The Tipping Point - How Little Things Can Make a Big Difference - by Malcolm Gladwell, Little, Brown and Company, New York - Boston, © 2000, 2002 by Malcolm Gladwell, 301 pp, PB $15, Time Warner AudioBook, © 2005, 3 CDs, 3 hours, $24, read by the author. http://www.gladwell.com/tippingpoint/index.html

The Tipping Point is a book about change and presents a new way of understanding why change so often happens quickly and unexpectedly. Gladwell says the best way to understand the emergence of fashion trends, the ebb and flow of crime waves, the transformation of unknown books into bestsellers, or the rise of teenage smoking or any number of other mysterious changes that mark everyday life is to think of them as epidemics. Ideas and products and messages and behaviors spread just like viruses do. The three rules of the Tipping Point - the Law of the Few, the Stickiness Factor, the Power of Context - offer a way of making sense of epidemics. They provide us with direction for how to go about reaching a Tipping Point.

The Law of the Few: On the afternoon of April 18, 1775, a young boy who worked at a livery stable in Boston overheard one British army officer say to another something about "hell to pay tomorrow." The stable boy ran with the news to Boston’s North End, to the home of a silversmith named Paul Revere. Revere listened gravely; this was not the first rumor to come his way that day. As the afternoon wore on, Revere and his close friend Joseph Warren became more and more convinced that the British were about to make a major move that had long been rumored - to march to the town of Lexington, to arrest the colonial leaders John Hancock and Samuel Adams and then on to the town of Concord to seize the stores of guns and ammunition that some of the local colonial militia had stored there. At 10 o’clock that night, Warren and Revere met and decided they had to warn the communities surrounding Boston Harbor. At midnight Revere jumped on a horse at the ferry landing at Charlestown and began his "midnight ride" to Lexington passing through Charlestown, Medford, North Cambridge, Menotomy - knocking on doors and telling them to spread the word "The British are Coming." Each in turn spread the word to others like a virus until alarms were going off through the entire region.

When the British finally began their march toward Lexington on the morning of the nineteenth, their foray into the countryside was met - to their utter astonishment - with organized and fierce resistance and they were soundly beaten. From that exchange came the war known as the American Revolution. Gladwell feels the Paul Revere’s ride is perhaps the most famous historical example of a word-of-mouth epidemic.

The Tipping Point For Hush Puppies - the classic American brushed-suede shoes with the lightweight crepe sole - came somewhere between late 1994 and early 1995. The brand had been all but dead until that point. Sales were down to 30,000 pairs a year, mostly to backwoods outlets and mall-town family stores. Wolverine, the company that makes Hush Puppies, was thinking of phasing out the shoes that made them famous.

But then something strange happened. At a fashion shoot, two Hush Puppies executives - Owen Baxter and Geoffrey Lewis - ran into a stylist from New York who told them that the classic Hush Puppies had suddenly become hip in the clubs and bars of downtown Manhattan. "We were being told," Baxter recalls, "that there were resale shops in the Village, in Soho, where the shoes were being sold. People were going to the Ma and Pa stores, the little stores that still carried them, and buying them up." Baxter and Lewis were baffled at first. It made no sense to them that shoes that were so obviously out of fashion could make a come-back. "We were told that Isaac Mizrahi was wearing the shoes himself," Lewis says. "I think it’s fair to say that at the time we had no idea who Isaac Mizrahi was."

By the fall of 1995, things began to happen in a rush. Designers called wanting to use Hush Puppies in their spring collections. In Los Angeles, the designer Joel Fitzgerald put a twenty-five foot inflatable basset hound - the symbol of Hush Puppies brand - on the roof of his Hollywood store and gutted an adjoining art gallery to turn it into a Hush Puppies boutique. While he was still painting and putting up shelves, the actor Pee-wee Herman walked in and asked for a couple of pairs. "It was total word of mouth," Fitzgerald remembers. In 1995, the company sold 430,000 pairs of the classic Hush Puppies, and the next year it sold four times that, and the year after that still more, until Hush Puppies were one again a staple of the wardrobe of the young "American male."

In 1996 Hush Puppies won the prize for best accessory at the Council of Fashion Designers awards dinner at Lincoln Center, and the president of the firm stood up on the state with Calvin Klein and Donna Karan and accepted an award for an achievement that - as he would be the first to admit - his company had almost nothing to do with. Hush Puppies had suddenly exploded, and it all started with a handful of kids in the East Village and Soho, who were wearing them precisely because no one else would wear them. And then the fad spread. No one was trying to make Hush Puppies a trend, but that’s exactly what happened. The shoes passed a certain point in popularity and they tipped.

