Revisionist History - Wolfgang's Law - Part Two

Episode Date: October 15, 2026

We’ve known about a solution to violent crime for decades. Why hasn’t it been adopted everywhere? And what are the costs of waiting so long? You can order The American Way of Killing at Gladwell.com or wherever books are sold.See omnystudio.com/listener for privacy information.

Malcolm Gladwell here. My new book, The American Way of Killing, investigates America's gun violence crisis. Why is the richest country in the world plagued by such lethal violence? Through a series of stories, interviews, and archival tape, I confront one of today's most urgent moral dilemmas and examine why the U.S. has never quite understood its own problem and why you can't fix what you refuse to see clearly. Get the American Way of Killing at Pushkin.fm slash audiobooks or at Audible, Spotify, or wherever audiobooks are sold.

When 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,

pull 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.

That's John Puskis, 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. And then, working only through that tiny hole, using long instruments, delicately so a new artery in place, bypassing the one that's blocked.

In the beginning, even for Puscus, it felt impossible. After I'd done ten, I saw, I saw, 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 was 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, Puskas 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, you 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? Where are we in the adoption curve? 2%. Wait, 2%. 2%, maybe 3? 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 at 50. What year did you do your first operation, that sort, roughly? First like that? 97 or 8? So 30 years ago. Yeah.

My name is Malcolm Gladwell. You're listening to Revisionous 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. In 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, which 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 focused deterrence strategy first tried in 1995? At almost the exact moment that John Puscus and his fellow pioneers began experimenting with their new approach to cardiac bypass. Back in the mid-90s, a 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.

It's dangerous to be in relationships. It's dangerous to go outside. It's dangerous to leave the blood. 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, 1% 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 extremely concentrated and it's extremely networked. But none of that had been carried into thinking and policy. Kennedy and his colleagues then 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 focus deterrence was born. It 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. You were shocked by what happened. I was shocked by what happened. I was shocked by what happened. The cops had everybody. Nobody could believe that what was clearly going on had happened.

In 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 what 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, my God, Eureka, and by the end of the year, they had let it all fall apart. Homicides 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 of proselytizing was Baltimore. What 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

that John Puscus, 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 in Baltimore.

I am not a good enough person not to think about writing the op-ed piece that says this is how many people died in Baltimore because of that. The 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? Music you love. Radio stations. Everywhere you go.

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Malcolm Gladwell here. My new book, The American Way of Killing, investigates America's gun violence crisis. Why is the richest country in the world plagued by such lethal violence? Through a series of stories, interviews, and archival tape, I confront one of today's most urgent moral dilemmas and examine why the U.S. has never quite understood its own problem and why you can't fix what you refuse to see clearly. Get the American Way of Killing at Pushkin.fm.com or at audiobooks or at Audible, Spotify, or wherever audiobooks are sold.

My 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 for 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. But 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 a good one. is too difficult. We 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. He'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 wrist.

ribs. Under the best of circumstances, that's an invasive procedure, with 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. Mix 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, you know, listening to my presentation and then standing up, you know, we have a given take after presentations at scientific meetings, which is a good thing. And he stands up and said, well, you know, Dr. Puskas is 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 our cardiac surgeon, 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 to 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 at, 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. But 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 three or four 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 instruments that were holding. And those instruments are being together passed through an incision that may be only four centimeters long and two centimeters wide, but it could be six or eight centimeters deep. And we're going to try to put 20 stitches to connect to our, 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 two and a half millimeters wide or two millimeters wide each, meaning the sutures will 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 this 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 episode, 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 end 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 police 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 his note says on Monday, it was reported that he's a rude kid, he's aggressive, and he was disrespectful, and we had to go back in. Me, GVU, went in and gave him a message again, reiterated some things, and the importance of him stand out of the city, separating himself from any activities that can get him jumped up. And because his mother was, she was free and patient, went in at that point. points, you saw him and put them in a group home. But if you can give us updates, and hopefully it's a positive update, what do you 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. Word three. Williams turns to Hope, one of the 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, um, This mom is overwhelmed. Honestly, they're not. They're still coming back and forth to the city. I think she'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.

office. She's just very disrespectful. Lou is still going, and yesterday he met with his life coach and two 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 District police officers, Sergeant Garrett speaks 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'd 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 navigate those many kids. but at this point, I'm not sure they're not in compliance at all. 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, like, we're here to support you. You have to do these things. The older man mentioned parenting classes. Hope mentioned housing support. What is that? Another handful of people at a minimum?

