Category: Psychology

Patient-Reported Health Information Deserves Respect

Patients may have more accurate knowledge of their health than the information found in doctors’ blood tests, as reported in the study summarized below. The credibility of patient self-knowledge provides an added reason, besides respect for freedom, why government should not mandate an individual’s food and drug decisions.

(p. D4) . . . a . . . study . . . suggests that how patients say they feel may be a better predictor of health than objective measures like a blood test. The study, published in Psychoneuroendocrinology, used data from 1,500 people who took part in the Texas City Stress and Health Study, which tracked the stress and health levels of people living near Houston.

. . .

The study found that when people said they felt poorly, they had high virus and inflammation levels. People who reported feeling well had low virus and inflammation levels.

“I think the take-home message is that self-reported health matters,” said Christopher P. Fagundes, an assistant psychology professor at Rice University and a co-author of the study. “Physicians should pay close to attention to their patients. There are likely biological mechanisms underlying why they feel their health is poor.”

For the full story see:

Tara Parker-Pope. “Doctors, Listen to Patients.” The New York Times (Tuesday, July 19, 2016 [sic]): D4.

(Note: ellipses added.)

(Note: the online version of the story has the date July 15, 2016 [sic], and has the title “Doctors Should Listen to Patient Instincts.”)

The academic paper co-authored by Fagundes and mentioned above is:

Murdock, Kyle W., Christopher P. Fagundes, M. Kristen Peek, Vansh Vohra, and Raymond P. Stowe. “The Effect of Self-Reported Health on Latent Herpesvirus Reactivation and Inflammation in an Ethnically Diverse Sample.” Psychoneuroendocrinology 72 (Oct. 2016): 113-18.

Kahneman’s “Adversarial Collaboration” Might Bring Us More Joy and Better Science

(p. A19) Professor Kahneman, who died . . . at the age of 90, is best known for his pathbreaking explorations of human judgment and decision making and of how people deviate from perfect rationality. He should also be remembered for a living and working philosophy that has never been more relevant: his enthusiasm for collaborating with his intellectual adversaries. This enthusiasm was deeply personal. He experienced real joy working with others to discover the truth, even if he learned that he was wrong (something that often delighted him).

. . .

Professor Kahneman saw . . . “angry science,” which he described as a “nasty world of critiques, replies and rejoinders” and “as a contest, where the aim is to embarrass.” As Professor Kahneman put it, those who live in that nasty world offer “a summary caricature of the target position, refute the weakest argument in that caricature and declare the total destruction of the adversary’s position.” In his account, angry science is “a demeaning experience.”

. . .

Professor Kahneman meant both to encourage better science and to strengthen the better angels of our nature.

For the full commentary see:

Cass R. Sunstein. “The Value of Collaborating With Adversaries.” The New York Times (Wednesday, April 3, 2024): A19.

(Note: ellipses added.)

(Note: the online version of the commentary has the date April 1, 2024, and has the title “The Nobel Winner Who Liked to Collaborate With His Adversaries.”)

The Absence of a Randomized Double-Blind Clinical Trial Is Used as an Excuse to Ignore an Emergency Procedure That Saves Lives

In an urgent emergency the son and wife of a man with a stopped heart, improvised the use of a toilet plunger to get his heart to start pumping again. In his wonderful account of the sources of insight, Gary Klein told a different example of urgent emergency improvisation: “Wag” Dodge saved himself from a massive wildfire racing toward him by lighting a match to the grass at his feet to pre-burn a patch he could lie down in. When the wildfire reached him, it passed on both sides, avoiding the patch that now had no fuel. Neither the son-and-mother, nor Wag Dodge, got their insight from collaboration or a randomized double-blind controlled trial.

(p. D5) In 1988, a 65-year-old man’s heart stopped at home. His wife and son didn’t know CPR, so in desperation they grabbed a toilet plunger to get his heart going until an ambulance showed up.

Later, after the man recovered at San Francisco General Hospital, his son gave the doctors there some advice: Put toilet plungers next to all of the beds in the coronary unit.

