Maggie Jackson, writer and columnist

We’ve all heard of the distracted pilots who overshot the Minneapolis airport. But did you know that medical errors due to distraction place many people in danger every day?

A reader sent me a fascinating dispatch from the medical world on a series of San Francisco-area programs to reduce medical errors while nurses are dispensing medications. Nurses reduced their errors nearly 90 percent at nine Bay-area hospitals over the past year, and a key to the effort lay in new techniques to reduce distractions.

You can imagine what happens. Hospitals are busy places, with the level of care growing more complex by the day. A nurse dispensing medicine at bedside gets interrupted, mixes up one medicine for another, and the results can be fatal. Errors in administering medicine cause 400,000 preventable injuries in hospitals and $3.5 billion in extra medical costs annually, according to the Institute of Medicine.

The focus on distractions at Kaiser South San Francisco Medical Center began with orange vests – similar to those construction workers wear, according to an article in Nursezone, an online news site for the field. Quality-control nurses thought that wearing the vests as a kind of walking “do not disturb” sign could reduce interruptions during pill dispensing.

At first, floor nurses balked, seeing the vests as “cheesy” and “demeaning.” But first results showed that two units cut their errors in half in just four or five months simply by using the vests and educating nurses about reducing distractions.

The word spread throughout the hospital and across the Kaiser system, and a test of nine hospitals reduced medical dispensing distractions about 88 percent in the past year. The larger program includes many more safety steps from checking patient identity twice to turning up the lights and – my particular favorite – turning down the television. (I recall taking my then-two daughter to the dentist for the first time and watching amazed as the hygienist tried to give her a first brushing lesson with the tv blaring. Since then, I’ve always switch off the tv when a dentist or assistant come in the room.)

As a result of the intervention, giving medicines is “a more focused process,” says Suzi Kim, RN, BSN, and a staff nurse at Kaiser West Los Angeles hospital. Without interruptions, “we can think clearly.”

And if hospital staff can think clearly, perhaps they can do more to see and treat the whole human being. I hope so. As important as these anti-distraction programs are, procedures shouldn’t be the end of the story. While medical folks need to focus to do their work correctly and to problem-solve, they also need to restore focus to their interaction with the patient.

That’s the topic of my next blog, which will run tomorrow.

Months ago, Cali Williams Yost had a wish. In her FastCompany blog, she hoped that Distracted would start an attention movement similar to the new environmentalism sparked by Rachel Carson’s Silent Spring. And indeed, wherever I speak, people everywhere are asking, ‘where do we start? How do we regain our focus and spark the ‘renaissance of attention’ that you describe in your book?’

Well, that nascent movement just may be starting to pick up speed. Some signs:

 People are talking. There are debates and discussions everywhere about our crisis of distraction. At work, people are drilling down into the roots of overload. At home, parents aren’t smiling much anymore about their kids’ addiction to texting. A new study showing the inefficiencies of multitasking is inspiring heated debate. (See my previous post on the research.) This is important. It’s time to come together and focus on the problem. That’s how solutions get sown.

 People are acting.  A Seattle University communications professor recently held an innovative faculty workshop on the impact of distraction on student life. Professors everywhere are frustrated by a chronic lack of attention in the classroom. But organizer Mara Adelman coaxed the discussion beyond griping and finger-wagging.

At the workshop, faculty talked about setting up clear, firm rules on tech use in class and holding kids accountable – no attention, no recommendation. But faculty also did a lot of soul-searching, according to the wonderful website that Adelman set up to keep the momentum of the event going. They talked about collectively working through “technoquette” issues, role modeling focus in their lives, and reminding one another and students how opportunities for connection and conversation are lost amidst epidemic distraction. One faculty member wrote later, “I used to complain about distraction but never spent time to analyze this problem. This workshop made me sit down and find ways to control distraction in my personal life and in the classroom.”

This is exciting, and it’s not a one-off example. I’ve heard of others crafting training events based on my book and other resources. Add to this the uptick in both state and employer bans on driving distracted, and I see the makings of a 360-degree movement.

Write to me if you have ideas on how to move the process forward!

PS – Check out this great blog post by Andrea Saveri, one of my favorite thinkers, on multitasking and the often overly simplistic discussions that erupt when we debate about the impact of technology on our lives. Hear, hear!

