Pondering the ethereal.
In high school it was a great surprise for me to discover that the United States is overwhelmingly protestant. Living in Cajun country, I had simply assumed that most of the country was Roman Catholic.
There are so many fascinating quirks and oddities that living in a ‘foreign’ culture offers. There are the differences of food, and music, but also the general approach to life. The importance of culture was another surprise as I got older; I assumed that, across the US, the main differences in cities was their size. Then I arrived in Lafayette to go to college, and realized that some cultures have distinct personalities; and, just as with people, some are decidedly more upbeat, optimistic, and happier. That outlook pretty much sums up the Cajuns & Creoles here, and Lafayette is currently ranked as the happiest city in the US. This observation is more than a peripatesis, it is the insight that started me thinking about the book I am writing, and that book prompted me to start this blog.
In addition to the preceding, there’s the Cajun language. There are delightful words and phrases here. When you’re just driving around you’re out rodayin’,[1]I’m not sure how to represent the Franglais, but it’s from the French, roder, ‘to prowl.’ and gradoux is the nasty stuff on the bottom your shoe, or the tasty stuff on the bottom of the pot. The Cajuns and Creoles have also picked up words from the Indians: popcorn is tac-tac,[2]In France it’s called maïs gonflé, ‘swollen corn,’ which sounds a bit repulsive to me. and a bullfrog is a ouaouaron (‘wa-wa-rrron’), both of them nice bits of onomatopoeia.
One that is particularly interesting is the word for a deep thinker or an intellectual: a jongleur, a juggler. That’s how I feel sometimes when I’m thinking, trying to find some pattern connecting several different things. It can be tricky to keep them all in active memory, and quickly move from one to the next. It is very much like trying to juggle several balls in the air, without dropping any.
Which can lead to problems. I’ll be working on this blog or some other problem, thinking about several things and rapidly shifting them in front of me, and one of the kids comes and interrupts my thinking. I have to struggle not to show my irritation, because I know that when I get back to work, the balls will have all fallen into a pile with a lot of other ideas. I’m not sure where I was; I’m not even what ideas I was working on. It may take me several minutes to remember what I was doing, and a while longer to load all the different ideas back onto the RAM chip in my head so I can resume analyzing the problem.
Just as with circus juggling, it takes time and practice to learn to juggle ideas. Medicine has certainly helped me learn the skill, struggling to consider several ongoing diseases, symptoms, or drugs at the same time. Some of my colleagues do this better than others. From time to time I have seen a physician consider three or four symptoms and settle on a diagnosis, when considering a few additional symptoms would have pointed to a different diagnosis, or possibly to the realization that the problem was minor. And vice versa: just recently I saw a case where a physician ordered an expensive and traumatic workup on a patient, that just a bit of reflection could have avoided.
Sometimes I see this limitation with nurses and other staff. I’ve worked with some great nurses, but I have come to realize that, despite the intelligence of so many of them, they were trained as clerks, they are primarily trained to perform certain tasks in certain ways. Nobody ever throws them in the deep end of the medical pool and says ‘Figure it out,’ which is what eventually happens in medical practice. So even as I carefully listen to them – and I should note that they are often right, and catch something I missed – I also have to be aware that at times they may miss something important, simply because they don’t yet have enough information, and they haven’t been encouraged to consider it.
Again, it’s not the nurses, it’s their training. On occasion I have known nurses who went to medical school and became outstanding doctors. In fact, one of their strengths is that they will juggle in aspects of patient care that traditional doctors do not see. I remember one time that the medical team of senior faculty, residents, and students were struggling to understand a patient who was not responding to the medicine. Suddenly the RN-MD resident said, “I bet he’s not getting his evening dose.” Sure enough, she pulled the chart, and flipped to a section that few doctors ever look at, and she was right.
Continued below…
I see juggling limitations in all of life. For various reasons, people often pick out only two or three ‘symptoms’, or even less, with the problems in their lives and stop looking for others. And in research and politics. I think we can agree that, to be truly open-minded, we should always be willing to toss in more possibilities, even if it means we have to drop a consideration with which we are more comfortable. But it takes practice.
And too often I run across people who only juggle a single ball at a time. It’s univariate thinking: look at one problem without considering how it relates to everything else. I mentioned Donald Trump’s US-Mexico wall. Yes, illegal immigrants are a problem, but we also need to juggle in many other concerns facing the country. Of all the problems we see, is the biggest one illegal immigrants? And even if it were, is a wall the best way to solve it? And what happens if we deport all the illegals at once, what chaos does it create in our economy, and in our overall stability and progress? Sometimes I get the impression that people who buy into this plan may be juggling a single ball.
