Feb 17, 2010 at 6:00 am

A friend recently turned me on to Alan Deutschman’s great book “Change or Die.” The title refers to the moment when your doctor tells you that you must adjust your lifestyle to avoid a particular, imminent death that your current behaviors are leading to.

Interestingly, it doesn’t seem to be Deutschman’s goal to save lives by changing the behavior of his readers, at least not exactly. He seems to be more ambitious than that. Using the examples of three unrelated institutional systems, he points out how our culture has come to accept failing patterns. He starts with the example of standard treatments for heart disease, pointing out that heart patients will change their diets and will exercise for a short while after being given the “change or die” speech, but without reinforcement, most heart patients fail to effect the life changes their doctors prescribed.

Thereafter, Deutschman focuses on the systematic failure of American criminal justice. Recognizing that rehabilitation must necessarily be central to the system’s goal (because unrehabilitated criminals are a danger to society), Deutschman points out that a 2002 U.S. Department of Justice review of records in 15 states revealed nearly 70 percent of inmates were rearrested within three years of release from prison, half within six months of release.

The third example dealt with the management of an automobile factory that had been closed because the employees could not be motivated to meet production quotas. In each of these examples, “success” was defined by something other than the implicit goal of the system being considered. That fact should tend to act as a slap in your face; recognizing that failure is an acceptable substitute for success (as long as there is a profit being made somewhere) should rankle any American citizen who ever believed in the promise of Democracy and/or the Constitution.

Thankfully, Deutschman offers exceptions to each of the systematic failures he introduces. In 1993, as part of an experimental program, a group of heart surgery candidates were given a year of behavior modification treatment, including stress-relieving exercise and nutrition guidance, which resulted in long-lasting changes in the behaviors of participants; 77 percent of them avoided surgery altogether. Meanwhile, in San Francisco, the Delancey Street Foundation has, for some 35 years, housed as many as 500 former inmates, offering a four-year program for reintegration into society that requires residents to work together in various business endeavors, financing and managing the residence with only one staff member, Mimi Silbert, a doctor of psychology and criminology. Nearly 60 percent of the participants in this program avoid rearrest.

Deutschman’s point is that real change is practically impossible without a human element, that it is only by recognizing the investment of compassion that individuals are likely to eliminate unproductive habitual behaviors.

And then, last week, my friend and I went to see “Up in the Air.” This Academy Award-nominated film tells the story of Ryan Bingham, a corporate “termination engineer” played by George Clooney. Bingham flies all over the country firing people for downsizing companies, and through his narration we learn he is happily unattached to people or possessions. Early on, however, he meets the attractive Alex (Vera Farmiga), and, coinciding with his little sister’s impending marriage, he starts to feel a connection, starts to see how empty his jet-setting life really is. Will he change? Does he have the power? The desire? Does he have such an opportunity?

Applying Deutschman’s premise, it isn’t likely to happen without a compassionate commitment from some “other.” Screenwriter/director Jason Reitman doesn’t offer an easy Hollywood ending, which is refreshing.

Meanwhile, it seems to be a metaphor for the many ways in which we all know we must change our behaviors. Our culture is built on a disease economy; our primary profit and tax-generating businesses foment illness, addiction, obesity and planetary destruction. We profit from temporary fixes that necessarily fail to eliminate the problems they purport to address. Massive systematic overhaul seems mandatory, but is there anyone who can show us the way?

For further consideration: It’s probably about time you saw the Coen Brothers’ film “A Simple Man,” which prominently features the Jefferson Airplane song, “Somebody to Love.”