Homeland Security Watch

News and analysis of critical issues in homeland security

October 21, 2014

Ebola, Fantasy Documents and Our Collective Inability to Tolerate Ambiguity

Filed under: Public Health & Medical Care — by Christopher Bellavita on October 21, 2014

Todays post is written by Jeff Kaliner. Kaliner is a public health emergency preparedness professional with twelve years in the field. For the last few years he has spent an unreasonable amount of time considering the intersection between complexity science, lessons that never get learned and homeland security. He holds a Master of Arts degree in Security Studies from the Naval Postgraduate School and a Master of Science in Education from Northern Illinois University.

Over the last few days the media has suggested that hospital emergency plans and procedures are basically unsuccessful with respect to the ongoing Ebola event.  The narrative lays out that hospitals (and in effect the larger public health system) have failed to plan properly and in turn are now reaping the consequences of poor preparation. The evidence is apparent: one dead Liberian national and two infected Texas nurses.

Connecting these dots in a linear fashion gives us the proof we need to believe what this narrative suggests: The last twelve years of federally fueled funds to enhance emergency health and medical programs at the state and local levels have not worked.  The implication is easy to understand; better planning and procedures (and more money?) would have prevented this very serious situation.

Although the story seems to have a tidy and easily understood cause and effect relationship, it is wrong.

The problem with this tale is the dirty little secret that a well-crafted plan or procedure cannot and will not be enough to manage a complex event. When implied that they can, these documents take on a symbolic quality that suggest they are somehow able to control reality.  As Lee Clarke (in his book Mission Improbable: Using Fantasy Documents to Tame Disaster) points out, plans in this realm “…are rhetorical devices designed to convince others of something.”  The “others” in this case might be federal or state grantors, the public, the media, response agencies, etc.  Clarke goes on to state:

It seems that fantasy documents are more likely to be produced to defend very large systems, or systems that are newly scaled up. When they are proffered as accurate representations of organizational capabilities then the stage is not only set for organizational failure but for massive failure of the publics those organizations are supposed to serve.

Sound familiar?

In other words, the plans the media have been referring to are fantasy documents.  They were partly crafted to give an illusion of safety and security.

To be clear, I am not arguing that plans should not be written and that capabilities should not be exercised.  What I am saying is that the best we can ever do in the face of an increasingly complex catastrophe is write a bad plan and admit that a capability that was pulled off flawlessly during an exercise will probably not produce the same results during the actual bad day. This is not an indictment of all the dedicated and committed emergency planners across the world.   This is an invitation to acknowledge what the best of them already know: response documents become more useless as the event becomes more complex.

Maybe one possible solution to the plan as fantasy document is to conceptualize an emergency situation as an unfolding set of unpredictable events in a unique eco-system. Every eco-system has a pre-determined elasticity or resiliency that allows it to bend a certain distance before it breaks. In this narrative, instead of asking whether or not our plans have worked (and in turn placing blame on a variety of systems) we might wonder if the resiliency of our current health and medical system has actually been compromised and to what extent by an emergent event.

This idea has become clearer to me as I have been reading The Age of the Unthinkable  by Joshua Cooper Ramo.  Ramo suggests that one way to think about the resiliency question is to visualize the eco-system of a lake.  He writes

“The stability of a lake ecosystem can’t possibly be reduced to a few variables. What matters isn’t something you can score quickly but rather the strange mesh of interactions that make a lake resilient or not….  What you can easily measure in these systems matters much less than what you cannot: How strong are the relationships between different parts of the lake ecosystem? How fast can it adjust to shocks? How far can you bend the food chain on the lake before it breaks? In short, how resilient is it?”

What if we tried to apply aspects of this idea to how we define, manage and evaluate emergency response? What if instead of trying to bend reality to our whims by absurdly trying to measure the potential success or failure of our plans, procedures and capabilities (before the event), we looked a little deeper at the complex set of variables that make up a health and medical eco-system during an event and drew conclusions about how well we were doing based upon a more nuanced and admittedly ambiguous set of factors?  Factors including our ability to adapt, learn and change in real time.

As Ramo states: “Resilience allows us, even at our most extreme moments of terror (in fact, precisely because we are at such a moment), to keep learning, to change. It is kind of a battlefield of courage, the ability to innovate under fire because we’ve prepared in the right way and because we’ve developed the strength to keep moving even when we’ve been slapped by the unexpected.”

Preparing in the right way certainly means developing plans and procedures.  But that’s just where it starts. Ultimately there is no one playbook or plan that will quickly solve the multitude of problems that occur during complex events. In an unordered world, we all will have to become more comfortable with the messy reality that there is not just one factor that means we have won or lost the battle (think: Mission Accomplished).

