Wolfgang's Law - Part Two

Introduction to the problem

0:00This is Jacob Goldstein from Business History. When the internet arrived, most people used it to look things up. Others saw what it could really do. The same is true with ChatGPT. ChatGPT work goes beyond answering questions. Give it a goal, plus things like notes, files, feedback, data, or project plans, and it can help create a brief, analysis, deck outline, tracker, or workflow. You stay in control, reviewing the work and choosing the final result. Put ChatGPT to work on your most ambitious ideas and projects.

0:31Get started at ChatGPT.com by selecting Work Mode, available on Plus and Pro plans. This is a paid message from Apple Card. It's easy, I think, in the hubbub of our lives to lose track of our spending. We pay the bills and move on, and don't understand the deeper patterns in our spending, the many different decisions we're making, knowingly or unknowingly. You have to understand where your money is going in order to make better decisions about it. That's one reason Apple Card stands out to me.

1:03You can earn unlimited daily cash back on every purchase you make. I also appreciate the simplicity. Apple Card doesn't have annual, late, or over-the-limit fees. No fees ever. There's even an option to open a high-yield savings account through Apple Card. And while I haven't done it yet, if I do, my daily cash can grow automatically over time without any extra effort. When you better understand your spending habits, it's easier to make your money work harder for you. Apply in the Wallet app on your iPhone today.

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2:05Terms and more at applecard.com. This is Jacob Goldstein from What's Your Problem? Running a business is hard enough. Don't make it harder with a dozen apps that don't talk to each other. One for sales, another for inventory, a separate one for accounting. That's software overload. Odoo is the all-in-one platform that replaces them all. CRM, accounting, inventory, e-commerce, HR. Fully integrated, easy to use, and built to grow with your business. Thousands have already made the switch.

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2:50Pushkin.

Cardiac bypass surgery

2:55When the arteries that feed your heart become constricted or blocked with plaque, the flow of blood that brings oxygen to the heart muscle starts to dwindle. You get chest pains, a feeling of pressure, tightness. If the plaque ruptures or a clot blocks the artery, you can suffer a heart attack or heart failure, a chronic weakening of the heart tissue, fatigue, shortness of breath. So what heart surgeons have done for over half a century is a workaround. Cut open the whole chest, make a long incision down the length of the sternum,

3:28pull back the ribs, hook the heart up to an external pump, then sew a new artery directly onto the heart, bypassing the blockage. Cardiac bypass surgery. What we do is actually pretty complicated. There are a lot of ways to foul up a heart operation. You've got to get it right. There are 500 steps in this operation, and probably 300 of them can turn it south in an important way.

3:57That's John Puskus, a cardiac surgeon at Emory University in Atlanta. In the late 1990s, a handful of doctors around the world started experimenting with a new approach. Minimally invasive cardiac surgery. MIX for short. Don't cut open the whole chest. Just make three small incisions between two ribs. Open up a small hole. Put in a tiny camera so you can see. And don't use an external pump. Keep the heart going the whole time.

4:27And then, working only through that tiny hole, using long instruments, delicately sew a new artery in place, bypassing the one that's blocked. In the beginning, even for Puskus, it felt impossible. After I'd done 10, I swore I would never do another. But soon, somebody created a robot that made the sewing a lot easier. The instruments got better. Practice made surgeons more comfortable. And it became clear that the minimally invasive approach

4:58was much better than the old approach. The patient is often out of the hospital in a couple of days instead of a week. They can recover in two weeks instead of six weeks. Less infections. Less bleeding. Less time in the ICU. Within a short time, Puskus and his fellow pioneers became convinced that the rest of their profession would quickly follow their lead. If we give the simplest explanation for your enthusiasm 30 years ago, it was, you did this operation and you were like,

5:30you said to yourself, oh, wow, that was better for the patient. Is that why, and you thought that that should be enough. Is that what you were thinking at the time? Yes. I mean, that should, what more do you need? Yeah. To me, that was intuitively obvious and highly motivating. So what actually happened? I'm curious, first of all, so where are we now? If I need a cardiac bypass operation somewhere at a major hospital in the United States, what percentage of those are going to be done using minimally invasive techniques?

