I read this latest addition to the CT Health Policy Project Book Club on a long flight and couldn’t put it down. It should be required reading for every advocate. Malcolm Gladwell’s latest book describes why the underdog often wins against what initially seems like long odds. After he drills down on the story of David and Goliath, the reader comes to see that Goliath didn’t stand a chance. Often being under-resourced, disadvantaged and/or overwhelmed is a large advantage. With examples like the myth of smaller class size, difficult childhood experiences as an advantage, how under-resourced rebels were so effective in Northern Ireland, and perception matters for little fish in big ponds he makes the case that at a point, increasing resources backfire. I will be using a lot of the lessons and drawing inspiration from this book, as a health care advocate up against large and imposing opponents. There is power here at the bottom of the food chain.