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Paul Spector, M.D. Headshot

Against All Odds

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I was going to call this piece "A Plea For Risk Literacy," really just a form of math literacy, but thought few titles could better guarantee no one would read it. For most of us, math is our first academic experience of being plain wrong. An incorrect answer in math is never "interesting" the way a response in English or even history class might be. No math teacher ever admiringly uttered the phrase, "Now that's an different perspective." I'll never forget the math teacher who called my answer "not even wrong." No one likes being wrong, but we turn our backs on math at a cost.

We live in a culture where the art of estimation is essential if we hope to understand the wide range of magnitudes and time frames that are tossed around in every day discourse. Whether considering the national debt or your mortgage rate, the population of China or the daily loss of brain cells, an earthquake of 4 or 6 on the Richter scale, the date of the Industrial Revolution or the origin of the universe, you're lost without some basic math smarts that provide a sense of proportion.

Now more than ever, we are flooded with data that could inform our decisions. This is particularly true when it comes to our health. Doctors no longer dictate treatments. In the age of "informed consent", we are presented with the odds of this procedure or medication having "x" benefits and "y" risks. We are expected to make our own decision. (And the complexity of patient decision-making will increase dramatically as the human genome is deciphered.) Yet we rarely use the pertinent data when we make our choices.

Why do we play the odds rather than calculate them?

On a fundamental level, we seem hardwired for bad decision-making. We like to presume that we have control over what happens to us. We believe that if we stick to a plan, the desired result should occur. If we take "good" care of ourselves (or if we are "good"), we will grow old and prosper. But any 10 year high school reunion demolishes these naive assumptions.

Daily life provides shedloads of examples of just how bad we are at understanding the odds -- the popularity of the lottery, casinos, junk food, and cigarettes. Like disagreeable information of any kind, when we don't like the odds we remove them from consciousness. And when we fail to bury disturbing odds, we unwittingly seek data that will bind our anxiety. The newspaper we read, the TV shows we follow, the people with whom we socialize, are all chosen to confirm our view of the world, that we're doing the right thing, that we know, that we are secure.

We are masterful at avoiding the discordant experience of learning something that contradicts our beliefs. And we are equally disturbed when others respond to new information and change their stance. In politics, it's pejoratively labeled flip-flopping, a career ender.

Certainty is seductive. But the reality is that we live in a sea of uncertainty. And yet we are raised (and raise our children) to believe the opposite. Can this change? I think so. While the complexity of the kaleidoscopic forces that drive our choices is overwhelming, there are things we can do in order to encourage better decision-making. And math may be one of the most powerful antidotes to emotionally-based judgements.

Here's a short list of ideas that could be applied at any stage of development, from kindergarten to think tanks.

Encourage suspicion of experts and the accepted verities.

Explore who profits from one set of data versus another.

Introduce children to probability calculation early in a real-world accessible form using something they find interesting, like a favorite player's batting average, or the chances of winning at tic-tac-toe, or the relative risk of getting a filling with and without brushing your teeth. Teenagers specialize in risk. Why not teach them the math of uncertainty in an area that might capture their interest? What are the odds of getting pregnant or contracting a STD with unprotected sex?

Most importantly, we must attempt to get more comfortable with the messy business of ambiguity, complexity and not knowing. If we could delay even briefly that reflexive leap to embrace social or intellectual ready-made conceptions, it could have enormous impact. Like fast food, these packaged ideas allow some immediate soothing, but provide nothing that nourishes. In the end, they make us sick because in adopting beliefs that are not our own, we blind ourselves to what we really think and feel. And without such knowledge, making the right choice is against all odds.

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