The hospital didn’t do that, but the idea got the doctors thinking about better ways to do CPR, or cardiopulmonary resuscitation, the conventional method for chest compressions after cardiac arrest. More than three decades later, at a meeting of emergency medical services directors this week in Hollywood, Fla., researchers presented data showing that using a plunger-like setup leads to remarkably better outcomes for reviving patients.

. . .

The new procedure, known as neuroprotective CPR, has three components. First, a silicone plunger forces the chest up and down, not only pushing blood out to the body, but drawing it back in to refill the heart. A plastic valve fits over a face mask or breathing tube to control pressure in the lungs.

The third piece is a body-positioning device sold by AdvancedCPR Solutions, a firm in Edina, Minn., that was founded by Dr. Lurie. A hinged support slowly elevates a supine patient into a partial sitting position. This allows oxygen-starved blood in the brain to drain more effectively and to be replenished more quickly with oxygenated blood.

. . .

. . ., a study carried out in four states found . . . [p]atients who received neuroprotective CPR within 11 minutes of a 911 call were about three times as likely to survive with good brain function as those who received conventional CPR.

. . .

Dr. Karen Hirsch, a neurologist at Stanford University and a member of the CPR standards committee for the American Heart Association, said that the new approach was interesting and made physiological sense, but that the committee needed to see more research on patients before it could formally recommend it as a treatment option.

“We’re limited to the available data,” she said, adding that the committee would like to see a clinical trial in which people undergoing cardiac arrests are randomly assigned to conventional CPR or neuroprotective CPR. No such trials are happening in the United States.

Dr. Joe Holley, the medical director for the emergency medical service that serves Memphis and several surrounding communities, isn’t waiting for a larger trial. Two of his teams, he said, were getting neurologically intact survival rates of about 7 percent with conventional CPR. With neuroprotective CPR, the rates rose to around 23 percent.

His crews are coming back from emergency calls much happier these days, too, and patients are even showing up at fire stations to thank them for their help.

“That was a rare occurrence,” Dr. Holley said. “Now it’s almost a regular thing.”

For the full story see:

Joanne Silberner. “How a Plunger Improved CPR.” The New York Times (Tuesday, June 27, 2023 [sic]): D5.

(Note: ellipses added.)

(Note: the online version of the story has the date June 15, 2023 [sic], and has the title “How a Toilet Plunger Improved CPR.”)

The Gary Klein book that I praised above is:

Klein, Gary. Seeing What Others Don’t: The Remarkable Ways We Gain Insights. Philadelphia, PA: PublicAffairs, 2013.

The “study carried out in four states,” and mentioned above, is:

Moore, Johanna C., Paul E. Pepe, Kenneth A. Scheppke, Charles Lick, Sue Duval, Joseph Holley, Bayert Salverda, Michael Jacobs, Paul Nystrom, Ryan Quinn, Paul J. Adams, Mack Hutchison, Charles Mason, Eduardo Martinez, Steven Mason, Armando Clift, Peter M. Antevy, Charles Coyle, Eric Grizzard, Sebastian Garay, Remle P. Crowe, Keith G. Lurie, Guillaume P. Debaty, and José Labarère. “Head and Thorax Elevation During Cardiopulmonary Resuscitation Using Circulatory Adjuncts Is Associated with Improved Survival.” Resuscitation 179 (2022): 9-17.

Babies’ Curiosity Leads Them to Prefer Persons Who Inform

(p. C2) . . . Katarina Begus of Birkbeck, University of London and her colleagues . . . started out exploring the origins of curiosity. When grown-ups think that they are about to learn something new, their brains exhibit a pattern of activity called a theta wave. The researchers fitted out 45 11-month-old babies with little caps covered with electrodes to record brain activity. The researchers wanted to see if the babies would also produce theta waves when they thought that they might learn something new.

The babies saw two very similar-looking people interact with a familiar toy like a rubber duck. One experimenter pointed at the toy and said, “That’s a duck.” The other just pointed at the object and instead of naming it made a noise: She said “oooh” in an uninformative way.