A New York Times piece on the toll that frenetic texting is having on teens’ sleep patterns, family lives and times for quiet, connected thinking.

A Wall Street Journal blog by a commuter who stopped in a busy train station to help an unconscious woman whose plight was ignored by hurried passersby.

A Boston Globe column that I’m researching on companies cracking down on texting/cell phoning drivers who madly multitask their way down our highways.

What do these articles and issues have in common? Hurry Sickness, as I’ve written before, corrodes time for daydreaming, for serendipitous togetherness, for undivided attention. If members of our society can’t pause to help a (literally) fallen woman, or make it a priority to look one another in the eye rather nurture a preference for trading Tweets, then we risk far more than stress-related health disorders. We risk a crumbling in the fabric of our society.

In my upcoming May 30 Balancing Acts column on distracting driving, I will recount how a big global engineering firm - populated by on-call, blackberry-addicted employees - banned all phoning and texting while driving, yet found a year later that almost all of its workforce reported no drop in productivity.

Stunning. And yet logical. With a little time management, calls didn’t require instant responses most of the time. (In fact, many hurried calls made while multitasking result in mistakes that take another call to rectify.) As well, the firm’s employees regained something precious - time to mediate on work (and life) problems, rather than simply knee-jerk reacting. Perhaps companies are tightening such policies to avoid litigation in the event of accidents, but whatever their motivation, the outcome may be a helpful nudge to employees to stop and think about the costs of constant lives of hurry. 

Isn’t it amazing that we need a near-death threat before we rethink the quality of our lives?

      “Are you listening?” cries the father character in Distracted, a play I saw last weekend in New York. “Name one friend of ours who really listens,” he demands of his wife.

      This fast-paced and often funny play focuses on a couple who are trying to decide whether to medicate their son, who’s been diagnosed with ADD. The play resembles a tv sitcom, with plentiful one-liners, quick-change staging and one-dimensional characters. There is the baffled mom wanting to do the right thing for her son; an angry, hyper dad who sees his son as just another rambunctious boy; an exhausted teacher; prescription-happy shrink, and on and on.

       But there are poignant moments, especially when the play raises questions that transcend the narrow issue of treatments and diagnoses. In these moments, the audience is brought face to face with the deeper costs of our scattershot focus and punctured togetherness. Then, we begin to see the mini-tragedies of mutual inattention that we experience and set in motion each day.

      The dad, for instance, is always hopping up and down, interrupting his wife, checking his pda and storming out of meetings with specialists. So it’s particularly powerful when he suddenly begins his lamentation about listening. Few of the characters truly listen to one another. They’re too busy pursing their own agendas. (How fitting that I sat in front of two couples who chatted to one another audibly throughout the play.)

     Like many people, I noticed a seeming decline in mutual listening in our society, but until I wrote about this skill in my Globe column, I underestimated its importance and complexity. Listening demands practice, patience and critical thinking. It is a learned skill, and a building block of good relations. “Listening is really the skill of being in the conversation, rather than being in your own conversation,” says Jim Bolton, who does corporate training in listening.

      We also can’t really consider how we listen, without thinking about our soundscapes. A new inter-disciplinary field of aural architecture has grown out of early acoustical engineering work. Barry Blesser and others in the field explore the aural aspects of physical spaces, including how they affect relationships. For example, consider how the hushed quiet of a church affects people’s interactions within. Or how television, jet engines and loudspeaker announcements affect the social environment of an airport. Soundscapes aren’t just a matter of volume control, just as listening isn’t simply an act of hearing.

     At the end of the play Distracted, the mom has an epiphany: if her son has an attention-deficit, perhaps he needs more of her attention.  In the closing scene, she and her husband quietly watch as her son dances to his favorite music. Playwright Lisa Loomer told the New York Times that she thought that this scene may be misinterpreted. But I think she got it right. Fractured, frazzled, absent attention is a modern syndrome that we can’t afford to ignore. 

Postscript: After finishing this post, a kind soul sent me a Guardian UK blogger’s piece defending her right to twitter at the theater. Sending Tweets during a show may be rude to the actors and audience, writes Ruth Jamieson, but “not twittering is so rude” to her followers. “They are my priority,” she writes. Remember neuroscientist Susan Greenfield’s controversial remarks about how social networking tools may be infantilizing us - promoting instant-gratification, impulsivity, short attention spans? 

