Double Lens 199
The definition and criteria of ‘‘good’’ can be unclear, and ultimately
illusory.
Despite efforts to remain ‘‘objective,’’ emotional biases in interpreta-
tions of data and pessimistic beliefs—at times irrational—crept in. Com-
mon cultural beliefs about luck and fate conflicted with scientific per-
spectives on the occurrence of random events. Scott, the physician with
the infected foot, for example, felt he had ‘‘bad luck,’’ and had to remind
himself that chance events occurred independently. Even doctors could
at times believe they were somehow ‘‘cursed.’’
I’m not a religious person, but how could all these things happen?
Why me? Bad luck. I don’t know if that’s true. Maybe it’s one of
those old wives’ tales: if you have a negative perspective, small
events can become bigger. If you start flipping a coin, you can get
100 heads in a row. But the odds of the next one being heads or
tails will still be 50–50. So there’s an aggregate of events, but that
doesn’t change the odds of what the next event is going to be: they
are random.
Still, Scott had trouble believing that he had not somehow been fated to
get sick. He grappled with his fears, though they conflicted with his
rationality.
With patients, clinicians may contribute to optimism or pessimism.
Doctors may underestimate and under-explain risks to patients—especially
iatrogenic risks, about which providers may feel guilty or awkward. As
one surgeon said, ‘‘Medicine systematically underestimates the compli-
cations we cause in messing with people’s bodies.’’ Such minimization of
risks may reflect physicians’ discomfort regarding the possibility of iat-
rogenic side effects. Anne suggested, too, that physicians’ hubris biases
them in defining their ‘‘success.’’ This optimistic bias may reflect magi-
cal thinking, too. As we will see, doctors themselves may exercise an
important magically-imbued placebo effect.
Questions emerged as to what constitutes an ‘‘appropriate’’ amount of
fear, and how to make that determination. Certain physicians appeared
pessimistic, overly afraid of bad but rare events in ways that appeared out
of proportion to the likelihood of such events actually occurring. Per-
ception of risks to oneself may be shaped by a variety of factors, from
personal to professional. Walter said, ‘‘Doctors don’t often understand
statistics or bell curves. You may emotionally feel very compelled to treat.
The people who most often opt for surgery say, ‘Get this out of me.’ ’’ This