In the book Complex Adaptive Systems: An Introduction to Computational Models of Social Life, Miller and Page write, “Complexity arises when the dependencies among the elements become important.”  Certainly there are many elemental dependencies involved in the current Ebola outbreak.  Understanding and learning how these dependencies interact with one another to create new and unexpected aspects of this ongoing situation is critical to an effective response.

We can no longer reduce the negative events (the death of a Liberian national and the infection of two Texas nurses) that take place within quickly evolving eco-systems to simple platitudes. In this respect, false narratives (such as the ineffectiveness of a magical plan) need to be quickly identified and confronted as the simple and all too easy explanation for a very complex set of events that will probably never be truly understood.

If we do not identify these narratives for what they are, we diminish the two critical capabilities that we will need to consistently practice if we are to truly be prepared for 21st century challenges:

1) an emergency response system that has the political will and ability to quickly learn and adapt during the course of an emergent event; and

2) a media and public that will provide a type of unconditional support and understanding to let it happen.

Regardless, until we are all prepared to think about and understand the world in ways that reflect a more interdependent and non-linear sensibility, our reliance on simple narratives will remain. That reliance certainly works well for the media, but it’s just bad news for the rest of us.

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12 Comments »

Comment by Quin

October 21, 2014 @ 8:13 am

Jeff,

Great post! I think some of the answer might be the movement to capability based planning efforts. So rather than trying to map out every scenario, instead you concentrate on figuring out what you have prior to any type of incident, how these capabilities might be packaged, and then presumably train on problem solving and problem identification skill sets so that decision makers can both proactively and reactively respond in the most efficient manner possible. Unfortunately at the Federal level, the idea has take root, but there doesn’t appear to be the political will or even the bureaucratic identification of the steps needed to carry out such a system. JMO of course.

Comment by William R. Cumming

October 21, 2014 @ 9:31 am

Agree great post! Yes a complex world and becoming more complex over time! Complexity may bring the apocalypse.

In the meantime CDC has issued new EBOLA guidelines.

BETTER LATE THAN NEVER?

Comment by Jeff Kaliner

October 21, 2014 @ 11:38 am

Thanks, Quin.

I do agree with you regarding capabilities, but only to a certain point. First, there is no way to pre-identify every capability that will be needed for every scenario. Ideally we identify and exercise the capabilities we will need based on threat scenarios, HVAs etc. However my point about complexity is that it will produce scenarios that we have never seen before. In doing so, we will not have the corresponding capabilities in our tool belt to the manage unique and emergent.

Second, just like a a plan, feeling too confident about a binder of capabilities that were executed flawlessly during an exercise (or even the last event) does not take into consideration the revolving door of individual competencies that is our homeland security workforce. In other words, retirements, layoffs, job changes, will effect organizational capabilities. Or the distinct possibility that just like a plan, a capability will be affected by the emergency itself in that workers may be unable or choose not to show up for their jobs.

That is why I argue for a type of adaptation capability. This capability would encourage individual and organizational knowledge of complexity, network theory, inter-crisis and intra-crisis learning, etc. And encourage individual and organizational skills and abilities such as improvisation, learning in real time and critical thinking.

One way to think about it is that we strengthen and focus our ability to learn and build emergent (modified or new) capabilities on the fly. I believe we could build that type of organizational and individual competency set to augment what we already have.

Thanks for giving me the opportunity to clarify and expand some of my thoughts.

Comment by Philip J. Palin

October 21, 2014 @ 12:09 pm

Jeff: Thanks for a wonderfully written post. Cogent, concise and, at least for me, compelling.

A question, then a world-weary gripe (that may provide some grist for answering my question):

Do I hear you correctly,that you perceive a need to explicitly prepare the public for ambiguity? In other words, we — a democratic we — should anticipate an increasing “gap” between specific readiness and an increasingly complex context. This gap being a persistent aspect of increasing technological, social, economic (etc.) complexity?

That is what I hear, but I may be projecting.

The gripe: It has been nearly four decades since I completed my liberal arts undergraduate degree. But this was already well into the post-oil embargo reality that, even then, we recognized had pretty much brought to an end the Post-World War II status quo. Every class we took, including the “Origins of European Civilization: 300-700 AD” pronounced the paradigm shift (it was a new term then) that was sweeping the planet. We congratulated ourselves for engaging in a college education that had — these were the words used in the graduation valedictory — “prepared us to be comfortable with ambiguity.”

But since then we seem to have — educationally, culturally, politically — mostly gone in the other direction; almost becoming obsessive compulsive in our desire for predictability and control. So, if I am not projecting, I certainly agree with your diagnosis. But I am sadly skeptical of the “dis-eased” population being willing to persist with an effective therapeutic regime.

Comment by Jeff Kaliner

October 21, 2014 @ 6:15 pm

Phil:

Thank you and you are not projecting. You have correctly discerned my subtext.