The Rise and Fall of New York Crime is analyzed by Gladwell. There was a time, in the desperately poor New York City neighborhoods of Brownsville and East New York, when the streets would turn into ghost towns at dusk. Ordinary working people wouldn’t walk on the sidewalks. Children wouldn’t ride their bicycles on the streets. Old folks wouldn’t sit on stoops and park benches. The drug trade ran so rampant and gang warfare was so ubiquitous in that part of Brooklyn that most people would take to the safety of their apartment at nightfall. Police officers who served in Brownsville in the 1980s and early 1990s say that, in those years, as soon as the sun went down their radios exploded with chatter between beat officers and their dispatchers over every conceivable kind of violent and dangerous crime. In 1992, there were 2,154 murders in New York City and 626,182 serious crimes, with the weight of those crimes falling hardest in places like Brownsville and East New York. But then something strange happened. At some mysterious and critical point, the crime rate began to turn. It tipped. Within five years, murders had dropped 64.3 percent to 770 and total crimes lad fallen by almost half to 355,893. In Brownsville and East New York, the sidewalks filled up again, the bicycles came back, and old folks reappeared on the stoops. "There was a time when it wasn’t uncommon to hear rapid fire, like you would hear somewhere in the jungle in Vietnam," says Inspector Edward Messadri, who commands the Police precinct in Brownsville. "I don’t hear the gunfire anymore."

New York City police pointed to strategies. Criminologists pointed to the decline in the crack trade. Economists said the gradual improvement in the city’s economy and the would be criminals became employed. Gladwell discounts all these explanations inasmuch as this was happening in other cities around the country.

The Power of Context: Bernie Goetz and the Rise and Fall of New York City Crime. On December 22, 1984, The Saturday before Christmas, Bernhard Goetz left his apartment in Manhattan’s Greenwich Village and walked to the IRT subway station at Fourteenth Street and Seventh Avenue. He was a slender man in his late thirties, with sandy-colored hair and glasses, dressed that day in jeans and a windbreaker. At the station, he boarded the number two downtown express train and sat down next to four young black men. There were about twenty people in the car, but most sat at the other end, avoiding the four teenagers, because they were, as eyewitnesses would say later, "horsing around" and "acting rowdy." Goetz seemed oblivious. "How are ya?" one of the four, Troy Canty, said to Goetz, as he walked in. Canty was lying almost prone on one of the subway benches. Canty and another of the teenagers, Barry Allen, walked up to Goetz and asked him for five dollars. A third youth, James Ramseur, gestured toward a suspicious-looking bulge in his pocket, as if he had a gun in there.

"What do you want?" Goetz asked.

"Give me five dollars," Canty repeated.

Goetz looked up and, as he would say later, saw that Canty’s "eyes were shiny, and he was enjoying himself. . . . He had a big smile on his face," and somehow that smile and those eyes set him off. Goetz reached into his pocket and pulled out a chrome-plated five-shot Smith and Wesson .38, firing at each of the four youths in turn. As the fourth member of the group, Darrell Cabey, lay screaming on the ground, Goetz walked over to him and said, "You seem all right. Here’s another," before firing a fifth bullet into Cabey’s spinal cord and paralyzing him for life.

When Goetz turned himself in on New Year’s Eve, the New York Post ran two pictures on its front page: one of Goetz, handcuffed and head bowed, being led into custody, and one of Troy Canty - black, defiant, eyes hooded, arms folded - being released from the hospital. The headline: "Led Away in Cuffs While Wounded Mugger Walks to Freedom." Talk radio dubbed Goetz the "Subway Vigilante" who had fulfilled the secret fantasy of every New Yorker who had ever been mugged or intimidated or assaulted on the subway. Goetz was easily acquitted on charges of assault and attempted murder. The evening of the verdict, there was a raucous impromptu street party.

Goetz became a symbol of the dark moment when the city’s crime problem reached epidemic proportions. Pictures of the crime scene, taken by police, show that the car Goetz sat in was filthy, its floor littered with trash and the walls and ceiling thick with graffiti, but that wasn’t unusual because in 1984 every one of the 6,000 cars in the transit Authority fleet, with the exception of the midtown shuttle, was covered with graffiti - top to bottom, inside and out. Fare-beating was so commonplace that it was costing the Transit Authority as much as $150 million in lost revenue annually. There were about 15,000 felonies on the system a year - a number that would hit 20,000 a year by the end of the decade - and harassment of riders by panhandlers and petty criminals was so pervasive that ridership of the trains had sunk to its lowest level in the history of the subway system.

