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Who doesn't love a good list? Check. Done. Surgeon and New Yorker staff writer Atul Gawande is such a wonderful writer that his book, The Checklist Manifesto: How to Get Things Right is a bestseller beloved even by people who hate making lists. At
http://gawande.com/the-checklist-manifesto reviewer Malcolm Gladwell makes the point
that while Gawande started
"with his experiences as a surgeon. But before long it becomes clear that he is really interested in a problem that afflicts virtually every aspect of the modern world-and that is how professionals deal with the increasing complexity of their responsibilities."
We can also abuse our lists. When feeling overwhelmed, I have added simple tasks to long checklists, just for the comfort of crossing something off and feeling progress. Not that it's a bad thing to check off "Clean computer screen" or "Feed dog."
But parents drown in a tsunami of checklists. There are two types: to-do and warning signs. The routine (school supplies to buy) and the creepy to scary (how to treat head lice or recognize child abuse). I am not the only one who has checked a list of symptom of dread disease and reassured myself that no, my child doesn't have that one. Phew.
That was an early mistake we made when our daughter, Lisa, started developing anorexia. Several lists I checked said that eating disorders usually start in middle school years. When Lisa started acting strangely, she was already junior in high school. So we decided it must be something else.
I write about this in our book, Hungry: A Mother and Daughter Fight Anorexia:
We've been reading and writing lists since we became parents, to help organize our thoughts and actions, and to draw comfort. Sometimes the lists, and flow charts telling you what's an emergency, can lead you astray. A friend will never live down having whisked her baby to the pediatrician because of the white spots in his mouth, an alarming sign of thrush, a fungal infection. The spots were drops of breast milk. On the other hand, you child spikes a fever but doesn't have a stiff neck. Check the list. OK, phew! Probably not meningitis. We print out lists, like Signs of Choking, and post them by the phone.
The warning signs of eating disorders can be trickier. There are so many possible symptoms, and they often describe feelings that aren't out of the range of normal, or they are open to wide interpretation. At the very well-respected site www.somethingfishy.org , there are thirty-two signs and symptoms of anorexia/bulimia, and eighteen for compulsive overeating/binge eating. Some are helpful, others not. Who doesn't, for example, occasionally "make self-defeating statements after food consumption"?
I encourage parents to turn to page 21 in the book Help Your Teenager Beat an Eating Disorder by James Lock, M.D., Ph.D., and Daniel Le Grange, Ph.D. There are nine heads-up signs, and eleven that mean it's time to call in an expert. Among the former are suddenly deciding to be a vegetarian, which has a surprising correlation to eating disorders, and diet books. Lisa did become a vegetarian, and she read some diet books, but mostly it was magazines full of diet and fitness tips - and lists.
My point is that lists are useful in organizing our actions; they can also lead us astray. In my next post I'll talk about the warning signs that did add up for Lisa.