6:01Where are we in the adoption curve? Two percent. Wait, two percent? Two percent, maybe three. Oh, I thought it would be 50. No, no, not even close. No, not even close. It's unlikely that I will live long enough to see it 50. What year did you do your first operation? That sort, roughly. First, like that? I'm 97 or 8. So 30 years ago. Yeah.

Revisionist history podcast

6:31My name is Malcolm Gladwell. You're listening to Revisionist History, my podcast about things overlooked and misunderstood. This is another episode tied to my new book, The American Way of Killing, about why the homicide problem in the United States is so much worse than everywhere else in the Western world.

6:52In the last episode, I told the story of what is happening right now in Baltimore, historically one of America's most dangerous cities that seems, improbably, on its way to being not that dangerous at all. Baltimore is a case study in the astonishing effectiveness of what is called focused deterrence, an idea that turns the traditional notion about crime fighting on its head. But this, part two, is about a much bigger issue,

7:24which seemingly comes up all the time whenever groups or societies or companies are presented with new and better ways of doing things, which is that new ideas take longer to get accepted than they should. Because when was the focus deterrence strategy first tried? In 1995. At almost the exact moment that John Puskas and his fellow pioneers began experimenting with their new approach to cardiac bypass. Back in the mid-90s,

Operation ceasefire in Boston

8:07a criminologist named David Kennedy and two of his colleagues visited the gang unit of the Boston Police Department in the city's troubled Roxbury neighborhood. What we saw in the general street dynamic and talking to the cops and talking to kids on probation and what people said a lot was that we're just withdrawing. It's so bad out there that it's dangerous to have friends.

8:37It's dangerous to be in relationships.

8:40It's dangerous to go outside. It's dangerous to leave the block. We are just cutting ourselves off and hunkering down. But the group of cops and outreach workers they talked to told them that their problem in Boston was the result of a very small number of young men who were having arguments, who were trapped in cycles of revenge and retaliation. We know exactly who they are, the police officers said. The killings are predictable. They were the population that were the, you know,

9:131% of their age group across the city that was at the core of what was going on. It was Wolfgang's law, the law we talked about in the previous episode, all over again. Everything in social science says the way this stuff works is it's extremely concentrated and it's extremely networked. But none of that had been carried into thinking and policy. Kennedy and his colleagues

9:46then worked with the people they met in Boston to create something called Operation Ceasefire. Find the small group of people at the heart of the violence epidemic. Talk with them. Work with them. Encourage them. Have someone from the community, someone they look up to, give them advice, a helping hand. Warn them that if they slip up, the law will come down hard. And if they do slip up, make sure the law comes down hard. Boston is where the philosophy of focused deterrence was born.

10:17It worked remarkably well. It worked better than anything anybody had ever done before. And it worked dramatically better than we ever dreamed that it might. The people who did this were shocked by what happened. And you were shocked by what happened. I was shocked by what happened. The cops had every... Nobody could believe that what was clearly going on had happened.

10:49In 1995, there were 96 murders in Boston. Over the next four years, it went from 59 to 43, then to 35, and in 1999 to 31. 31, by the way, is ridiculous. At the time, nobody had ever seen numbers that low in a big American city. So Kennedy and his colleagues began traveling the country city to city, telling everyone that they should be doing

11:19what Boston was doing. Minneapolis put the plan together. Homicides plummeted. Almost a 90% reduction in homicide in Minneapolis over the first summer that it went into effect. And left it in the hands of the locals. You know, we proved, you know, my God, Eureka! And by the end of the year, they had let it all fall apart.

