believed that every problem can be solved through an operational plan, a bigger version of replacing a leaky faucet through a DIY video, makes it easier to massage away the cramps that result from economic, social, and political failure and those pesky long term consequences when they inevitably occur.

The “message is the massage”, as it were.

Pandemics have lots of explicit characteristics that make them difficult to manage using the mechanical, operational planning, and contingency planning that passes for prevention and safety these days:

  • The dynamic process of a pandemic emerges from the relationship between people. Each and every contact has the capacity to spread the virus, but there is also no guarantee that the contact will, and in the immediacy of the contact, no way to tell what happened. There is no way to calculate the probability that any single contact will result in the spread, except over group and population averages that are nowhere near granular enough to track the actual dynamics of the pandemic. Your “track” of a pandemic is always well behind the reality because bugs are faster than we are and have a much longer track record of undoing our best plans for safety than we do for stopping them. This means that the evolution of the pandemic is, among other things, Fractal (everywhere at every level) and inherently uncertain.
  • You can’t negotiate with a virus. You can’t intimidate a virus. A virus is like a tiny Terminator. That means that none of the standard political memes and longstanding manipulation techniques available for everyday use will actually permit social, political, and financial elites to manage pandemics the way they manage everything else of importance to them.
  • Our society ordinarily uses the concept of Risk Management to deal with failure and disaster. Because the dynamic of a pandemic is a CAS, its actual path of destruction will remain uncertain until the current pandemic is over. Real Uncertainty is very, very different from calculable risk. In an uncertain ocean of possibility, every published Risk is wrong and is being used for some additional purpose besides authentically managing the actual pandemic.
  • As Italy has discovered in Lombardy, being supremely confident of your individual and community’s economic strength, high health status,  and social superiority doesn’t stop the corpses from decomposing in their homes, or the stereotyped social worth calculus of global medicine from throwing whole communities under the train.
  • So, in the rollup to the pandemic maximum (number of people affected, the peak of the Bell-Shaped Curve), all the numbers you are being told daily are underestimates (obviously). But it seems to me that most of the time people make decisions about their behavior on the numbers with which they are presented. How many people have been diagnosed today, and should I go to the store and buy food, or drop my child off at daycare one more day, or get drunk at the bar with my friends one more time? Our decisions are almost never made using an actual appreciation of the potential impact. Instead, we are conditioned to make choices that don’t match reality by the very efforts to educate us about what and how we should choose.
  • Although this should be obvious, it isn’t the lethality of Covid-9 that is the greatest threat. Although this virus is somewhere around 20 times as lethal as the annual flu, it doesn’t come close to our ancestral pandemics.  The problem is that our healthcare system is designed around the industrial notion of Just-In-Time supply, treatment, and disposition. If everyone who got the virus had the mild version, we would be able to manage the number pretty much no matter how many there were. But 15-20% of those who become ill (some estimates are as high as 40% for risk of complications) need more than basic illness care. We are all in real trouble if that population shows up in the emergency room on the same day. If the critical care system collapses, it won’t just be people with Covid-19 complications who will die. People with other conditions that ordinarily would have gotten competent treatment aren’t going to get it.

This is why the strategy for managing the pandemic is to first contain, then mitigate the results, as in #flattenthecurve. The goal is to avoid completely overwhelming the healthcare system, under the motto, “Flatten the Curve”; it is not an attempt to prevent death, which can’t be done, but to spread it out so that system failure doesn’t dramatically increase the number who die.

#flatten the curve is a genuine strategy. It is a framework for making decisions about the two things we can never control:

  • The unpredictable future;
  • The eternal scarcity of resources.

#flattenthecurve creates a space of possibilities where we can build and implement operational plans that are consistent with this strategy. Many such plans are being rolled out now. Because the pandemic is fractal, the operational plans resulting from the strategy have to be fractal as well. At every level, there are things we can do to support the strategy. We don’t necessarily need to wait to be told what to do, as long as what we do in our own lives and with those about whom we care is driven by the constraints of the #flattenthecurve possibility space.

If we avoid the collapse of healthcare, we will not only minimize death in the short term, but we will create a timeframe for the longer term that allows for better choices.

Because, like all strategies, #flattenthecurve isn’t a complete answer to a pandemic (there is no complete answer to a novel pandemic).

