This has been the pattern of many important but stalled ideas. They attack problems that are big but, to most people, invisible; and making them work can be tedious, if not outright painful. The global destruction wrought by a warming climate, the health damage from our over-sugared modern diet, the economic and social disaster of our trillion dollars in unpaid student debt—these things worsen imperceptibly every day. Meanwhile, the carbolic-acid remedies to them, all requiring individual sacrifice of one kind or another, struggle to get anywhere.
I've already written about Atul Gawande's superb essay on slow ideas, but I wanted to pull one or two more ideas out from the essay. The first is his idea of a carbolic-acid remedy.
It comes from the first question he asks in the essay. Why did anesthesia catch on so quickly when antiseptics took much longer? Both came about at roughly the same time, there were economic incentives for both and both were equally difficult to implement. Gawande's conclusion is that antiseptics solved an invisible problem: germs. Anesthesia, on the other hand, solved a very visible problem: the patient's pain during surgery. He also points out that antiseptics was painful for doctors. Carbolic acid often burned doctors hands and they had to operate in a shower of the stuff. Anesthesia was completely pain-free for the doctors who used it.
This is the dual nature “carbolic-acid remedies”: they solve an invisible problem and are painful to implement. As Gawande points out, may of the problems we currently face (global warming, poor nutrition, the banking crisis) are of this nature. They are invisible problems and the solutions to them are not easy. I'm not entirely sure if Gawande's mentorship-based solution is the answer to all of these problems, but it's worth considering. I also like the term “carbolic-acid remedy” as a reminder of the challenges that these types of problems raise.