11:48Homicides, in short order, went back up. Anthony Braga, his colleague, went to Stockton, California, which had a terrible gang problem. Same pattern, same intervention, same kind of success, same kind of collapse a couple of years later. New Orleans, promising at first, then back to the old ways of doing things. City after city, same story over and again. And one of the places David Kennedy visited on that first round

12:19of proselytizing was Baltimore. What year did you go to Baltimore? 97. Oh, just right after Boston? Yeah. Baltimore in the mid-1990s had one of the worst homicide problems in the United States. Baltimore had every incentive in the world to try something new. And a group of experts presented the city with evidence, hard evidence, about how to solve their problem. Kennedy and his colleagues gave the same speech to Baltimore

12:49that John Puskus, the cardiologist, was giving to his fellow surgeons. There's a much, much better way to do this. And when did Baltimore finally get around to putting that solution into practice? More than 20 years later. I mean, this is like, it's heartbreaking. Yeah. We're talking about, you know, in the interim, thousands of people were in Baltimore. I am not a good enough person

13:21not to think about writing the op-ed piece that says this is how many people died in Baltimore because of that.

13:35The last episode was about the Baltimore miracle, how one of the most dangerous cities in America is solving its crime problem. This episode is about an equally pressing question. Why did it take so long?

13:59This is Jacob Goldstein from Business History. Imagine Henry Ford trying to create the assembly line. He had factory plans, production schedules, supply information, research, and ideas coming from all directions. His team spent years studying how to make the process work. Now, imagine having ChatGPT work. ChatGPT work can help with big projects that have lots of steps. You give it the goal along with real information like notes, files, reports, feedback, and project plans. It can use approved apps,

14:30connected tools, and files to help turn all of that into something useful. A plan, an analysis, a tracker, a presentation outline, or a workflow you can keep improving. And you stay in control. You give direction, review the work, approve actions, and choose the final result. Would Henry Ford have built the assembly line faster with ChatGPT? We'll never know. Ford didn't have ChatGPT. You do. Put ChatGPT to work on your most ambitious ideas and projects. Get started at ChatGPT.com

15:01by selecting Work Mode, available on Plus and Pro plans. This is a paid message from Apple Card. It's easy, I think, in the hubbub of our lives to lose track of our spending. We pay the bills and move on and don't understand the deeper patterns in our spending, the many different decisions we're making knowingly or unknowingly. You have to understand where your money is going in order to make better decisions about it. That's one reason Apple Card stands out to me. You can earn unlimited daily cash back

15:32on every purchase you make. I also appreciate the simplicity. Apple Card doesn't have annual, late, or over-the-limit fees. No fees ever. There's even an option to open a high-yield savings account through Apple Card. And while I haven't done it yet, if I do, my daily cash can grow automatically over time without any extra effort. When you better understand your spending habits, it's easier to make your money work harder for you. Apply in the Wallet app on your iPhone today. Subject to credit approval,

16:03variable APRs for Apple Card range from 17.74% to 27.99% based on credit worthiness. Rates as of October 1st, 2026. Existing customers can view their variable APR in the Wallet app or card.apple.com. Savings is available to Apple Card owners subject to eligibility. Savings and Apple Card by Goldman Sachs Bank USA, Salt Lake City Branch, member FDIC. Terms and more at applecard.com.

16:34These days, there are more people than ever telling you how to manage your health. And we've all gone down an internet rabbit hole exploring the latest health trends. Your social media feed is packed with wellness advice telling you to cold plunge, protein max, detox, track your sleep. But what's actually real? What's exaggerated? What's just wrong? That's exactly what Health vs. Hype from the American Medical Association and iHeart Media's Ruby Studio is here to find out. Each episode, Emmy-nominated

17:04science communicator Trace Dominguez, who's racked up billions of views across PBS, Discovery Channel, and YouTube, talks to health influencers, real people, and most importantly, doctors, to separate fact from fiction. Because when it comes to your health, who you listen to matters. Listen to Health vs. Hype on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

17:32My new book, The American Way of Killing, has as one of its central themes that the conversation Americans have about criminal violence is dishonest. And by that, I mean something very specific. This is what I write. By dishonest, I don't mean that one or both sides in the fight over guns are deliberately lying. Dishonesty comes in many more subtle flavors than that. A conversation that starts with the best of intentions can become dishonest

18:02for any number of reasons. When either side pretends that something is consequential when it is not. When either side avoids the right conclusion because it is too difficult. Or when either side blinds itself to the truth through laziness or indifference. The American conversation about guns is rife with these kinds of dishonesties. In the course of the book, I explore all the various ways in which Americans engage in this kind of dishonesty.