As it occurs to me, the resilience of our planet (not just as individuals or nations) is inextricably tied to our ability (or inability) to tolerate ambiguity.

Just recently, our inability to do so has proved very deadly and destabilizing. I think most would agree that 9/11 was a definite slap “by the unexpected.” Our response, far from tolerating the ambiguity of the moment, was a move into the two longest wars this country has been engaged in. In other words, a collective ability to count to ten was bypassed by the need to react and a war is always a good way to simplify a situation.

But simplify it never did…major recession, Iran, Syria, ISIS, etc. Our quick need to snuff out ambiguity arguably led to more complexity. As I remember it, you couldn’t even utter the phrase “blowback” in the early days of post 9/11 zeitgeist. In other words, the public space did not exist to even consider any of the variables in the 9/11 equation.

(Artists might have been the first to create the space to explore the issues from different perspectives. But that’s what artists do. Unless they are controlled by the state. And then all bets are off…)

To be clear, although I can not remember for sure, I imagine I was also ready to “hit back” hard and fast after 9/11. However I am clear that that the need to hit Iraq did not make sense to me. But that did not seem problematic to most at the time.

The idea can further be stretched to globalization. I believe it is Fathali Moghaddam who makes the argument that loss of national identity is a contributing factor to move some vulnerable souls to identify with extremest positions. I would imagine a few white men in this country might fit the bill as well.

Regardless, I would argue that loss of an identity by what ever means will create ambiguity in individuals and groups. Again, what better way to deal with this sense of loss and confusion but through a clear and clean narrative that brings us back to the powerful story of right and wrong and good and bad.

That’s where western myth and religion kicks in. For the most part, myth and religion in this context has been used to explain and inform natural phenomena and moral ambiguity for at least a few thousand years. Hard to break old habits…even after the introduction of the scientific method.

On the other hand, eastern ways of understanding the world certainly seem to embrace ambiguity with a little more comfort. Maybe that is why you have seen that tolerance disappear from the university over the years. Not sure when you were specifically an undergrad, however from what you imply, I imagine the curriculum may have still been influenced by 60’s fueled liberalism. Hell, even Nixon visited China!

For me, the question boils down to: “how do we really know anything.” We have advanced in our methods of deciphering the undecipherable be we certainly still fall far short for having a perfect system and ultimately we still can not predict the future regardless of what big data might tell us And that’s hard…it’s hard for me.

But that is why I have embraced ideas such as complexity science and network theory. Admittedly a novice, the exploration of these types of concepts gives me a little more breathing room around the difficult questions and problems that inhabit my life and that of the world I live in.

They help to give me some space. Space that helps me sit with the moment for a just a second longer. Space that might give me just a moment more to learn or adapt and then to keep moving after I have been slapped by the unexpected.

So, yes…I believe we need to prepare the public for ambiguity. Preparing them for the next “bad day” by having a kit or a plan is insufficient. Won’t solve this bigger issue that we are identifying and for me, is basically moving the deck chairs while a larger planetary crisis unfolds.

As a friend said to me today…homeland security is a state of mind. A mind that is either working to tolerate ambiguity, or one that isn’t.

Comment by Arnold Bogis

October 21, 2014 @ 9:20 pm

Jeff, Not to pick a fight but I remember that one could actually go beyond just mentioning “blowback” post 9/11, but actually posit it as a legitimate topic of conversation (perhaps because at the time I was in academia.). Now…not so much. Even in the most liberal of spaces. “Draining the swamp,” and “narratives” used to have a much more prominent place in the counter terrorism conversation.

Phil, also picking an obvious fight…but regarding your story. While nice that a bunch of college students regarded the oil embargo and other events at the time a paradigm shift, you still entered the 80’s with a global enemy with true global reach. Since the collapse of the Soviet Union we have been grasping for an organizing adversary. Terrorism, unfortunately or not (depending on your view), plays this role. I’d wager there are much stronger arguments to be made that the 1990s were spent searching for an appropriate adversary rather than embracing ambiguity.

Comment by Philip J. Palin

October 22, 2014 @ 4:58 am

Arnold and Jeff: Thanks to both of you. I was not trying to describe my youth as a time that embraced ambiguity (though there were some particular youths who did so). Rather it was — already — a time when many, not just the young, recognized the reality and even potential of ambiguity.

I absolutely agree that despite it’s considerable potential, ambiguity has not been enthusiastically embraced. Then or now. I like Arnold’s hypothesis that with the collapse of our Marxist-Leninist other, we have been left less able to make sense of our self. It is as if we exist only in contrast and China is, well, so damn ambiguous, entirely too similar to us (in ways that make us uncomfortable).