Then the babies saw one of the experimenters pick up an unfamiliar gadget. You would expect that the person who told you the name of the duck could also tell you about this new thing. And, sure enough, when the babies saw the informative experimenter, their brains produced theta waves, as if they expected to learn something. On the other hand, you might expect that the experimenter who didn’t tell you anything about the duck would also be unlikely to help you learn more about the new object. Indeed, the babies didn’t produce theta waves when they saw this uninformative person.

. . .

Babies leap at the chance to learn something new—and can figure out who is likely to teach them. The babies did prefer the person in their own group, but that may have reflected curiosity, not bias. They thought that someone who spoke the same language could tell them the most about the world around them.

For the full commentary see:

Alison Gopnik. “Mind & Matter; Babies Show a Clear Bias—To Learn New Things.” The Wall Street Journal (Saturday, Oct. 29, 2016 [sic]): C2.

(Note: ellipses added.)

(Note: the online version of the commentary was updated Oct. 26, 2016 [sic], and has the same title as the print version.)

Begus’s co-authored academic paper is:

Begus, Katarina, Teodora Gliga, and Victoria Southgate. “Infants’ Preferences for Native Speakers Are Associated with an Expectation of Information.” Proceedings of the National Academy of Sciences 113, no. 44 (2016): 12397-402.

Conservatives Are Better Than Liberals at “the Separation of Facts from Feelings”

(p. A13) I don’t know who’s going to win the presidential election, and neither do you. Neither, for that matter, does Nate Silver, notwithstanding his reputation as a political prognosticator. He is more accurately characterized as a forecaster, which is to say that he deals in probabilities, not outright predictions.

. . .

. . . since I first encountered his work in 2009, Mr. Silver has always struck me as an honest practitioner. Although he describes himself as a “center-left liberal,” he frequently provokes antagonism from fellow liberals when his data and analysis point in directions they’d rather not go.

. . .

Mr. Silver’s career as a political pundit is something of an accident. After earning a bachelor’s degree in economics at the University of Chicago in 2000, he went to work as a KPMG consultant. Bored with his job, he started playing online poker, at first for fun. He says he “eventually deposited money at a real-money site and ran it up from 25 bucks to 15,000 bucks.” He quit KPMG and got a part-time job writing about baseball statistics, but 80% of his income came from poker winnings.

Then in 2006 Congress passed the Unlawful Internet Gambling Enforcement Act, which effectively banned online poker by making it unlawful for the sites to accept payments. “That killed my livelihood,” Mr. Silver says. “I started following politics. I had more time on my hands. I also wanted to see the people behind the bill ousted from office, which they were.” Its primary sponsor, Rep. Jim Leach (R., Iowa), lost his bid for a 16th term.

Mr. Silver still plays poker semiprofessionally—in person—and has earned $855,800 in tournaments, according to the Hendon Mob database. He has a new book out next week, “On the Edge: The Art of Risking Everything,” in which he interviews professional gamblers, venture capitalists, adventurers and others known for their “mastery of risk” and develops a philosophical framework around their insights.

The book touches only lightly on politics, but some of its concepts have obvious application. One of them is “decoupling,” which means, roughly, thinking with analytical detachment, including the separation of facts from feelings. Journalists used to call it objectivity, an aspiration that has fallen out of fashion in recent decades, especially in the Trump era.

A failure to decouple explains the widespread denial of Mr. Biden’s decline in the months before his withdrawal. Clear evidence became mistakable when distorted through the lenses of partisanship, ideology and antipathy toward Mr. Trump. There is no reason to believe people on the left are intrinsically more prone to this sort of error, but Mr. Silver thinks that “liberal bubbles are bigger than conservative bubbles.” Domination of big cities and influential institutions makes it easier for those on the left simply to ignore opposing views.

For the full interview see:

James Taranto. “The Weekend Interview; President Kamala Harris? What Are the Odds?” The Wall Street Journal (Saturday, Aug 10, 2024): A13.

(Note: ellipses added.)

(Note: the online version of the interview has the date August 9, 2024, and has the same title as the print version.)