18:33But in this episode, I want to focus in on the second of those dishonesty definitions. When either side avoids the right conclusion because it is too difficult.

Resisting new solutions

18:45We have a sense, I think, that people resist change because they aren't convinced that change is necessary. We need awareness of the problem. But is that true? The millionaire with a house on the beach in Florida who calls himself a climate skeptic is not really a climate skeptic. It's possible his home insurance has gone up tenfold in those 25 years. He's forcibly reminded of how real climate change is every time he looks at his bank account.

19:15He's not in denial of the problem. He just doesn't like the solution. He doesn't want to leave paradise and be forced to move inland. The fight for minimally invasive cardiac surgery has run into the same roadblock. Very few people in the world of cardiology are in denial about the problems with conventional cardiac bypass. You're cutting open someone's chest and pulling back their ribs. Under the best of circumstances, that's an invasive procedure

19:45with a whole host of associated complications and side effects. The resistance comes from the fact that most cardiac surgeons just don't like the solution.

19:59Mix is harder. The chest is no longer wide open in front of the surgeon. Now the surgeon is working through a few tiny holes guided by a camera. It's an entirely new set of skills to master. I remember now it's 20 years ago a very famous now deceased elder statesman of cardiac surgery listening to my presentation and then standing up. We have a give and take after presentations at scientific meetings which is a good thing and he stands up

20:30and said well you know Dr. Puskas has now managed to transfer the pain of surgery from the patient to the surgeon. But even that doesn't answer the question because since when are cardiac surgeons the true cowboys of the operating room afraid of something hard the real issue goes deeper than that. Mix isn't an improvement. It doesn't allow you to do what you already do only better. It isn't like the transition from a car that gets 20 miles to the gallon

21:00to a car that gets 40 miles to the gallon. It's a fundamentally different way of operating. In the old bypass surgery the surgeon could see and touch everything right in front of him and most of the time in those days it was a him. He could direct traffic and everyone else around the operating room just silently followed his lead.

Team dynamics in surgery

21:22But with Mix it's a totally different approach. You know this is not men's singles tennis it's really more akin to you know soccer it is without a doubt a team sport and it's not 11 men on the field but it's 3 or 4 around that patient that have to coordinate their activities in an extreme way in the sense that a millimeter here or there of my right hand affects my partner's left hand and the

21:53instruments that we're holding and those instruments are being together passed through an incision that may be only 4 centimeters long and 2 centimeters wide but it could be 6 or 8 centimeters deep and we're going to try to put 20 stitches to connect two arteries using suture that's finer than human hair at the bottom of that hole and we're going to put those sutures in 20 sutures into two arteries that are 2.5 millimeters wide or 2 millimeters wide each meaning the sutures

22:24will be a tenth of a millimeter apart and we've got to do that precisely the three of us working in that hole so it's not just what I want or what I'm psychologically or physically able to adapt to doing or embrace as a mandate for innovation can I bring my team along can I retrain them retain them and keep them engaged in the commitment to doing

22:55this operation in a new way that's harder for us and better for patients what Puskas is talking about the difficulty of moving a profession from tennis to soccer is exactly the issue with focused deterrence it's not simply a better way of doing policing it's a completely new way of doing policing where the police have to transition from being the principal driver of crime-fighting to being one component of a larger crime-fighting team in the last

23:26episode we listened in on a management meeting the weekly sessions in Baltimore's western district where about 25 people gather in a room to discuss the most urgent cases of the moment I want to go back to that meeting to a case the group discussed near the