If we minimize the total number of people who actually get the virus this time around, we leave open the possibility, in fact, the inevitability, of an annual/multi-year cycle of recurrence, much like the annual flu season. But we also will have time for a genuinely effective vaccine, drugs that interfere with the ability for the virus to enter lung cells and cause damage, improved access to (hopefully) more sophisticated and cheaper ventilator systems, and a much deeper experience of acute and long term clinical care for the fallout from the virus.

If everyone on the planet had gotten the virus in one bell-shaped curve, we might have 140 million dead, and be treating the long term effects for many years. And there would be no resources for the mitigation and management possibilities mentioned above.

A well-chosen strategy doesn’t eliminate the reason for its necessity. Rather, it enables you to manage the current and future states of the original trigger for the common good.

We have lost touch with the idea that we should think about the long term together, instead of simply maximizing our individual gratification in the short term. I hope this pandemic proves to be a tonic for our social foresight about our common threats.

Because, as bad as this virus will be, there are far worse novelties that could arise, and we don’t have any idea which one will surface next.

Working together to build real safety and flexible response must be the lesson we take from this evolving experience that we all share, and we need to use this experience to dramatically improve how we manage our uncertain future.

(P5): Local Community Use of the Recovery Model for CAS Change

A diagram of a Community-Based Recovery Model. The core of the diagram is a red oval labeled Individuals and Families; The Connected  Yellow Ovals include Home: Permanent Housing; Health: Recovery, Health, and Wellness;  Purpose: Employment and Education; and Community: Social Inclusion.

Although Recovery is a model first developed for people with lived experience of mental illness, and although the word Recovery seems to point to the idea of cure as a solution to disability, as the model has developed, it is an excellent framework for small mutual support social groups to use person-centered planning to forge individual paths to personal autonomy and freedom of choice.

Recovery allows a person with the support of others who understand their lived experience of disability to manage those parts of life that interfere with that individual path. It doesn’t matter whether the interference is from a so-called “symptom” or a so-called “social determinant”. The process of finding a way to reduce or eliminate the constraint is the same.

The resources in the slide are only the tip of the iceberg in making use of the Recovery Model. The Guiding Principles of Recovery also clearly show the connection to the driving and organizing power of Person-Centered Planning:

Recovery:

  • emerges from hope
  • is person-driven
  • occurs via many pathways
  • is holistic
  • is supported by peers and allies
  • is supported through relationship and social networks
  • is culturally based and influenced
  • is supported by addressing trauma
  • involves individual, family, and community strengths and responsibility
  • is based on respect

This model is also useful for thinking about how to organize locally to produce a change in the CAS that enable or destabilize our personal and group advocacy efforts. The Recovery model should be a core of organizing locally regardless of the kind of lived experience that triggers an embrace of this model. It is also a key to building organized change through the collaboration of different disability communities (including the Substance Use Disorder community). With a common person-centered model of how we achieve together, we can be more effective advocates.

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(P5): The Heuristic of Disability Rights

A large crowd of persons using wheelchairs carrying an American-style flag with stars in the form of a wheelchair, charging across a hill.

The idea of Disability Rights has served as a heuristic for our community for centuries, in small local ways, and for the last half-century as a global organizing framework (a scaffold) for the pursuit of personal autonomy and real choice.

In the process, our community has deepened and enriched the idea of civil rights to embrace the many ways that the context of personal autonomy and choice has on making those values real in the world. More than just the concept of context framing the possibilities of freedom, we have concretely defined, repeatedly, the many real ways the nature of the context can limit or support personal autonomy.

In fact, this exploration of the ways that the larger social context, in both cultural assumptions, infrastructure, and ideas about the meaning of disability, is the most important way that personal autonomy and choice are constrained, far more than the particulars of any disability characteristic.

Our community has explored the possibility space of Disability Rights to expand the impact of our insights and our advocacy practice on the larger world. That effort has resulted in a significant increase in personal possibility over these decades and the increasing sophistication of our advocacy.

At the same time, the model we have used is increasingly brittle, given the larger political and economic evolution of our society, in particular, and globally. This kind of limitation is true of all heuristics. They are never silver bullets but must always be judged in terms of their current strategic effectiveness.

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(P5): Creating Possibility Spaces

An ocean tidal pool as an example of a possibility space.