I now hear Jeff suggesting that, eventually, reality will push hard enough that we will come into a new narrative. Makes sense. But I’m not sure the new narrative will be any more friendly to ambiguity than our current tattered plot. Could be less so. At the core of my angle on reality is uncertainty, respect for mystery, embrace of complexity and an openness to profound otherness. Many peers emerge from the same tradition, texts, and present context claiming a very different narrative.

So… what do we do? I resonate with the five final paragraphs in Jeff’s response to my question. But rather than “tolerate” ambiguity, I suggest the value of evangelizing for it. What is the good news of ambiguity? What is its benefit? How does it contribute to our happiness? What is its relationship with the beautiful, the good and the true?

But by the way, there is in the narrative-of-ambiguity that I have inherited (and adapted) a warning that evangelists for this gospel are seldom well-received and have often ended up wounded (or worse) as others seek to impose clarity.

Comment by William R. Cumming

October 22, 2014 @ 8:28 am

Mary Parker Folette is said have always asked clients “What business are you in?” and e.g. when consulting for a shade company remarked she thought their business was “control of light’!

What is the business of HS? Based on posting and comments on this blog would seem ambiguous. I would argue that the business of HS is civil security!

Comment by William R. Cumming

October 22, 2014 @ 10:55 am

The DoD domestic team for EBOLA will spend its time training others on how to utilize protective gear.

Comment by Jeff Kaliner

October 22, 2014 @ 10:25 pm

Hey Arnold –

I am thinking that I saw a second post from you earlier? I came back tonight to respond but what I may or may not have seen (I’m tolerating the ambiguity) is now gone. Something about a dust up…?

Philip – I like where Arnold points and you finish with regards to the challenge in identifying ourselves without an “other” to bump up against. I would agree that for the most part, “the terrorist threat” or terrorism has filled the void.

But how much have we purposefully enhanced it to help rebuild our identity after the fall of the wall? The wall was that symbolic separation between self and other. Once we tore “down that wall”, I would argue, things got a little murkier. Did we have a higher tolerance for ambiguity in the 90s? No “major” wars that I can think of in the 90’s with US involvement.

However, since we have made reference to the 70’s, I would argue that Henry Kissinger saw the value of playing the foreign policy ambiguity card. If I am not mistaken, he opened up conversations with China understanding that having a relationship with an adversary might help avert mutual destruction. Reagan certainly valued his relationship with Gorbachev.

So the black and white of the “other”narrative might just be an over simplification. It was more a strange dance with an adversary…maybe they both learned from JFK and the Bay of Pigs.

Regardless, although our more recent leaders have claimed they do not negotiate with terrorists, there seems to be ample evidence to the contrary. Again, a dance. A public narrative and a hidden reality. Ambiguous…

Why the dance…why not the reality? In a sense it seems we/our government/our media do add to the “other” narrative. Yes, there are enemies out there and groups that want to do us harm (for all sorts of reasons), but it is much more complex than just that.

I’ll go back to it’s easier to understand us vs. them. Easier to fill uniforms and sell all the consumables that come along with jingoism and a war machine. Yes…I am pointing to what ultimately be the least ambiguous piece to this puzzle…the need to feed the beast.

The fascinating dance of capitalism and democracy can’t be left out of this conversation. Phil, tolerating ambiguity, or even worse an embrace, just might be bad for the bottom line. And that sounds to me like a a homeland security problem no one wants to deal with.

Regardless, an interesting question…does an increasing tolerance of ambiguity negatively affect an economy? We certainly know that war helps stimulate the markets. And war also helps to disambiguate foreign policy narratives…

Wonder what Mr. Kissinger might say?

Comment by Philip J. Palin

October 23, 2014 @ 4:20 am

Jeff: In my experience ambiguity is an unavoidable aspect of any real relationship. The more I come to know someone, the more ambiguities are exposed. Traditional cultures: less modern, non-urban, less mobile social contexts are often very adept navigating internal ambiguities (external can be a different issue). But Japan — mostly modern and urban — nearly worships ambiguity, and has often succeeded in turning external ambiguities to commercial advantage. I take your point that mass-market economics may never embrace ambiguity. But a good deal of what is called mass-customization seems to depend on the ambiguous as market opportunity.

I think your original intuition about narrative is correct. Somehow late 20th/early 21st Century America is telling itself a story (or contending stories) that are less about the adventurous journey ahead and more an argument about whose fault it is that we took a “wrong” turn some ways back. Very broadly conceived, homeland security is one of several sub-plots aimed at avoiding future wrong turns and through whole community, resilience, and other such ambiguous notions resuming the journey. But we have not yet succeeded in turning the narrative from argument to adventure.

Comment by Jeff Kaliner

October 23, 2014 @ 5:14 am

Phil:Great point about Japan. Thanks for your input on this. Your insight and perspective are appreciated.

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