Sunday, November 16, 2014

Ostrich Pseudoaxioms

An old essay I wrote, publishing it again:

"The truth may be puzzling. It may take some work to grapple with. It may be counterintuitive. It may contradict deeply held prejudices. It may not be consonant with what we desperately want to be true. But our preferences do not determine what's true." - Carl Sagan
In his existential exploration of earth's place in the universe, Carl Sagan came to the conclusion that truths about this universe and about our existence within it seemed to constantly contradict human explanations for it.  The human explanations for the cosmos have been fathomed since the beginning of language and perhaps even earlier, as the elementary human brain started its pondering of the skies.  In all of philosophical and religious history, the questions of why we are here were confronted by spiritual leaders, thinkers, and scientists of the time.  To conceivable each one of these theories and to almost every individual's concept of the truth of the physical world, we can confidently disregard as rubbish.
These theories whether personally derived or institutionally propagated, flow freely throughout time and are believed as if they were as true as knowing red is red. Ask one of the devout 68 million Catholics in the world when Earth was created and their answer is my proof of this.  Or, had you asked a Spaniard in the age prior to Galileo whether the sun was the center of the planetary system, you would have been met with swift censorship.  This of course would have come under the indictment given to any copernican theory of heliocentrism at the time which was that it was "false and contrary to scripture".  Human beings emotional, spiritual and philosophical brain regions are a complicated smattering of neurons that seem to resist and deny hard evidence at every opportunity.  Maybe there are some psychological or neurological explanations of this, of which I am ignorant of.  Whatever it is, it is quite clear that people stick to their guns once a decision is made.  This is particularly true when the circumstance being pondered is of a vast and overarching concept of life and its place in the universe.  However, this emotionally driven stagnation of truth exists in other aspects of human cognition.  An example I would like to discuss is that of the resistance by intelligent, learned, and honest people in the medical field whom try desperately to "hold deeply held prejudices", and to "determine truth by preference."  
In a book by Dr. David Newman, Hippocrates' Shadow, the young and hard-headed emergency physician points out endless examples of what he calls, "Ostrich Pseudoaxioms."  Imagine a fabled, yet clear and extremely simplified example: for decades physicians are taught the practice of treating heart attacks acutely with potion #5.  This practice has gone on for years without extensive study, but cases where patients lives were saved were reported in the literature and then this practice continued to be taught as the treatment.  Then suddenly, 5 major institutions across the world study potion # 5's efficacy as a treatment in randomized controlled clinical trials, the gold standard of medical proof.  Each of these studies shows that firstly, there is NO benefit to potion # 5 during heart attack when compared to a sugar pill and secondly, there were a few deaths that were convincingly due to the administration of potion #5.  Most people with average intellect would imagine the practice of giving potion #5 would stop immediately, right?  Nope, those silly doctors keep on giving it!  Well, they say, its still "in the guidelines." There are countless potion #5's that are given in medicine as we speak. Are you taking one?
 This is a dumbed down scenario of a complicated situation, but represents actual patterns of physician behavior.  The administration of potion #5 becomes a "pseudoaxiom" or a false-self-evident truth.  These are believed truths, falsely taught and proliferated by medical institutions who knowingly deny the evidence that contradicts their "truthiness" (thanks Colbert).  Physicians awareness of the evidence, but quiet denial or hiding from this contradictory data, allows these propagations to become what is known quite eloquently as Ostrich Pseudoaxioms.  Doctors are shoving their heads in the sand to avoid grappling with the acceptance of uncomfortable orcounterintuitive evidence that distorts their own hard-wired concept of what the truth is.
Maybe you always thought doctors were smart enough to make the leap into the counterintuitive, if it was proven by the science they so diligently claim to worship. Perhaps, it was always convenient to think that physicians have no deeply held intellectual prejudices, and that the proof was in the pudding.  But in the end, just as Dr. Sagan pointed out to us long ago, and as Dr. Newman begrudgingly demonstrated in his passionate expose of the medical world:
Physicians also like to have their preferences determine what truth is.

9 comments:

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