Baltimore management meeting

23:41end of the session moving on to the next referral we have this young man that's Reginald Williams the man running the management meeting he was he's an associate of a recent fatal shooting victim and so we had some safety concerns so we had to do a relocation right away the young man let's call him Lou had a close friend who had just been murdered and the

24:12police believed through their analysis of the social dynamics of the crime that Lou might be next so they wanted to move Lou and his family to a residential hotel outside the city until the situation calmed down but the plan isn't working Lou doesn't want to go Williams knows this because he has twice gone to see Lou himself as this note says on Monday it was reported that he's a rude kid he's aggressive and he was disrespectful and we

24:42had to go back in me and GVU went in and gave him a message again reiterated some things and the importance of him staying out of the city separating himself from any activities that can get him jumped up and because his mother was pretty impatient when at that point she saw him put him in a group home but if you can give us updates and hopefully it's a positive update what do

25:12you have for it now throughout the exchange that follows I want to count the number of people who get involved in trying to rescue Lou so Reginald Williams is one the GVU he mentions is the group violence unit that's two officers from the Baltimore Police Department who came with him on his second visit so that's two more people we're at three Williams turns to Hope one of

25:44the outreach workers she works for YAP youth advocate programs Williams believes the whole family is in danger they actually need to stay out of school do their classes online and in fact get out of Baltimore entirely it's Hope's responsibility to convince them to do that she's having trouble so this mom is overwhelmed honestly they're not they're still coming back and forth to the city I think

26:14she's getting packed up he's actually at school we communicated to them that he they nobody should be going to school should not be in the city it's been communicated several times so today we'll type up something and have her sign off on it we are now up to four people working on the Lou case hope continues we actually saw him yesterday at school he was still kind of standoff and she's just very disrespectful Lou is still going and yesterday he met with his life coach and

26:45two other teachers wait Lou has a life coach and two other teachers at the school are involved trying to talk sense into him that's number five six and seven at that point one of the western

27:01speaks up he's been involved in the case as well that's eight then an older man joins the conversation he's one of what are known as a community moral voice I spoke to the mom and I told her the importance of making sure that he remained at the hotel he do virtual learning as a matter of fact I told her to make sure all the kids go through virtual learning but again like Hope was saying she does not control that household her kids does so it's very hard and we're trying to get her parenting classes to help her

27:32navigate those many kids but at this point I'm not sure they're not in compliance at all so we're up to nine Hope speaks up again and we did like we because of the intensiveness of it the seriousness of it we connected her with every resource I've sent letters to housing support to get her bumped up on the list and things but I had to let her know we're here to support you you have to do these things the older man mentioned parenting classes Hope

28:02mentioned housing support what is that another handful of people at

28:11more than a soccer team we're now past a dozen professionals involved minimum for what by the way isn't even a murder case Lou isn't a victim or a perpetrator he's just someone who they think might one day be a victim or a perpetrator this is the exact point that Poskus the cardiologist was making transitioning from tennis to soccer from being the person who orchestrates an operation to being just one of a team is really really hard even for people who are

28:42as motivated towards excellence as surgeons are the transition requires not just a change in skills but a change in identity you have to agree to play a completely different role and what is the one thing that professionals who have trained to inhabit a particular identity do not want to do change that identity now keep in mind surgeons at least have a degree of autonomy in how they practice if

29:12you are a senior cardiac surgeon at a big hospital and you want to learn how to do mix you can do it but in the case of homicide prevention this fundamental change in identity needs the support of a whole layer of other people the mayor has to agree and so does the police commissioner and the

29:37being asked to support a team of more than a dozen people police officers outreach workers moral voices life coaches parenting counselors housing assistants to convince Lou who hasn't done anything yet except possibly be in harm's way to move with his family to a hotel outside the city that the city is paying for and to cap it all off Lou wants no part of any of this when has law and order the most politically potent

30:07three words in American society ever been used to describe a program like this the detective in our imagination is supposed to solve the crime with the help of an eager young sidekick he's not supposed to be on the phone with a parenting counselor trying to talk sense to a mom in over her head there's a reluctance to adopt these things and an eagerness to be able to prove that the old way is still the best way