Possibility Spaces are generated by Governing Constraints-not directly, as in a machine, but by, as it were, increasing the likelihood of interaction among what is within the possibility space. The Tidal Pool in the image is a sort of perfect example of the possibility space concept. The life generated in, and adapted to, a tidal pool is uniquely resilient to change, and elegantly adaptive in its response to change because of the exposure to constantly shifting disturbances. Such resilience is the promise of the concept of the “possibility space”.

Possibility spaces are entities that allow the creation of new enabling relationships and the destabilizing of existing relationships:

American Racism: American Racism began (well before there was an America) as an economic machine that generated vast profits for those who could create and maintain the enslavement of human beings and their exploitation for personal gain. But the evolution and expansion of its successful implementation also provided a space for antiracist initiatives. The important thing to grasp from this is that all possibility spaces have within them the possibility of change if we are willing to build enabling relationships that reflect human values and destabilize the ones that don’t. Such resistance doesn’t dissolve the possibility space, but it does force it to evolve and makes it less resilient.

Only a new possibility space can “replace” the existing one. And governing constraints are viciously resilient. Thus, resistance is not a strategy, however necessary it might be to resist. Resistance does force the existing possibility space to age. But, creating a new possibility space is tough.

Jazz: Wynton Marsalis describes the underlying dynamic of improvisational jazz as the abstraction of a melody line, a chord structure, and a rhythm to create an improvisation(s) that asks, “How might these components of a musical entity have played out differently in real-time?” This is an excellent description of a possibility space. This general frame provides a neat way to envision any possibility space as a force for creative and positive advocacy.

The Unavoidable Exhaustion of a Possibility Space: As a possibility space ages, the old enabling relationships (the ones that justified the creation of the governing constraint) become increasingly narrow and the existing relationships become increasingly brittle making small collapses more likely, and resistance more productive.

Assumptions that Weaken Possibility Spaces: When we assume that a system is a machine, we undermine the “possibilities” in the Possibility Space of our advocacy work. The systems we are trying to change commonly operate with the aphorism, “When you hear hoofbeats, think horses, not zebras”. This assumption is also very common in healthcare, and I believe it accounts for a fair number of misdiagnoses and medical mistakes. The reasoning of the aphorism is that the problem you face right now is more likely to be common than uncommon. That sounds reasonable.  But it is based on the idea that the problem space is a set of discrete machine parts. You identify the right part and then replace it.

We don’t actually make a kind of probabilistic judgment that there is a higher likelihood of horses than zebras. We pick horses as the problem and ignore any other possibility until we have completely failed with the horse “hypothesis”. This behavior is reinforced by systems of care or supports that are designed to reduce cost first and use fail-first and cost-based step methodologies as the core of our decision-making. Evidence-based frameworks, treatment protocols, and the euphemism, “Standard of Care”, are all conceptually related to the hoofbeat aphorism. These mindsets guarantee mistakes.

These issues affect our advocacy approaches as well. We become more predictable when we use the same techniques repeatedly to solve advocacy issues. Our targets adapt at various levels (local policies, hearing decisions, court cases, efforts to weaken laws, etc.). Our Advocacy Possibility Space shrinks over time, requiring more resources and more energy to accomplish less valued outcomes.

At the same time, if we use our creativity in pulling together advocacy actions, we can reasonably assume that the system will see horses rather than our advocacy zebra. This can be a real advantage. But it points out that one of our advantages as advocates is the use of novel interaction to destabilize a weak constraint in our target. Novel intentions and valued outcomes create their own possibility spaces and provide us with a new way of looking at the current Advocacy Possibility Space.

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(P4): The OODA Loop

Complex Diagram of the OODA Loop. See description through link below diagram.

OODA Loop Diagram Long Description

The OODA loop (see picture above) was created by John Boyd to help explain why some fighter pilots were much better than others in aerial dogfights. His basic premise was that you could win if you made good decisions faster than the other pilot. This was oversimplified over time to mean just faster decisions, without the part about better decisions.

The most important part of the OODA loop for advocates is the “Orient” phase. Successful use of the Orient Phase requires not especially the observation of where the opponent is, but rather a deep understanding of how your opponent thinks about reality. What does your opponent value? What risks are paramount in their thinking? After all, you want to know where your opponent is going. As Wayne Gretzky said, “I skate to where the puck is going to be, not to where it has been”.