No one likes to be called a baby, whether they are age five or 35. That’s one reason why recent comments by British neuroscientist Susan Greenfield that today’s technologies may be “infantilizing the brain” are inspiring heated debate – and plentiful misunderstanding. I don’t agree with all that she said about virtual social relations, but she’s right to raise these fears. Only through well-reasoned public discussion and careful research can we begin to understand the impact of digital life on our social relations and on our cognition. Recently, I was asked by the Neuronarrative blog to comment on the brouhaha:

What did she say? In a statement to the House of Lords and in interviews, Lady Greenfield first pointed out that our environment shapes our highly plastic brains, and so it’s plausible that long hours online can affect us. She’s right. “Background” television is linked to attention-deficient symptoms in toddlers. High stress impedes medical students’ mental flexibility. I agree that “living in two dimensions,” as she puts it, will affect us.

As a result of video games and Facebooking, are we acting like babies, living for the moment, developing shorter attention spans? Again, she’s right to worry. Facebook and video games aren’t passive. Yet much of digital life is reactive. We settle for push-button googled answers, immerse ourselves in “do-over” alternate realities, spend our days racing to keep up with Twitter, email and IM. This way of life doesn’t promote vision, planning, long-term strategizing, tenacity – skills sorely needed in this era.

Consider this issue as an imbalance of attention. Humans need to stay tuned to their environment in order to survive. We actually get a little adrenaline jolt from new stimuli. But humans need to pursue their goals, whether that means locating dinner or hunting for a new job. By this measure, our digital selves may be our lower-order selves. As ADHD researcher Russell Barkley points out, people with the condition pursue immediate gratification, have trouble controlling themselves and are “more under the control of external events than of mental representations about time and the future.” He writes that ADHD is a disorder of “attention to the future and what one needs to do to prepare for its arrival.” Today, as we skitter across our days, jumping to respond to every beep and ping and ever-craving the new, are we doing a good job preparing for the future?

Finally, Lady Greenfield spoke about two types of social diffusion prevalent in digital living. First, she correctly points out that today’s fertile virtual connectivity has a dark side: it’s difficult to go deeply when one is juggling ever-more relationships. This is both common sense, and backed up by research showing that as social networks expand, visits and telephone calls drop, while email rises. Second, Lady Greenfield observed how virtuality distances us from the “messiness” and “unpredictability” of face-to-face conversations. In other words, digital communications can weaken the very fabric of social ties. As I wrote in my book Distracted, an increasingly virtual world risks downgrading the rich, complex synchronicity of human relations to paper-thin shadow play.

If it weren’t for the Net, I likely wouldn’t have found out about Lady Greenfield’s comments, nor been able to respond to them in this way. Yet going forward, we need to rediscover the value of digital gadgets as tools, rather than elevating them to social and cognitive panacea. Lady Greenfield is right: we need to grow up and take a more mature approach to our tech tools.

Addendum: SharpBrains.com recently published part two of my interview with them.

We’re so busy, so “productive,” ticking off items off our agendas, clicking through over-stuffed in-boxes. But in what sense are we productive ? Could it be that we are racing ahead in the most shallow senses of the word?

 This is a particularly timely question as we reap the fall-out from an era of unprecedented, and often unthinking abundance. By unthinking, I mean activity without thought to consequence, to ourselves and others. Activity without perspective, especially on the future. Isn’t that the core of what’s been happening in terms of the environment, crimes like Madoff’s, and even the disintegration of deep family rhythms and rituals?

A short but important column in the U.K.’s Guardian newpaper this past weekend drives to the heart of this question of the cult of busyness.

“Telling ourselves we’re hugely stressed makes us feel important, in demand, even energised; it also gives us permission to avoid confronting deeper issues,” writes Oliver Burkeman.

 He writes, “… busyness is the perfect excuse: if you’re convinced that you’re overstretched and overwhelmed, you’re spared the terrifying prospect of actually doing the things, and making the changes, that you want - or say that you want, since busyness spares you from examining that question, too.”

