On medicine, ambiguity, and the value of an interdisciplinary approach
|Sep 24||Public post|| 4|
Noah here. All work can be plotted between the routine and the creative. The routine side represents algorithms, from the simple steps you follow while baking cookies to the more complicated recommendation engines that power websites we all use daily, while the creative side represents art. (Lots of people like to use art and science as the representatives, but I think there’s too much art in science for that to work well.) For most of us, work is a mix of both sides. Writing, for example, is clearly a creative pursuit (as anyone who has faced a blank page can attest), but it’s also governed by rules of grammar and spelling, which fall squarely on the routine side of the spectrum. I’m fascinated enough by this idea and its implications that I’ve named my new company, Variance, after one way of explaining this spectrum.
Why is this interesting?
There seems to be a bit of a conversation going on in the world of medicine about where, exactly, the doctor’s job falls in this mix. I was reminded of this topic by a recent op-ed from Dr. Rose Olson in The BMJ about the relationship between art and medicine.
Does art have any place in medicine? In the age of evidence based medicine, abstract creative processes like art may seem irrelevant. Yet a careful look into medicine’s “objective data” reveals its often nauseating number of presumptions and limitations. So when a patient’s signs and symptoms fail to follow the textbooks, and all clinical algorithms have been exhausted, how is the doctor to proceed? This is exactly where art can lend great value—by teaching us comfort with ambiguity. While artists may have a specific message in mind when crafting their work, similar to medicine, each viewer is affected in a distinct and often unpredictable way. Interpreting art is a meditation in seeing things from multiple points of view and growing to respect that others may not agree with your interpretation. Physicians have a lot to gain from learning to navigate these grey areas.
She goes on to highlight a growing body of research that “suggests that early exposure to art interpretation in medical education may in fact increase students’ ability to tolerate ambiguity.” I happen to have run into one of those pieces of research by way of a piece in the journal Ophthalmology by Malcolm Gladwell and David Epstein (author of The Sports Gene and the more recent Range). The editorial is a kind of introduction to some research that appeared in the issue in which ophthalmologists were sent to art observation classes and then tested to see if it changed the way they went about their job. “The question was, would lessons in a field far from their own make them better at the observational and diagnostic skills that lie at the core of ophthalmology? And the answer is that it did, substantially. Taking would-be physicians out of the hospital and into a museum—taking them out of their own world and into a different one—made them better physicians.”
“Observation and description are critical to the practice of medicine,” [the authors of the study] write. But they point out that physical examination courses in medical school generally focus on memorization of clinical signs, without regard to developing the underlying skill of observation. Cognitive psychologists have repeatedly shown that this variety of teaching will not lead students to develop broadly applicable skills that will serve them for a lifetime. It will, instead, lead to a reliance on algorithmic rules for familiar situations. And algorithms, of course, are algorithmic: wonderful so long as they are facing a problem they have seen exactly before, and terrible when confronted with a novel situation. “Interestingly, we noted a decline in the overall score of the control group,” the authors write, in one of the most intriguing (and troubling) moments in the article. Without a foundation in the basic skills of observation, further medical training may have the effect of eroding the skills of the would-be ophthalmologists.
It seems clear that no matter what you do, having some diversity of thought and experience can make you much better at your job. One of my favorite quotes on this idea comes from designer Michael Bierut, who after many emails asking him why he blogged about so many things that weren’t “design”, finally answered that “the great thing about graphic design is that it is almost always about something else. Corporate law. Professional football. Art. Politics. Robert Wilson. And if I can’t get excited about whatever that something else is, I really have trouble doing good work as a designer. To me, the conclusion is inescapable: the more things you’re interested in, the better your work will be.”
Hopefully, that’s something that comes through in this email as well. (NRB)
Chart of the Day:
Super interesting data showing how many people actually know which shows come from what streaming services (h/t Jon Lombardo). “To measure each platform’s brand awareness among consumers, Morning Consult asked 1,193 to 1,198 respondents if they could name a show that aired on a given television network or streaming service. Out of the 16 platforms listed in the survey, which included all the broadcast networks, as well as select cable channels and streaming services, Netflix was the winner, with 43 percent of respondents correctly naming an original program. HBO was a close second, with 38 percent of people being able to name an original show.” (NRB)
Thom Yorke on desert island discs. Some of his picks: Scott Walker’s “It’s Raining Today,” Nina Simone‘s “Lilac Wine,” R.E.M.’s “Murmur,” Talking Heads’ “Born Under Punches,” Sidney Bechet’s “Blue Horizon,” Neil Young’s “After the Gold Rush,” and “Freeman Hardy & Willis Acid” by Aphex Twin and Squarepusher. I’ve put them all together here. (CJN)
Thanks for reading,
Noah (NRB) & Colin (CJN)
PS - Noah here. I’ve started a new company and we are looking for our first/lead product designer to join the team in Brooklyn. If you are a product designer or know anyone who is great, please share. Dinner’s on me at a restaurant of your choice if you help us find someone.
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