For example, in an advocacy negotiation over, say, a complex support for a student, the Orienting Framework of a typical ISD or special education administrator focuses on cost, required program resource commitment (including staff, skills, general availability), precedent (will hundreds of other students/families request the same service if we support this student?), and the political consequences of agreement to the requested support from other staff, other parts of the education system, and the general public.

While it might seem as though these concerns are matter-of-fact, they are not. Underlying all of them is the decision-making rationale AND fear-driven concern for personal and system liability if things go sideways for some reason. Because the fear of such liability is never entirely rational (we can’t know the future), the Orienting Framework is sensitive to surprise, regardless of its source.

The use of the OODA Loop as a tactic in disability rights advocacy is often about producing novel challenges to the system as it is now and as it thinks/feels now. Thus, a successful challenge to a system with a novel destabilization requires that you have a clear understanding of how your target thinks and feels.

These challenges don’t have to be radical or revolutionary. They must, however,  be initiatives that the system hasn’t run into before.

Often, there also need to be several destabilizations. A bad habit of naïve advocates is to create a destabilization (say, a complaint) and then sit around waiting for a response. Delay (because it requires nothing but avoiding action) is always available as a default response for the system you are challenging, and it is used as much as possible by that system.

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(P4): Record-Keeping

An ancient written text not in English

Record-keeping is the great unsung heuristic of effective advocates. It is unsung because it seems tedious and time-consuming and seldom drives change by itself.

In the bad old days, record-keeping was incredibly tedious. For example, imagine what it took to transcribe a recording of a meeting before digital frameworks were available to support such tasks.

For example:

  • Using a live transcribe app on a phone to record a meeting and generate a correctable text.
  • Spoken note recording.
  • Composite resource documents so that related information can be reviewed in one place or document by a simple email invitation.
  • Notification when emails are read and by who.
  • Easy encryption.
  • Easy sharing of info and events in an advocacy network through apps like Slack.
  • Social Media as an adjunct to advocacy work.

It is also far easier to collaborate and organize around advocacy information, initiatives, and events through separate personal, support groups, targets, and public venues.

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(P4): Tactical Heuristics

Typical Military Tactic Maneuvers: frontal attack; break through attempt; contra flanking including extended wing contra flanking and mobile force contra flanking; successful break through including stabilizing flanks and rear operation; Hammer and anvil including unyielding front anvil and mobile hammer; Flank counterattack; decoy and destruction; Break through with advance and Counterattack.

ngd-Excuse the typos in the image. I couldn’t find another image that communicated the same stuff….

Here are some guides to making tactical decisions when you are advocating. There are many more out there and you will discover them through your advocating experience as well as the experience of others:

  • Record-Keeping: Deep record keeping has always been an advantage that advocates could have over the systems. The data that advocates develop tend to be useful for advocacy-if you have a record of it. But we often don’t make use of it effectively. This is especially unforgivable with modern digital record-keeping tools easily available.
  • The OODA loop: The OODA loop is a famous model created for pilots involved in dogfights. But its uses go well beyond this original inspiration.
  • Multiple Advocacy Initiatives: Advocacy Targets often interpret multiple advocacy initiatives as far more threatening and anxiety-provoking than single initiatives, even when multiple initiatives require almost no additional effort.
  • Nucleation: Several low-profile similar advocacy initiatives can be used to produce system change without triggering significant counter-responses.
  • Cycles as exploitable weak constraints: Everything in a CAS operates in cycles. We typically don’t pay attention to this, even though there are real exploitable opportunities if we take the time to observe and learn.

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Part 4: Advocacy Heuristics

A complex image. See Text from Image and Notes link below the image.

Text from Image and Notes

What is a Heuristic?

As a tool for disability rights advocacy, a heuristic is a framework of meaning that provides a way of developing an advocacy tactic, strategy, or organization. At its simplest, a heuristic is a rule-of-thumb, that allows us to make decisions about what to do more easily. Mostly heuristics are used to develop tactics, but they can be used at any level of decision-making and for any advocacy purpose. Heuristics represent a distillation of someone’s experience and reflection on what worked in the past.

