From the Editor: Are We Hungry Yet?

I spent a bit of time in the hospital recently. I wouldn't recommend recuperation as a leisure-time activity, but it's anything but boring. As the days went by, I was dazzled by how painlessly my surgeons worked and how quickly I was up and around. I got to observe some interesting drug side-effects—a brilliantly itchy rash for me and a cool, creepy hallucination for my roommate. I got to eavesdrop on a discussion of a commonly used medication, a conversation that managed to get almost all of the facts wrong at least twice. I met a couple of promising surgical residents and some accomplished nurses, and I got to discover for myself how thoroughly one moderately medicated man can entangle himself in an IV line, an oxygen cannula, and a bed control.

Patrick Clinton

The most surprising experience of the lot, though, came when after five days of fasting my surgeon decided it was time for me to start eating again. The kitchen sent the "clear liquid" tray—apple juice, broth, fruit ice, and Jell-O—and I untangled my tubes and set to work.

I don't think I'd ever truly realized how much red Jell-O you can fit in an eight-ounce plastic cup. I spooned and swallowed, then rested and spooned some more. I dozed for a while, then forced down another bite or two. The cup looked like I hadn't touched it. My sister, a veteran of more hospital stays than I've had, claims the nurses sneak in while you're asleep and add more Jell-O to the cup. I never caught them at it, but it sure would explain a few things.

I knew I needed to eat if I was ever to get home. In an abstract way I wanted to eat. But I had no appetite. And so the easiest, pleasantest activity in the world turned into a battle of will that for the most part I lost. It was the same thing at every meal: a scoop of mashed potatoes that had me defeated within two nibbles, an eternity of noodle soup, a particularly vast and unconquerable slice of french toast. And more red Jell-O.

I was thinking of that red Jell-O as I read the stories in this month's issue. Because, in a way, that's exactly what several of them are about: Things that you know are good for you and are going to pay off, but for the moment you just can't seem to swallow them.

The clearest example is our roundtable discussion about Electronic Data Capture (EDC) in clinical trials. Our panelists, who've all had substantial success with EDC, got down to the nitty-gritty: How do you prevent a company-wide implementation from turning into a series of pilots that no one takes seriously? How do you get the right people to take ownership of a new technology? How (to put it another way) do you get them to pick up the spoon, open wide, and swallow?

I think that's actually an important way to look at things. In the old days, the big problem corporations faced was red tape—the tendency to bog down every decision in endless processes and management controls. Today, I'd argue, the culprit has changed. Today it's the changes companies know they need to make but defer because they're just not ready—not red tape, but red Jell-O.

What I learned sitting in front of my hospital tray is how amazingly hard it is to eat when you're not hungry. The equivalent business question, I suppose, is this: If you need to change, and you know it, how do you develop an appetite for change that gets you through? The answer is not obvious. We've got a few tips in this issue, but we'd love to hear more. Let us know: What's your red Jell-O these days? What's the thing you need to swallow and can't? And what seems to help? We'll all be here, spoon in hand, awaiting your advice.