The “new book” by Silver mentioned above is:

Silver, Nate. On the Edge: The Art of Risking Everything. New York: The Penguin Press, 2024.

Pious Climate “Scare Tactics” Lead to Despondency and Bad Policy

(p. A15) Whatever happened to polar bears? They used to be all climate campaigners could talk about, but now they’re essentially absent from headlines. Over the past 20 years, climate activists have elevated various stories of climate catastrophe, then quietly dropped them without apology when the opposing evidence becomes overwhelming. The only constant is the scare tactics.

. . .

After years of misrepresentation, it finally became impossible to ignore the mountain of evidence showing that the global polar-bear population has increased substantially.

. . .

For the past three years the Great Barrier Reef has had more coral cover than at any point since records began in 1986, with 2024 setting a new record.

. . .

Today, killer heat waves are the new climate horror story. In July President Biden claimed “extreme heat is the No. 1 weather-related killer in the United States.”

He is wrong by a factor of 25. While extreme heat kills nearly 6,000 Americans each year, cold kills 152,000, of which 12,000 die from extreme cold. Even including deaths from moderate heat, the toll comes to less than 10,000. Despite rising temperatures, age-standardized extreme-heat deaths have actually declined in the U.S. by almost 10% a decade and globally by even more, largely because the world is growing more prosperous. That allows more people to afford air-conditioners and other technology that protects them from the heat.

. . .

Scare tactics leave everyone—especially young people—distressed and despondent. Fear leads to poor policy choices that further frustrate the public. And the ever-changing narrative of disasters erodes public trust.

Telling half-truths while piously pretending to “follow the science” benefits activists with their fundraising, generates clicks for media outlets, and helps climate-concerned politicians rally their bases. But it leaves all of us poorly informed and worse off.

For the full commentary see:

Bjorn Lomborg. “Polar Bears, Dead Coral and Other Climate Fictions.” The Wall Street Journal (Thursday, Aug. 1, 2024): A15.

(Note: ellipses added.)

(Note: the online version of the commentary has the date July 31, 2024, and has the same title as the print version.)

“A Pattern of Stumbles Across the World of Generative A.I.”

(p. B1) Days before gadget reviewers weighed in on the Humane Ai Pin, a futuristic wearable device powered by artificial intelligence, the founders of the company gathered their employees and encouraged them to brace themselves. The reviews might be disappointing, they warned.

. . .

(p. B5) Its setbacks are part of a pattern of stumbles across the world of generative A.I., as companies release unpolished products. Over the past two years, Google has introduced and pared back A.I. search abilities that recommended people eat rocks, Microsoft has trumpeted a Bing chatbot that hallucinated and Samsung has added A.I. features to a smartphone that were called “excellent at times and baffling at others.”

For the full story see:

Tripp Mickle and Erin Griffith. “Inside the Spectacular Flop of a Bold A.I. Device.” The New York Times (Friday, June 7, 2024): B1 & B5.

(Note: ellipsis added.)

(Note: the online version of the story was updated June 7, 2024, and has the title “‘This Is Going to Be Painful’: How a Bold A.I. Device Flopped.”)

People Feel “Stuck” in Lives Lacking Freedom and Hope

People need more control over their lives to feel hopeful for a free flourishing future. Fewer government regulations and more innovative firm managers could allow more of us to be “unstuck,” working on challenging but doable projects that improve the world and allow fulfilment. (I discuss these issues in more depth in Openness to Creative Destruction.)

(p. 9) The hallways on the television shows I watch have been driving me mad. On one sci-fi show after another I’ve encountered long, zigzagging, labyrinthine passageways marked by impenetrable doors and countless blind alleys — places that have no obvious beginning or end. The characters are holed up in bunkers (“Fallout”), consigned to stark subterranean offices (“Severance”), locked in Escher-like prisons (“Andor”) or living in spiraling mile-deep underground complexes (“Silo”). Escape is unimaginable, endless repetition is crushingly routine and people are trapped in a world marked by inertia and hopelessness.

The resonance is chilling: Television has managed to uncannily capture the way life feels right now.

We’re all stuck.

What’s being portrayed is not exactly a dystopia. It’s certainly not a utopia. It’s something different: a stucktopia. These fictional worlds are controlled by an overclass, and the folks battling in the mire are underdogs — mechanics, office drones, pilots and young brides. Yet they’re also complicit, to varying degrees, in the machinery that keeps them stranded. Once they realize this, they strive to discard their sense of futility — the least helpful of emotions — and try to find the will to enact change.

. . .

We’re not stuck in our circumstance. We’re stuck in the ways of living that perpetuate it.

If enough of us give up the sense that things are inevitable — that we’re stuck — it’s possible that we can course-correct humanity, or at least nudge it toward a hopeful path.

There’s another more realistic option that offers a thrill and reward of its own. If we don’t let the stucktopia keep its hold on us, if we rebuke it, maybe we shift ourselves ever so slightly toward optimism, and give the system whatever small hell we can.

For the full commentary see:

Hillary Kelly. “It’s Not Your Imagination. We’re All Stuck.” The New York Times, SundayOpinion Section (Sunday, July 7, 2024): 9.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date July 6, 2024, and has the title “Welcome to Stucktopia.”)

Movie Entrepreneurs Often Self-Finance Their Projects

(p. C4) The essential tragedy of movies is that they are wildly expensive to make and release. That’s one reason that filmmakers, especially those who want to control the means of production, have funneled their own money into their projects as long as movies have been around. Charlie Chaplin invested in his own work, as did John Wayne and Spike Lee. In 1979, when Coppola’s partly self-financed war film, “Apocalypse Now,” opened, he told The Times, “If I ever get the bucks that, say, George Lucas got from ‘Star Wars,’ I’d put every penny into changing the rules.” Lucas, who had invested his own money to help make “Star Wars,” used profits from that film to continue the series.

. . .

Weeks later, . . . all I could think about was something [Coppola] said in 1982. “It’s so silly in life not to pursue the highest possible thing you can imagine, even if you run the risk of losing it all,” he said. “You can’t be an artist and be safe.”

For the full story see:

Manohla Dargis. “Willing To Risk It All For Art.” The New York Times (Friday, June 8, 2024): C1 & C4.

(Note: ellipses, and bracketed name, added.)

(Note: the online version of the story has the date June 6, 2024, and has the title “Francis Ford Coppola: ‘You Can’t Be an Artist and Be Safe’.” In the last quoted paragraph, I quote the numbers from the print version. The online version, as of the time I checked, had numbers from June 10, 2024.)

Neuroscience Evidence Suggests Knowledge Can Be Nonverbal

You can know how to ride a bike, without you being able to explain how to ride a bike. Michael Polanyi’s famous bike example shows that some actionable (“tacit”) knowledge can be nonverbal. Our dachshund Walter knows (nonverbally) that when I get the watering can from the top of the refrigerator, he is likely to be able to run out of the door to the deck with me soon. A dog can have nonverbal knowledge. In some areas of knowledge, most especially in medicine, we often mandate that action is only allowed based on verbal knowledge, and even more narrowly, on a particular kind of verbal knowledge, randomized double-blind clinical trials (RCTs). Outcomes outcomes would be better and quicker if we allowed action on all kinds of knowledge.

(p. D5) Dr. Fedorenko . . . [is] a cognitive neuroscientist at M.I.T., using brain scanning to investigate how the brain produces language. And after 15 years, her research has led her to a startling conclusion: We don’t need language to think.

. . .

The scientists . . . ran studies to pinpoint brain circuits that were involved in language tasks, such as retrieving words from memory and following rules of grammar. In a typical experiment, volunteers read gibberish, followed by real sentences. The scientists discovered certain brain regions that became active only when volunteers processed actual language.

Each volunteer had a language network — a constellation of regions that become active during language tasks. “It’s very stable,” Dr. Fedorenko said. “If I scan you today, and 10 or 15 years later, it’s going to be in the same place.”

The researchers then scanned the same people as they performed different kinds of thinking, such as solving a puzzle. “Other regions in the brain are working really hard when you’re doing all these forms of thinking,” she said. But the language networks stayed quiet. “It became clear that none of those things seem to engage language circuits,” she said.

In a paper published Wednesday [June 19, 2024] in Nature, Dr. Fedorenko and her colleagues argued that studies of people with brain injuries point to the same conclusion.

Strokes and other forms of brain damage can wipe out the language network, leaving people struggling to process words and grammar, a condition known as aphasia. But scientists have discovered that people can still do algebra and play chess even with aphasia.

For the full story see:

Carl Zimmer. “Is It Still a Thought If It’s Not in Words?” The New York Times (Tuesday, June 25, 2024): D5.

(Note: ellipses, bracketed word, and bracketed date added.)

(Note: the online version of the story has the date June 19, 2024, and has the title “Do We Need Language to Think?” Where the wording of the versions differs, the passages quoted above follow the online version.)

The Nature paper co-authored by Fedorenko, and mentioned above, is:

Fedorenko, Evelina, Steven T. Piantadosi, and Edward A. F. Gibson. “Language Is Primarily a Tool for Communication Rather Than Thought.” Nature 630, no. 8017 (June 20, 2024): 575-86.

Polanyi’s tacit knowledge is different from Hayek’s local knowledge, although they are both important and are often discussed together. Michael Polanyi’s description of “tacit knowledge” can be found in:

Polanyi, Michael. The Tacit Dimension. Garden City, New York: Doubleday & Co., 1966.

“Everyone Just Exchanges Platitudes and Inanities Because They Are Afraid to Say Anything”

(p. B3) The younger generation has frequently called out Japan’s entrenched elders for their casual sexism, excessive work expectations and unwillingness to give up power.

But a surprise television hit has people talking about whether the oldsters might have gotten a few things right, especially as some in Japan — like their counterparts in the United States and Europe — question the heightened sensitivities associated with “wokeness.”

The show, “Extremely Inappropriate!,” features a foul-talking, crotchety physical education teacher and widowed father who boards a public bus in 1986 Japan and finds himself whisked to 2024.

. . .

The show was one of the country’s most popular when its 10 episodes aired at the beginning of the year on TBS, one of Japan’s main television networks. It is also streaming on Netflix, where it spent four weeks as the platform’s No. 1 show in Japan.

. . .

Not so subtly, the show . . . comments on the evolution toward more inclusive and accommodating offices, caricaturing them as places where work is left undone because of strict overtime rules and employees apologize repeatedly for running afoul of “compliance rules.”

Such portrayals strike a chord in Japan, where there have been complaints, often expressed on social media, about “political correctness” being used as a “club” to restrict expression or to water down television programs or films. Part of what fans have found refreshing about “Extremely Inappropriate!” is how unrestrained the portions set in the Showa era are.

While critics have called the series retrograde, some younger viewers say the show has made them question social norms they once took for granted — and wonder about what has been lost.

Writing for an entertainment-oriented Web publication, Rio Otozuki, 25, said that the series “must have left many viewers thinking inwardly that the Showa era was more fun.”

. . .

Kaori Shoji, an arts critic who was a teenager in the 1980s, said she loved “Extremely Inappropriate!” She particularly appreciated how the series illuminated the chilling effects of today’s tighter policing of workplaces.

“Everyone is just playing a game to see who can be the least offensive person that ever walked the earth,” Ms. Shoji said. “Everyone just exchanges platitudes and inanities because they are afraid to say anything. Surely that cannot be good for a workplace.”

For the full story see:

Motoko Rich and Kiuko Notoya. “In Japan, a TV Show Makes Young Viewers Pine for the ‘Inappropriate’ 1980s.” The New York Times (Saturday, June 8, 2024): B3.

(Note: ellipses added.)

(Note: the online version of the story has the date May 29, 2024, and has the title “A Show That Makes Young Japanese Pine for the ‘Inappropriate’ 1980s.” The online version says that the print version was on page B1 and had the title “In Japan, A Flashback To the 1980s”, but my print version was on page B3 and had the title “In Japan, a TV Show Makes Young Viewers Pine for the ‘Inappropriate’ 1980s.”)