Soccer is 11 people to a side. This is more 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 Puscus, 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 as 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 you 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 city council and the DA and the DA. And most of all, the taxpayers of the city, who are being 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 three 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 in an eagerness to be able to prove that the old way is still the best way. Puscus 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 cloth 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 you 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 statesmen myself in pointing out these obvious 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 whether it's sensible or advantageous to you? Is it even ethical to think that way? I would argue it's not. That is not a consistent. consensus opinion in medicine.

And nor, apparently, is it in crime prevention. Music you love, radio stations, everywhere you go, the podcasts everyone's talking about, all in one place, and it's free. I heart radio. Whatever you want to hear. Listen anytime, anywhere. Music, radio, podcasts, unlimited audio, it's on the free IHurt Radio app. One app, no subscription.

Always free. Grab the free app. Everywhere you go. Always free. Download the free IR Radio app today. Malcolm Gladwell here. My new book, The American Way of Killing, investigates America's gun violence crisis.

Why is the richest country in the world plagued by such lethal violence? Through a series of stories, interviews, and archival tape, I confront one of today's most urgent moral dilemmas and examine why the U.S. has never quite understood its own problem and why you can't fix. what you refuse to see clearly. Get the American Way of Killing at Pushkin.fm slash audiobooks

or at Audible, Spotify, or wherever audiobooks are sold. What 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 that 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 everyone 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 while the police were stopping me, the people that I knew in my neighbor who had guns and who did all this stuff,

they'd never seen to end up in handcuffs. Right? So I was very, very keen to the way that they were doing it versus it actually making my neighborhood feel safer. 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 focus 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 part, but not the first part, since the stick was a thing that they were most comfortable doing. They wanted to pretend to change without really changing. Then came the election of Scott in the fall of 2020. I 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 the last year and he said,

Brain, 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 then 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 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 experiences are very, very different than mine.

Before Pew was Stephanie Rawlings Blake. Scott grew up in Park Heights. Park Heights was tell. Rallings 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 Rested 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 her, Martin O'Malley, White. From D.C., dad was a lawyer. Before Amalley, Kurt Schmoke. three terms in office. 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 set down in handcuffs for no reason other than you were like black and outside, right?

So that happened to me seven times. Seven. Seven different time, 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.

When I went to middle school, we had their problem. High school, college, on the city 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 me. and everyone knowing that, I think, rises everyone, all of our 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 fucking do it, or you're going to go work somewhere else. Here is the explanation for why it took 30 years for focus 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. Young and Pew and Rawlings, Blake and Dixon, and O'Malley and Smoke all had a perspective on how to fight violence, and nothing was going to shake that. Even when someone showed up in 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. This is what the Nobel Prize-winning physicist Max Planck 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 a chance.

Listen again to Puscus. 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'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 people 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 wish. Division's History is produced by Nina Bird Lawrence with Lucy Sullivan and Ben Nadaf Halfring. Our editor is Karen Chikurgy, our executive producer is Jacob Smith, fact-checking by Sam Russick,

Original music by Luis Gera, mixing and mastering by Jake Korski. I'm Malcolm Gladwell. Malcolm Gladwell here. My new book, The American Way of Killing, investigates America's gun violence crisis. Why is the richest country in the world plagued by such lethal violence? Through a series of stories, interviews, and archival tape, I confront one of today's most urgent moral dilemmas and examine why the U.S. has never quite understood its own problem

and while you can't fix what you refuse to see clearly. Get the American Way of Killing at Pushkin.fm slash audiobooks or at Audible, Spotify, or wherever audiobooks are sold.