When my grandfather was a doctor in South
Wales, the local hospital proudly unveiled its first X-Ray
machine. At the official opening ceremony, the mayor removed his chain and all other
metallic objects to christen the device as its first ever “patient”. This was
only intended as a publicity stunt. Unfortunately the inaugural X-Ray revealed
a cancer somewhere in the mayor’s chest. They operated almost immediately but
he was dead within a month.
As my grandfather wryly observed, he would have survived
another five years without the operation.
One of the big unspoken topics of medicine is the proportion
of deaths which are in some way caused by the treatment not the disease – the technical
term is “iatrogenic”. Deaths as much or more the result of medical intervention
as of any illness. Or entirely new illnesses that only happen as a result of
prior treatment.
You would probably assume that, by and large, the better
funded your country’s health provision, the longer people will live. Actually,
this seems not to be true. Above a certain level of expenditure, the benefits
stop coming. Some economic theorists, among them Robin Hanson, believe this is
because once you spend more than a certain amount on medical treatment, the problems
arising from excessive intervention – because “we must be seen to do something” –
outweigh the benefits.
What’s certainly interesting is that Elvis and Michael
Jackson, two people both with personal physicians, died so young.
I can imagine what it must be like to be a personal
physician. Every day you must feel you have to do something to justify your
existence. Yet, in truth, most of the time people are better off being medically left
alone most of the time. And most illnesses may be best treated with rest and a
little warmth. All the same, the urge to do something must become
overpowering. We are, as several Darwinian experts have observed, over-wired to display
conscientiousness and effort. And sensible non-intervention can always risk
appearing like laziness or stupidity. So we always intervene.
The whole process of creating advertising needs to be very
alert to the risks of iatrogenic illness. We – and our risk-averse clients even more -
tend to assume that more research, more tissue sessions, more inputs, more
opinions will make the outcome better. Yet, as with medicine, beyond a certain
level they are more likely to be damaging than beneficial.
You learn this as a creative director. Some of the time, you
need to look at work and resist the urge to justify your salary. “It’s great, “you
force yourself to say. “Don’t change a thing.”
But many people involved in the commissioning and approval of advertising don’t
realise this. The whole idea is that research, reworking, endlessly protracted
approval processes are all contributing to the end product. As likely as not, they are
killing it.
Have any doubts? Try this experiment. Next time you are
asked for an opinion, don’t give one. Say you don’t know. Say it’s fine. Say “I
couldn’t have done it better myself.”
It’s difficult, isn’t it?
The result of this tampering is that simplicity gets lost.
Clarity gets muddied. Most likely of all, a certain charm gets killed off. For the hardest thing sometimes isn’t to do something good. It’s
to leave well alone. To get it simple and have the courage to keep it simple.
Which brings me to Johnny Cash.
He was once asked by another guitar-player to justify
himself. “Look”, said the struggling guitar-player, “Here I am playing, busting
my arse, making my fingers bleed while playing painful chords and complex riffs –
while all you do is stand there all evening and go dum-ditty, dum-ditty,
dum-ditty, dum-ditty ding.”
“I know”, said Mr Cash. “That’s because you’re still
looking. I’ve already found it.”
