Wisdom of Commoners
To read Kooks & Canaries Part I, click here
There are some recurrent themes on this blog. One is open-mindedness. Another is inclusiveness, and mutual respect for others. One other we have not gotten to, but will, deals with the Open Source/Open Content movement, as exemplified by software such as the massive Linux operating system,[1]It does everything that Microsoft Windows does, but unlike Windows, anyone can download Linux for free, read the programming code, and change it as they wish. There are hundreds of thousands of other … Continue reading and websites such as Wikipedia. Both of these approaches allow anyone to contribute to the content, and so they combine both open-mindedness and inclusiveness: there is no reason that a talented 10 year-old cannot contribute important code to the Linux kernel, nor become an authority on some topic on Wikipedia. Often opposing these, however, is professional arrogance.
The Importance of Amateurs
We often defer to a mindset in which we believe that only certified authorities are credible. There is much evidence to demonstrate the error in this. Many of the great thinkers of history were amateurs (Socrates, Darwin and Einstein come to mind). Returning to the previous post, drug companies spend a lot of time and money looking through medical customs among indigenous peoples, searching for new pharmaceuticals.
The pharmaceutical industry might think that looking to non-authorities for medical discoveries is a new idea, but it is not. In fact, it was an unschooled commoner who gave the West the foundation of modern medical therapeutics. In 1785 William Withering introduced foxglove[2]Digitalis purpurea tea as a treatment for dropsy,[3]Edema was earlier called ‘dropsy’, a form of the Greek ‘hydrops’, which refers to ‘water’. Edema is the accumulation of fluid in the body, typically around the … Continue reading which is a symptom of heart failure. What many people do not know is that Withering learned about the treatment from Mother Hutton, a folk herbalist.
The irony here is large. Too often, I have seen medical practitioners practice professional arrogance: they flick away the input of laypeople, when a laywoman gave us modern medicine.
Listening to Laypersons
The literature of all disciplines is filled with stories of leaders who added greatly to progress, simply by listening to ‘lay’ people. We have talked about the Petraeus/Nagle doctrine which is changing the military, and which originated with the experiences of the grunts on the ground. As we move into the future, we need to listen to all reasonable opinions; just because someone is not an authority does not mean we should discard what they have seen.
And the history books are filled with examples of enormous blunders from professional arrogance when authority refuses to listen to the ‘lesser’ opinions of non-authorities. In the early 20th century, Americans looked down upon the Cubans as scientific and intellectual inferiors. This was particularly true in meteorological circles, even though the Cubans had vast experience recognizing and tracking hurricanes. The Americans were so arrogant, not only did they ignore the Cubans, they forbade the Cubans from sending hurricane information to the US.
1900 Galveston Hurricane
The result of that professional arrogance was the worst natural disaster in US history. In 1900 the Cubans had evidence that a massive storm was headed toward the US mainland, but no one heard about it. At the same time, Isaac Cline was the meteorologist in Galveston,[4]Cline was also the meteorologist in New Orleans during the Flood of 1927; for some reason, the accounts I have read have missed that connection between the two disasters. and saw all of the classic signs of a hurricane. But American professional arrogance had also declared that no hurricane could hit so far west. So he raised no alarms. Between 6,000 and 12,000 people died.
American professional arrogance in medicine was as strong toward Cubans as was our professional arrogance in meteorology. We are taught that Walter Reed discovered that mosquitoes are the vector for yellow fever. In his research, Reed constantly cited the work of a Cuban, Carlos Finlay, who had worked out the source. Americans ignored Finlay however, and made Reed an international hero.
Professional Arrogance
We’ve talked about knowledge here, about how we make decisions with closed minds. Some of my medical colleagues are delightful, curious, open minded people. Others, not so much. I have heard there are investment advisers who will not accept doctors as clients because we’re so unreasonable. At times, I have been shocked at the professional arrogance of my colleagues, how recalcitrant and reactionary they become whenever someone tries to get them to consider different possibilities. The results, again, can be disastrous. I have no data, but it is my experience that the overwhelming majority of medical malpractice cases do not result because medical or support staff did not know their jobs, but because they would not listen to important information the patient or family was trying to provide.
Meteorologists, generals, doctors, and scientists are pretty much like the rest of us: they see what they want to see, and dismiss what they do not want to see. We all succumb to professional arrogance. That is a major theme on this blog, and the caution is that we would do well to keep open minds.
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Footnotes
↑1 | It does everything that Microsoft Windows does, but unlike Windows, anyone can download Linux for free, read the programming code, and change it as they wish. There are hundreds of thousands of other programs that replace all of the expensive commercial to which we believe we are chained. |
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↑2 | Digitalis purpurea |
↑3 | Edema was earlier called ‘dropsy’, a form of the Greek ‘hydrops’, which refers to ‘water’. Edema is the accumulation of fluid in the body, typically around the feet and ankles. Think of the swollen ankles you have seen in elderly women (men get it too, but pants will hide it). That’s edema |
↑4 | Cline was also the meteorologist in New Orleans during the Flood of 1927; for some reason, the accounts I have read have missed that connection between the two disasters. |