  Notice the word “terrifying.” Burkeman’s comments remind me of a man I met at a futurist conference who spoke glowingly of his new cell phone that worked globally. (This was a while back.) He told the audience, “Now, I never have to be alone.”

  Yes, it’s often terrifying to be alone with oneself. And it’s terrifying to take responsibility for ourselves - and for the care and keeping of our world.

   Addendum: A site called Sharp Brains and a blog called Neuronarrative both have posted email-interviews with me about Distracted. In both cases, the questions were intriguing.

It’s been heartening and exciting to experience the launch of Distracted. The tremendous response - Wall Street Journal, BusinessWeek, New York Times - underscores our collective uneasiness with the steep and mounting costs to our overloaded and distracted lives.

I’ve been particularly intrigued by the spectrum of interest. Parents, educators, politicos, corporate leaders, and workers alike - in this country and around the world - are interested in the book’s portrait of our lives and the suggested solution: to avert a dark age, we must spark a “renaissance of attention.”

Check out this week’s adaptation in BusinessWeek, along with a video interview of me: 

http://www.businessweek.com/magazine/content/08_25/b4089055162244.htm

Here’s the New York Times guest blog that will appear in this Sunday’s Business section:

http://shiftingcareers.blogs.nytimes.com/2008/06/10/attention-must-be-paid/

And today’s interview on BuzzFlash: http://www.buzzflash.com/store/items/1161

Last, Wisconsin Public Radio ran an hour-long talk-show on the book:

http://www.wpr.org/merens/index.cfm?strDirection=Prev&dteShowDate=2008-06-19%2016%3A00%3A00

Stay tuned! As I travel to Minneapolis, Boston, Washington, DC and other cities for talks about the book, I’ll blog further on people’s concerns and suggestions.

How did I come to write a book about attention — and our collective ADD?

The short answer is, I backed into the subject.

The Role of Technology — Overload, hurry, boundary-less living: these topics have been mainstays of my writing for the past decade. But a few years ago, I became fascinated by the role of technology in this new world. The computer, cell phone and then the pda seemed to be rewriting work, home and everything in-between. Was it all so simple: new gadgets, new world? And how could we tame these wondrous devices, since we certainly couldn’t go back to a tech-free age?

I sought clues in history, thinking that the first high-tech age, which ushered in inventions from the telegraph and cinema to the jet, rail and car, could show me how to manage our own frenetic time. And it was eye-opening — but not in the way I expected. I discovered that our lives of split-focus, hyper-mobility, and alternative realities are not all new. Rather, the first high-tech era ushered in new experiences of time, space and place that we’re still wrestling with today. Our age is essentially the culmination of forces unleashed centuries ago.

Epiphany! Attention is the Key — And most importantly, this age of speed and overload is undermining our powers of attention. Attention — that’s the key to understanding how to cope with 21st-century living. We’ve overstepped the boundaries of our attentional capacity – that’s why we’re increasingly miserable amidst our technological riches.

A dark age? — Those two words in the title of my book are attention-grabbers. Are they alarmist? As I began to investigate the fate of attention in a digital age, I dug into studies of turning points in civilization. Perhaps it shook me that great thinkers from Umberto Eco to Harold Bloom to Jane Jacobs have called our time a “dark age.” Perhaps I was struck by the fact that we so often label our own era a new age, be it digital or information. What is a dark age, and why do complex, affluent societies begin to falter? These questions are crucial to understanding the costs of our speed-driven, hyper-complex and attention-deficient lives.

That’s how I came to write a book about attention — and much more.

Distracted isn’t about weighty theories, or dusty trends from the past. It’s all about the new science of attention, which is mapping, decoding and defining this essential human skill for the first time. And it’s about our power bar-grabbing, frenetic multitasking, info-overloaded, cyber-centric, no-time-to-focus lives.

• We connect with millions of people across the globe, but have trouble grabbing dinner with those we love.
• We can tap into billions of info-bytes, yet increasingly we create knowledge from what’s first-up on Google.
• We’ve cut back on sleep and time with hobbies, friends and neighbors — yet still feel that we can’t afford to pause, relax — even take a vacation day.

Distracted is about how we shape the future — and whether we have much of a say in what tomorrow brings, or whether we’re going to give it half an eye and a shred of focus as we hurry on by, too distracted to notice the course of our lives.

Attention — that’s the key!