Making the expert listen
In the NY Times Diagnosis feature this week a key element of the story is a husband who tells a doctor that she has to reconsider the diagnosis and treatment being given his wife because it is not working. “We can’t go on this way,” he tells her.
For whatever reason, Dr. Lisa Sanders is able to hear his remark seriously, and she returns to the details of the woman’s medical history, where she discovers a new pattern and is able to make a fresh and successful diagnosis.
Doctors know that they should be open to the ideas and opinions of non-experts, and in fact they should rely quite a bit on them, Sanders notes:
In medical school, I was often told that if you listen, the patient will tell you what she has. It turns out that sometimes the patient’s husband will, too.
It appears, then, that experts are tempted by the tools of their expertise–the diagnostic tests, say, and the machinery and the science–tempted so fully at times that they might forget that the patient, and even the patient’s friends and family, may have in hand vital clues and even accurate judgments about a course of treatment. In an expert-dominated society, we need customs by which non-experts are granted their turn to speak in every arena, and we need experts who understand the limitations of their training and the science of their field. Sanders shows ways that one kind of expert can forget the lesson.
In fact, part of the problem might be a misunderstanding of the nature of science–a faith in its powers that is not accurately aligned with the amazing extent as well as the real limits of its powers. Possibly, too, experts play the odds, letting their science tell them the most likely diagnosis but forgetting that they are making a wager with a person’s life, not carrying out a rigorously logical methodology that always leads to truth.
(“A Heart Loses Its Way,” 12/3/10)