30:38Puskas grew up in a tiny town in northern Ontario mining country he's an outsider he said he was about to go to the funeral of one of his fellow mixed pioneers a man named David Taggart who he described as a short bald Scotsman who wore a pair of dungarees and an Oxford class shirt to every surgical meeting when everyone else around him was wearing a suit and a tie it's a lot easier to adopt a new identity when you aren't caught up in the value of the identity

31:09you already have but fundamentally you know we should not expect at the end of our career to be operating exactly the way we did when we began our career otherwise we haven't made any progress during our career and so I really reject that notion and you know I've been in heated debates and you know become a little bit more elder statesman myself and in pointing out these

31:40obvious truths and asking people to sort of recognize and look inside themselves and say hey did you really think you would finish your career performing surgery the same way you began your career if so is that ethical is it even not not whether it's sensible or advantageous to you is it even ethical to think that way I would argue it's not yeah that is not a consensus opinion in medicine and nor apparently is

32:11it in crime prevention this is jacob goldstein from business history imagine henry ford trying to create the assembly line he had factory plans production schedules supply information research and ideas coming from all directions his team spent years studying how to make the process work now

32:41imagine having chat gpt work chat gpt work can help with big projects that have lots of steps you give it the goal along with real information like notes files reports feedback and project plans it can use approved apps connected tools and files to help turn all of that into something useful a plan an analysis a tracker a presentation outline or a workflow you can keep improving and you stay in control you give direction review the work approve actions and choose

33:11the final result would Henry Ford have built the assembly line faster with chat gpt we'll never know Ford didn't have chat gpt you do put chat gpt to work on your most ambitious ideas and projects get started at chat gpt dot com by selecting work mode available

33:33telling you how to manage your health and we've all gone down an internet rabbit hole exploring the latest health trends your social media feed is packed with wellness advice telling you to cold plunge protein max detox track your sleep but what's actually real what's exaggerated what's just wrong that's exactly what health versus hype from the American Medical Association and iHeart Media's Ruby Studio is here to find out

34:03Grace Dominguez who's racked up billions of views across PBS Discovery Channel and YouTube talks to health influencers real people and most importantly doctors to separate fact from fiction because when it comes to your health who you listen to matters listen to health versus hype on the iHeart radio app Apple podcasts or wherever you get your podcasts the new pet ivity smart feeder for cats turns everyday meals into

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Mayors of Baltimore

35:35more

Mayors of Baltimore

35:36what happened in Baltimore the first time around is that no one believed the criminologist David Kennedy and his team the mayor at the time was focused on what was happening in New York City where the police were just arresting everyone all the time and he decided that approach made more sense so he called Kennedy's team into his office the day after Christmas in 1999 and said you're done this was the world

36:06that the current mayor of Baltimore Brandon Scott grew up in I'm 42 now 18 of the 42 years that I've been alive the city had 300 homicides right and many of those years they were arresting almost 100,000 people that's 100,000 arrests in a city of 600,000 which is insane do you know what that number is today 17,000 arresting

36:36everyone is the thing you do when you don't understand what your homicide problem actually is no one did in those years and no one was interested in why just seeing that well while the police were stopping me the people that I knew in my neighborhood who had guns and who did all this stuff they never seen to end up in handcuffs right so I was very keen to the way that they were doing it versus it actually making my neighborhood feel

37:06safe because I can tell you that didn't make me feel safer it didn't make my parents feel like our neighborhood was safer it damn sure didn't make my grandmother think that our neighborhood was safer because they were doing what they were doing a decade or so later there was a second attempt to bring focused deterrence to Baltimore but the city didn't want to embrace it all the way focused deterrence is carrot and stick gentle persuasion and swift and predictable consequences and the city wanted to do the second

37:37part but not the first part since the stick was the thing that they were most comfortable doing they wanted to pretend to change without

