Double Lens 211
knowledge had drawbacks: knowing about ‘‘the things the doctor doesn’t
say’’ and possible medical errors. Knowledge could serve denial, too.
These ill doctors assessed their own diagnoses differently than those of
their patients. Many became more critical of the medical literature, seeing
it as falling short, referring only to group means, not addressing individual
patients’ needs, and even ‘‘lying.’’ Many were stunned to receive only ‘‘the
cold, hard facts’’ from their physicians.
They varied in how they weighed medical information: whether they
accepted or believed they would defy the odds, were pessimists or opti-
mists, engaged in ‘‘good’’ or ‘‘bad’’ denial, and became more open to
complementary and alternative medicine. Regarding CAM, some of these
doctors had faith, while others remained biased or faced difficult judg-
ment calls.
Medical professionalization shaped these views. Trainees, lacking years
of experience and accumulated examples of treatments, often approached
risks and benefits differently than did more senior colleagues, overreacting
to traumatic cases. Consequently, medical education aims to develop
intuition about complex data. Yet how, exactly, does this training instill
such acumen? Various adages help, such as ‘‘common things happen
commonly’’ and ‘‘beware of ‘zebras.’ ’’ Medical school also inculcates the
notion of ‘‘theoretical’’ risks that are extremely low but still exist, and
hence, technically, not theoretical. Conversely, ‘‘medical student disease’’
can be seen as resulting from insufficient development of such intuition
among trainees.
These doctor-patients revealed, too, the extent to which emotions
molded perceptions of risks, and vice versa. Risks fueled anxiety and de-
pression that can in turn influence other decisions, and even disease pro-
cesses themselves. Ergo, feedback loops exist, as risk perceptions and
emotions affect each other. Even anticipation of these emotions can alter
interpretations of risks.
Individuals ranged, too, in the degree to which they sought statistics,
from avoidance to active pursuit. Presentations of information varied as
well. Physicians-of-record often assumed that these ill doctors knew or
wanted only the ‘‘brute’’ facts. And even these ill doctors found it hard to
challenge their providers’ presentations of information. Patients may abet,
not correct, their physicians’ assumptions, suggesting a degree of collu-
sion. However, such interactions concerning the framing of statistics, in-
cluding desires not to challenge physicians’ expectations of patients, have
been under-investigated.