Univariate thinking creates so many problems in government. We can watch any President and criticize his ideas and solutions as bone-headed. As I watch politics and think about it, however, I become more dubious about the reliability of our assumptions. Granted, sometimes the motives seem clear: a President is pro-business, or pro-environment, or pro-military, etc., and makes an incautious decision based on the ideology.
However, when the motives aren’t clear and the decision doesn’t readily make sense, we should stop and ask ourselves if we really understand how many considerations the Oval Office is facing; how many balls are in play, and what balls we can’t see. Do we really understand the ripple effects of a decision, how will it affect our allies and our enemies, how will it affect other initiatives that the Administration is working on; and what solutions are practicable given the current makeup of Congress and of the major players in the international community? When you get to the leadership of a nation as large as the USA, we’re employing many experts analyzing a myriad of issues, and all of them are tossing balls to the President.
Now we are talking about a level of juggling that most of us cannot comprehend. And so I think we are often much too hasty in accusing a particular Administration of being stupid, or even evil. We just can’t know all of the concerns that are in the air.
If you think about it, we can hardly blame our citizens. We really don’t teach our children to juggle multiple ideas; everything we teach them is in concrete, measurable steps. We certainly don’t encourage independent thought.
The closest thing to juggling that I can remember from school was matrix algebra; but even there we only learned concrete steps to solve the problems, rather than considering the real-world meaning of what we were doing. It was a great surprise to discover, 20 years later in grad school, that a matrix can be used to analyze a complex pattern of interrelated factors: consumers in an economy, governments or businesses in a complex mix of alliances and competitions, and plants and animals in an ecosystem. Adding to their usefulness, modern computers can solve nested matrices – those with equations and even other matrices inside the cells – in the blink of an eye, where I remember one 5 x 5 matrix that took me a couple of hours to solve. To the point of the previous post on fuzzy feedback, a complex matrix doesn’t so much tell us what will happen, as it helps us understand how a change in one part of the system might effect everything else.
As I have noted before, our educational approaches come out of simpler times, where it was not necessary, nor even desirable, for commoners to think deeply about their lives, their work, and least of all their church and king. We were trained to be univariate thinkers. For every situation there was some simple, strict rule to be followed, there was some authority to be obeyed. Progress was rare, and very slow. And so the greatest thinkers of the Medieval were not trying to solve any grand, real-world problems. Instead, major scholars of the day such as Thomas Aquinas simply tried to reconcile Christian and Classical thought; Rome only wanted to synthesize its two great traditions.
In fact, to question either the Church or the Classics, or worse to suggest they might be in error or even incomplete, was punishable by death. Galileo barely escaped with this head after proposing that the Earth moves around the Sun; and even after he recanted, he spent the remainder of his life under house arrest.
It won’t do anymore. We have to change our educational approaches. We need people who can consider more than one idea at a time.
We need to teach our children how to juggle.
Goddess juggling courtesy of Marco De Stabile on Flickr.
The human brain is a true wonder. Even mine. Many times during my work career, I’d be juggling a lot of projects and working on a particularly tough problem and just not making any progress. At the end of the day, I’d leave for home, frustrated that I’d not been able to solve the problem.
Typically, I’d get about 5-10 miles from work, and the solution would just pop into my head. Somehow, my brain had continued to work on the problem, and without the distraction of other things at work, it was able to put together the solution. It was always tempting to turn around and drive back to test the solution.
All I can say is that using simple algebra to solve dose calculations in nursing school (keeping in mind that Algebra is a prerequisite) resulted in raised eyebrows among the faculty who wanted to see their “nursing math” (matchstick math) employed.
I knew I’d made a horrible mistake at that point but there were other considerations.
They don’t like it much when they’re pulling out a sheet of paper and a pencil to demonstrate how to calculate a dose and you cut them off before they begin with the answer.
It’s reminiscent of the Dark Ages when the population thought the priests were performing magic when they spelled out a word.
Yes. Things need to change and in a big way. Unfortunately, what I see as a response to that sentiment is more exclusion, “returning to basics,” instead of expanding the limits.
My favorite is laissez les Bon temps rouler