The decline in crime in New York was anything but gradual. Something else clearly played a role in reversing New York’s crime epidemic. The most intriguing candidate for that "something else" is called the Broken Windows theory. Broken Windows was the brainchild of the criminologists James Q. Wilson and George Kelling. Wilson and Kelling argued that crime is the inevitable result of disorder. If a window is broken and left unrepaired, people walking by will conclude that no one cares and no one is in charge. Soon, more windows will be broken, and the sense of anarchy will spread from the building to the street on which it faces, sending a signal that anything goes. In a city, relatively minor problems like graffiti, public disorder, and aggressive panhandling, they write, are all the equivalent of broken windows, invitations to more serious crimes:

In the mid-1980s Kelling was hired by the New York Transit Authority as a consultant, and he urged them to put the Broken Windows theory into practice. They obliged, bringing in a new subway director by the name of David Gunn to oversee a multibillion-dollar rebuilding of the subway system. Many subway advocates, at the time, told Gunn not to worry about graffiti, to focus on the larger questions of crime and subway reliability, and it seemed like reasonable advice. Worrying about graffiti at a time when the entire system was close to collapse seems as pointless as scrubbing the decks of the Titanic as it headed toward the icebergs. But Gunn insisted. "The graffiti was symbolic of the collapse of the system," he says. "When you looked at the process of rebuilding the organization and morale, you had to win the battle against graffiti. Without winning that battle, all the management reforms and physical changes just weren’t going to happen. We were about to put out new trains that were worth about ten million bucks apiece, and unless we did something to protect them, we knew just what would happen. They would last one day and then they would be vandalized." Gunn began experimenting with new techniques to clean off the paint. On stainless-steel cars, solvents were used. On the painted cars, the graffiti were simply painted over. Gunn made it a rule that there should be no retreat, that once a car was "reclaimed" it should never be allowed to be vandalized again. "We were religious about it," Gunn said. At the end of the number one line in the Bronx, where the trains stop before turning around and going back to Manhattan, Gunn set up a cleaning station. If a car came in with graffiti, the graffiti had to be removed during the changeover, or the car was removed from service. "Dirty" cars, which hadn’t yet been cleansed of graffiti, were never to be mixed with "clean" cars. The idea was to send an unambiguous message to the vandals themselves.

Gunn’s graffiti cleanup took from 1984 to 1990. At that point, the Transit Authority hired William Bratton to head the transit police, and the second stage of the reclamation of the subway system began. Bratton was, like Gunn, a disciple of Broken Windows. He describes Kelling, in fact, as his intellectual mentor. And so his first step as police chief was as seemingly quixotic as Gunn’s. With felonies - serious crimes - on the subway system at an all-time high, Bratton decided to crack down on farebeating. Why? Because he believed that, like graffiti, farebeating could be a signal, a small expression of disorder that invited much more serious crimes. An estimated 170,000 people a day were entering the system, by one route or another, without paying a token. This farebeating cost the Transit Authority $150 million in lost revenue per year. Some were kids, who simply jumped over the turnstiles. Others would lean backward on the turnstiles and force their way through. And once one or two or three people began cheating the system, other people - who might never otherwise have considered evading the law - would join in, reasoning that if some people weren’t going to pay, they shouldn’t either, and the problem would snowball. The problem was exacerbated by the fact fare-beating was not easy to fight. Because there was only $1.25 at stake, the transit police didn’t feel it was worth their time to pursue it, particularly when there were plenty of more serious crimes happening down on the platform and in the trains.

Bratton is a colorful, charismatic man, a born leader, and he quickly made his presence felt. His wife stayed behind in Boston, so he was free to work long hours, and he would roam the city on the subway at night, getting a sense of what the problems were and how best to fight them. First, he picked stations where fare-beating was the biggest problem, and put as many as ten policemen in plainclothes at the turnstiles. The team would nab farebeaters one by one, handcuff them, and leave them standing, in a daisy chain, on the platform until they had a "full catch." The idea was to signal, as publicly as possible, that the transit police were now serious about cracking down on fare-beaters. Bratton also insisted that a check be run on all those arrested. Sure enough, one out of seven arrestees had an outstanding warrant for a previous crime, and one out of twenty was carrying a weapon of some sort. Suddenly it wasn’t hard to convince police officers that tackling fare-beating made sense. "For the cops it was a bonanza," Bratton writes. "Every arrest was like opening a box of Cracker Jack. What kind of toy am I going to get? Got a gun? Got a knife? Got a warrant? Do we have a murderer here? . . . After a while the bad guys wised up and began to leave their weapons home and pay their fares." Under Bratton, the number of ejections from subway stations - for drunkenness, or improper behavior - tripled within his first few months in office. Arrests for misdemeanors, for the kind of minor offenses that had gone unnoticed in the past, went up fivefold between 1990 and 1994. Bratton turned the transit police into an organization focused on infractions, on the details of life underground.