Even a very capable heuristic guarantees nothing. Heuristics have their own built-in bias and using them automatically prevents you from noticing that bias. Remember that heuristics are initiators of reflection, discussion, and collaboration to reach a decision for action that respects the current reality and the current context, not ways to save time and thought.

So, remember that you, too, come to advocacy work with an existing set of heuristics and their biases. Capable advocacy should always be an opportunity to question, explore, and reframe the automatic responses we all have living in our world of failed social justice.

I would also note that it is common for advocacy organizations to use heuristics more and more automatically as they age.

The image is from Scott Page who has done a lot of work in the usefulness and challenges of diversity as a framework for problem-solving. His work is noted in the text through the link under the image.

The complement of this view of diversity and advocacy (kind of the other side of the coin) is detecting weak constraints in the problem by deliberately avoiding the homogenization that arises in groups. This way of respecting the lived experience of persons is called distributed ethnography (DE). DE is a complement because diversity in groups helps with both problem-solving and detection of weak constraints if approached properly. These ideas are explored more completely through links in the “Text from Image and Notes”.

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(P3): Advocacy Organizations (Good Times and Hard Lessons)

An infinity sign colored like a rainbow

In our time, advocacy is organized around networks of advocacy organizations. This networking through organizations was a natural result of both the problems and successes of individual advocacy and the ongoing struggle for disability civil rights.  Advocacy organizing brings with it its own strengths and weaknesses, and it won’t surprise any reader of this blog that I view this understanding of advocacy organizations through the lens of Complex Adaptive Systems (CAS).

Any advocacy organization (or for that matter, any system we might focus on for advocacy) has at least three Governing Constraints:

  • The organization Mission (why it exists)
  • The organization plan for Reproduction (how it keeps the doors open)
  • Its framework of Hierarchy (how it controls)

To understand why advocacy organizations have their ups and downs, and how advocacy organizations age, you must understand how these Governing Constraints both cooperate and collaborate for the organization’s work over the course of time. Each of the Constraints creates its own possibility space, and the actual trajectory of the organization is a complex interweaving of collaborative and competitive choices in real-time.

The various parts of the organization’s infrastructure (Board, financing system, staff morale, network relationships both positive and negative, who is defined as a threat or competitor, etc.) also reflect this multi-constraint dynamic.

In modern organizations, even non-work time can reflect this dynamic to a varying extent.

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(P3): Meta-Systems Advocacy- Part 2

Famous cartoon of different stakeholder views of designing a tree swing. None of them except the customers original vision of a simple tree swing works as the customer intended

Long Description of Cartoon

More about the Differences Between the Two Kinds of Plans

Causal Models of change, like logic models, tie causal links between the steps from the beginning of the plan to the outcome. But, there is inherent uncertainty in change plans targeted at any CAS, which is inconsistent with the requirements for developing an operational plan like a logic model. We pretend that the problem and the plan are mechanically causal, eliding over the actual complexity. The effect of this is to weaken the so-called causal links and contract the potential outcomes of the plan.

Typically, we don’t just do this because of the obligation to create a mechanically causal plan for our proposal submission. We also do it because we try to make the plan match the perspective of the proposal reviewers about what constitutes a plan that is both creative and “realistic”. After all, if our plan is seen as too ambitious or too open-ended for the available money or the purpose of the RFP, it will be rejected.

But, if we were to stick very closely to the plan as we drew it up for the proposal, we would have great difficulty achieving our valued outcomes. So we fudge our proposal to meet the expectations of the reviewers while trying to keep our fidelity to the valued outcome we want to achieve.

This is a hard thing to do, and we tend to pull back on the impact of our outcomes to meet the realities of the funding possibilities available to us while reframing the outcomes and the steps as marketing memes in the RFP-required causal network.

A “plan” that respects the realities of a CAS is more like a plan for discovering the infrastructure of a room in the dark. You build a model of the room through experiments and exploration, not the traditional model of a plan. If you use a traditional model, you will miss important information about the room. If you experiment and evolve your plan based on what you discover, you can reach an understanding of the room, instead of imposing an inadequate meaning on the room using the traditional logic model approach.

Planning for change in a CAS requires constant engagement, not the “roll out the plan like dropping a rock off a cliff” approach that is almost universal in modern service/support/advocacy organizations.

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