Month: October 2012

George R.R. Martin, A Song of Ice and Fire, 5 Book Set Series, A Game of Thrones, A Clash of Kings, A Storm of Swords, A Feast for Crows, A Dance with Dragons by George R.R. Martin
My rating: 3 of 5 stars

I have enjoyed the Game of Thrones series right from the beginning, but this book was very disappointing. The writing was very laboured in places, with characters repeating themselves, and there weren’t enough dragons in it for me. It also seemed to take far too long for anything interesting to happen, and when something happened it took a long time to actually effect anything.

The title is a reference to the various bits of royalty that have connections with the original Dragon Throne, but the dragons that Dany is bringing up don’t do much for 90% of the book.

I was also really interested in what was going to happen to Arya, but the answer was – “not much”.

And we finally meet the three eyed raven but again what happens? “not much”.

The book could have been 25% shorter and not lost anything, it needed an edit. Rather like the Harry Potter “Order of the Phoenix” it felt like it had been rushed and then left.

The cliff hanger ending was really laboured, and I’m not sure I can be bothered reading book 6. I also thought it was possibly the last book in the series and was irritated that a good number of plot lines are still dangling.

Not sure I care enough to read the last book, assuming there aren’t books 7 and 8 after it.

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Better: A Surgeon’s Notes on Performance by Atul Gawande
My rating: 5 of 5 stars

This book is an easy read but very thought provoking.

One of the most interesting bits was where he examines the difference between the average Cystic Fibrosis centres and the best ones. All human activity has a bell curve attached to it, but CF treatment is very well understood and systematic. So why does one centre have startlingly better results than another?

In essence the better centre didn’t compromise, they didn’t think that (for example) 80% lung function was good enough, the patients under their care were expected to have 100% or better.

It’s the difference between 99.99% and 99.5% – we’d all be happy with 99.5, but excellence is in the remaining fraction of a percent, because when you add this up over several years this tiny difference means a lot. The sums are simple 99.5 over 5 years will give 97%, 99.99 will still be 99.99 or thereabouts. If you take this up over a patient’s life of 30 or 50 years the difference would be even more apparent.

I’ve hit this in other walks of life, for example project management, where you maybe have a 0.9 chance of finishing on time every iteration. This means that the chances of still being on track are as low as 0.6 after 5 iterations – it’s just mathematics. When building software having a fire break every so often to deal down the technical debt and reset the projects is perfectly doable, but if you’re looking for excellence in medical care or some other industry that could kill people then you have to become fanatical about getting higher scores

There are plenty of other excellent articles in the book, the fight to eradicate polio and the crazy situation faced by doctors in India are really great articles, and I learned a lot about how we could really help the people in poor countries. I admire Gawande’s honesty about his own shortcomings, this gives the writing a validity that it would otherwise lack. And the nutty unjust system that is the law based compensation for medical errors, that wrecks the chances of the poor to get help and helps no-one but the lawyers.

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