After the election of Rudolph Giuliani as mayor of New York in 1994, Bratton was appointed head of the New York City Police Department, and he applied the same strategies to the city at large. He instructed his officers to crack down on quality-of-life crimes: on the "squeegee men" who came up to drivers at New York City intersections and demanded money for washing car windows, for example, and on all the other above-ground equivalents of turnstile-jumping and graffiti. "Previous police administration had been handcuffed by restrictions," Bratton says. "We took the handcuffs off [the police and put them on the criminals]. We stepped up enforcement of the laws against public drunkenness and public urination and arrested repeat violators, including those who threw empty bottles on the street or were involved in even relatively minor damage to property. . . . If you peed in the street, you were going to jail." When crime began to fall in the city - as quickly and dramatically as it had in the subways - Bratton and Giuliani pointed to the same cause. Minor, seemingly insignificant quality-of-life crimes, they said, were Tipping Points for violent crime.

Broken Windows theory and the Power of Context are one and the same. They are both based on the premise that an epidemic can be reversed, can be tipped, by tinkering with the smallest details of the immediate environment. This is, if you think about it, quite a radical idea.

How does a novel written by an unknown author end up as national bestseller? Why do teens smoke in greater and greater numbers, when every single person in the country knows that cigarettes kill? Why is word-of-mouth so powerful? What makes TV shows like Sesame Street so good at teaching kids how to read? Gladwell thinks the answer to all those questions is the same. It's that ideas and behavior and messages and products sometimes behave just like outbreaks of infectious disease. They are social epidemics. The Tipping Point is an examination of the social epidemics that surround us.

The Tipping Point is the biography of an idea, and the idea is very simple. Ideas and products and messages and behaviors spread just like viruses do. The rise of Hush Puppies and the fall of New York’s crime rate are textbook examples of epidemics in action. Although they may sound as if they don’t have very much in common, they share a basic, underlying pattern. First of all, they are clear examples of contagious behavior. No one took out an advertisement and told people that the traditional Hush Puppies were cool and they should start wearing them. Those kids simply wore the shoes when they went to clubs or cafes or walked the streets of downtown New York, and in so doing exposed other people to their fashion sense. They infected them with the Hush Puppies "virus." Similarly a large number of people in New York got "infected" with an anti-crime virus in a short time.

Examples is that in both cases little changes had big effects. All of the possible reasons for why New York’s crime rate dropped are changes that happened at the margin; they were incremental changes. The crack trade leveled off. The population got a little older. The police force got a little better. Yet the effect was dramatic.

Finally, both changes happened in a hurry. They didn’t build steadily and slowly. It is instructive to look at a chart in the crime rate in New York City from, say, the mid-1960s to the late 1990s. It looks like a giant arch. In 1965, here were 200,000 crimes in the city and from that point on the number begins a sharp rise, doubling in two years and continuing almost unbroken until it hits 650,000 crimes a year in the mid-1970s. It stays steady at that level for the next two decades, before plunging downward in 1992 as sharply as it rose thirty years earlier. Crime did not taper off. It didn’t gently decelerate. It hit a certain point and jammed on the brakes.

These three characteristics - one, contagiousness; two, the fact that little causes can have big effects; and three, that change happens not gradually but at one dramatic moment - are the same three principles that define how measles moves through a grade-school classroom or the flu attacks every winter. Of the three, the third trait - the idea that epidemics can rise or fall in one dramatic moment - is the most important, because it is the principle that makes sense of the first two and that permits the greatest insight into why modern change happens the way it does. The name given to that one dramatic moment in an epidemic when everything can change all at once is the Tipping Point.

A world that follows the rules of epidemics is a very different place from the world we think we live in now. Try yawning and watch those around you. Within a few minutes, not only will you yawn again, but those around you will. The second of the principles of epidemics - that little changes can somehow have big effects - is also a fairly radical notion.

Many businesses have ordered copies of this book for all their managers and many key employees. Whether your field is medicine, health care, psychology, sociology, or group dynamics, this book synthesizes your knowledge and brings insights gleaned from disparate fields applying them to an impressive array of contemporary social behaviors and cultural trends. We are now experiencing everyone’s involvement in the health care arena: Universal criticism for the American way of doing things and a push that we should adopt the failed systems of socialism that are having huge problems throughout the world. The Paul Revere lesson of a simple message sent like a virus: "The British Are Coming - The British Are Coming" turned the tide of history. As medicine is being besieged by a similar destructive force, we need to spread another virus mimicking message to prevent the medical colonization of America by telling everyone: