A “capacity for sustained muddle-headedness”

Hat tip to Paul Lauenstein, and his physician brother, suggesting the great insights of the late Dr Larry Weed:

Great lines, great quotes, a lot of humor:

  • “… a tolerance of ambiguity …”
  • “Y’know, Pavlov said you must teach a graduate student gradualness”
  • “… a final diagnosis is a myth …”
  • “… there were getting more information on what they did than what they had …”
  • “If you cannot evaluate what you’re doing, then there is a very serious possibility that you do not know what you are doing.”
  • ”… they played `Sherlock Holmes’ too early. They asked the first question, and then the next question would be determined by the first question, because they were brought up in a CPC sort of atmosphere. `What do you think of next, doctor?”’

Unfortunately, it’s not clear medicine — or statistics — has progressed much beyond 1971. Note the 1999 report from the National Academy of Sciences,
To Err is Human.

The last quote reminds me of something I was taught in graduate school (in 1973, noting the above video is from 1971), when I took 6.871, Knowledge-based application systems, and medical decision support was covered as a subject. I distinctly recall that problems of software-physician interaction during the patient interview centered about the comparatively unstructured way which physicians gathered information, that they could not be constrained to using a diagnostic or taxonomic key as is popular in, say, Botany. The thought crossed my mind at the time, that “How do we know if the approach the physicians are using are the most effective?” However, being a student, and knowing next to nothing about diagnostic medicine, I suppressed my doubts and took the advice as definitive. Given Dr Weed’s comments, I should have been more assertive with my doubts. And, unfortunately and apparently, these methods of practice which Dr Weed criticized have gotten ingrained in decision support software for medicine. See E. H. Shortliffe, “Computer programs to support clinical decision making”, Journal of the American Medical Association, 258, 61-66, for their status as of 1986, some 15 years after Weed’s talk.

Incidentally, while I have found two additional references by medical authors to the title phrase of this post attributed by them to Alfred North Whitehead, that is, claims that Whitehead mentioned a “capacity for sustained muddle-headedness”. My online research has failed to turn up that reference. The closest I can find is a mention by Lomax in an article in the Journal of Psychiatric Practice, 17(1), January 2011, on page 46 where he quotes Whitehead from Whitehead’s 1938 book Modes of Thought where Lomax writes

Alfred Whitehead said that the job of the philosopher was “living with sustained muddle-headedness”.

Whitehead liked the term muddle-headed, even applying it to himself. I doubt he ever meant it, however, in exactly the way Dr Weed and colleagues used it.

About hypergeometric

See http://www.linkedin.com/in/deepdevelopment/ and http://667-per-cm.net
This entry was posted in American Association for the Advancement of Science, American Statistical Association, anemic data, Bayesian, cardiovascular system, David Spiegelhalter, machine learning, Massachusetts Institute of Technology, medicine, Paul Lauenstein, rationality, reason, reasonableness, risk, statistics. Bookmark the permalink.

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