The Specializing Non-Specialist

Last year my wife Betty came home from a shopping trip complaining of stomach and back pain, nausea, and vomiting. She had no fever, just a general feeling of malaise, and asked me to check out the source of the pain. While doing so I noticed the pain was pretty much everywhere, but worse in her lower right abdomen. I said, “It's probably appendicitis, let's get you in to get checked out.”

Sidebar: appendicitis symptoms usually include somewhat localized pain (she had pain everywhere, just a little worse over the appendix) and fever, but vomiting and back pain are unusual.

When we got to the ER the resident covering for the afternoon came in, read her charts from the nurse's interview, checked her blood work, and examined her. He then asked if she had back pain. When she said she had but not any more, the doctor said, “Hmm, that's unusual, I'd expect some back pain with kidney stones.” He examined her further, more-or-less ignoring her abdomen and hitting her in her lower back (trying to determine if her kidneys hurt). I asked, “I don't know, the pain is over her lower right abdomen, not in the back; why do you think it's kidney stones?” He said, “Your wife doesn't have any signs of appendicitis; nothing at McBurney's point, no fever, white count is normal, and there's no rebound pain. I'm sure it's kidney stones; we'll send you up for a CT scan of your lower half.”

McBurney's point is the specific area where appendicitis pain centers; it's about half-way along an imaginary line between the right hip and the navel.

Rebound pain is the term used when a pain gets worse as pressure to the pain area is released. In other words, the doctor will press on the area and then release; if the pain gets worse upon release, that's rebound pain.

When the results came back the resident came in and said, apologetically, “Well, it was appendicitis. We've scheduled your surgery and you'll be going up in about an hour.”

Why am I telling you this? I'm not making a point about the hospital, doctor, or my wife; I'm making a point about specialists. The ER doctor was a urologist. He thought “kidney stones” because he's trained to see problems with the urinary tract. Specialists often do that; while they catch a lot of things most people would miss, they have an observational bias. People who have a highly specialized knowledge very often cannot break out of that role to see the general picture. They're highly intelligent, but their very specialization causes them to miss the obvious.

I bring this up to make a point. Most departments in most companies place a high value on specialization. They offer certification in various disciplines and pay specialists very well... and who can blame them? Specialists often solve problems the average person in that field cannot. Any DB2 DBA can design a half-decent database; it takes a specialist to make that database behave in the most efficient manner possible. Specialists are valuable in other ways; consider who writes white papers. Everyone working with IMS knows who Rich Lewis and Bill Keene are, and anyone working with DB2 knows the names E. F. Codd and Craig Mullins.

Now I know you're all thinking, “Yeah, yeah, we know this. What's your point?” Remember the doctor in the ER? His expertise caused him to miss a diagnosis I, a non-medical professional, made easily. Nobody in the ER believed me because I wasn't in the medical profession. And no, I didn't get lucky... I know anatomy because I've studied it. I know human morphology; my paleontology background prepares me for that. I also know every person's body is unique; not everyone shows the same symptoms, the same patterns of disease.

My point is simple: the generalist, AKA the “specializing non-specialist,” gets no respect... and yet you need them. They see things specialists miss because the generalist has no biases specific to a given situation. Not everyone's cut out to be a generalist; it takes a very open mind and a wide range of knowledge across many fields of study.

A primary tool of the generalist is systems thinking, also called the Fifth Discipline (as described in the book of the same name by Peter Senge). In effect the systems thinker sees a given thing or event as influencing other things and/or events within an overall system. In short the systems thinker sees each event as an interaction between parts of a whole, and problems as breakdowns within the system.

I'll offer another analogy, this one from baseball. Even people who aren't baseball fans know who David Ortiz or Albert Pujols are; on the other hand, many baseball fans can't tell you what teams Alex Cora or Bill Hall play for. Naturally stars have a big influence on whether a baseball team wins a lot of games or not, yet the “little players,” the utility men, have an important role. Stars cannot play every day without increasing their injury risk or reducing their efficiency (you can't play your best when you're tired). That's where the utility players come in. They can play effectively while the star takes a break, and if one of the regulars goes down with an injury these utility players can replace them for weeks at a time without costing the team. Beyond that, because they can play anywhere the manager can rotate days off for their stars, so at most one star is sitting at any given time. Maybe a team cannot win a pennant with a team of Alex Coras, but a team needs at least one Cora to be a champion. Consider how many World Series MVPs are not regular players; of the non-pitcher World Series MVPs since the award started in 1955, 8 of 30 (about 27%) of them were not regular players for their teams and, if I named them, most of you would not recognize most of the names. Expand that to include non-World Series playoff games and the percentage of "unknowns" winning MVPS is higher.

And for those who think I'm only looking at fringe backup players, consider Craig Biggio (a certain Hall of Fame-level player) played catcher, second base, and outfield during his career, and made the All-Star team at catcher and 2b. Now there is an All-Star "supersub" for you.

Baseball recognizes the jack-of-all-trades; why not the corporate world? I understand why big-name specialists get recognized regularly, and I don't begrudge them at all; they deserve it. On the other hand, we the “specializing non-specialists” are just as important to the overall well-being of the company, yet we get nothing. To the contrary, we're often chided for not paying attention to our assigned job roles, and companies will not hire us because we don't specialize enough.

I welcome any and all comments about these observations. I have made an effort to network with people about this issue, learned a lot from a few people, and hope to learn more from my readers.