37:47I think it's very different for me than my predecessors Scott says that one of his aides Andre Bundley once made this argument to him we were together at the end of last year and he said you know I'm proud of you but I want you to know something and it's like what you know you're the first mayor to ever have to live through all the shit and I said what do you mean doc he said think about it you'll get it and then I did and

38:19then I thought about it and he's right Scott began to list his predecessors one by one so Mayor Young he's an older black man right Bernard Young grew up in the 1960s when Baltimore was a much calmer more prosperous place before Young was Catherine Pugh Mayor Pugh didn't grow up in Baltimore she came to Baltimore and went to Morgan State right her very very different than mine before

38:49Pugh was Stephanie Rawlings Blake Scott grew up in Park Heights Park Heights was tough Rawlings Blake was from Ashburton Ashburton and Park Heights are two different worlds still to this day and her dad was one of the most powerful men in the Maryland General Assembly of God rest his soul right like they're like family to me but we grew up in a different world before Blake was Sheila Dixon grew up middle class in the 60s before

39:19her Martin O'Malley White from D.C. dad was a lawyer before O'Malley Kurt Schmoke three terms office Schmoke Schmoke went to Yale then Oxford as a Rhodes scholar Scott was the first mayor to have lived the failure of the status quo firsthand remember this from the last episode we would just be outside and you know be sat down in handcuffs for no reason other than you were like black and outside right so that that happened to me seven times

39:50seven seven different times roughly from the age of 13 to 21 22 right before I came to City Hall none of his predecessors went through that I knew that this was the only approach because they've tried everything else my entire life and it has not changed right when I was born we had that problem when I went to elementary school we had that problem at the middle school we had that problem high school college on

40:20City Council it did not change so why would I continue to do something that I know hasn't worked versus trying something that has worked everywhere but here everyone knows that this is my number one two three four fifth priority reducing violence through this comprehensive approach way is priority one through five for

40:51me and everyone knowing that I think rises everyone all about people's attention to detail and knowing that like no matter what you're going to fucking do it because if you don't the mayor's going to say you're going to do it or you're going to work somewhere else here is the explanation for why it took 30 years for focused deterrence to take root people don't change their minds we keep hoping that they will because we're all born optimists but people don't

41:22young and pew and rawlings blake and dixon and o'malley and schmoke all had a perspective on how to fight violence and nothing was going to shake that even when someone showed up on their doorstep and said look at boston you could do that here so when does change happen when one generation leaves and a different generation comes in that believes something different because they've lived something different

41:52this is what the nobel prize winning physicist max plank meant when he famously said that science advances one funeral at a time the old guard has to be dead and buried before the new guard has

Generational change in medicine

42:07a chance

Generational change in medicine

42:08listen again to Puskas so you've gone to a lot of meetings and stood up and said here's this new thing I'm trying right you've been doing this for 20 years maybe more what happens when you say that when you stand up and what what's the response in the room so the younger people seem more interested and for a long time Malcolm I made the mistake of trying to convince my peers that ship has sailed the

42:38people that we're now focused on trying to change and to motivate are the youngest members of our profession you can't convince your peers that ship has sailed all you can hope for is that the new people understand something that the old ones didn't you plant a seed in 1997 and if you're lucky it bears fruit 30 years later build a better mousetrap they told us and the world will beat a path to your door I

43:09wish The Visionist History is produced by Nina Bird Lawrence with Lucy Sullivan and Ben Nadaf Halfring Our editor is Karen Chikurji Our executive producer is Jacob Smith Fact Checking by Sam Rusick Original Music by Luis Guerra Mixing and Mastering by Jake Korski I'm Malcolm Gladwell For I

43:54don't know how long maybe 12 13 years I've I've worn a whoop band on my wrist I started doing it because I met the founder of whoop at a conference he heard that I was a runner and he said oh you'll love this it's perfect for athletes and he was right I I have worn one ever since every time I work out I see how hard I worked how long I need to recover I wake up in the morning and I get a complete picture of how my sleep went which helps me understand the kinds of things that lead to a bad night and the kinds of things that lead to a good night it's

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