11 ms·

The peril of talking to normal people

156 points by mjirv 11y ago

__david__ 11y ago
This reminds me a lot of the chapter in "Surely you're joking, Mr. Feynman" where he enlists in the military and walks away with a 4f exemption. Same precision and honesty in his answers and the same misinterpretation by the doctor. You can find it online, the chapter is titled "Uncle Sam Doesn't Need You!"
douche 11y ago
Distressingly, this is why you should probably use the same rules talking with mental health and social service personnel that you would use with the police. Tell them nothing. Honesty does you no good, and can get you in a world of hassle. Works well with doctors as well. Tell them what is wrong with you, so they'll give you the right treatment without jerking you around and wasting your time.
- anonymous484 11y ago
  Yep. This guy was actually pretty lucky, as he could have gotten a tranquilizer shot and wouldn't have been able to argue his point for a while. With the hospital happily charging $10k/day :)
  - noobie 11y ago
    The author is actually a woman.
  - incompatible 11y ago
    Don't you generally have to give consent for medical treatment?
    - milkey_mouse 11y ago
      Not if they think you're mentally unstable enough to warrant them administering treatment, regardless if that treatment ends up being necessary or not.
      - suneilp 11y ago
        Does that open up the possibility of suing the psychiatrist.
        NamTaf 11y ago
        No they're exercising their duty of care with valid reason to believe it's the right course of action.
- noobie 11y ago
  >Tell them what is wrong with you, so they'll give you the right treatment Yeaaah about that, am I the only one concerned about the state of medicine, i.e. diagnosis? There always seems to be a myriad of symptoms that are common between various diseases/conditions. I honestly don't see how to blindly trust doctors. inb4 edit: I am not saying we shouldn't trust doctors.
  - DanBC 11y ago
    You can always ask your doctor why they think you have X and not Y. And whenever they recommend treatment it's always good to ask "What happens if we don't do this? What happens if we just watch and wait?"
    - Swizec 11y ago
      > And whenever they recommend treatment it's always good to ask "What happens if we don't do this? What happens if we just watch and wait?" And then you don't do that and spend $1400 in vet bills to find out your bird had a tummy ache. Thanks overly worried girlfriend.
      - thedaemon 11y ago
        There is only 1 thing that dog people and cat people can agree on. That is: bird people are really weird.
  - noir_lord 11y ago
    As someone who sees a lot of doctors the ones I really trust are the ones who say "I don't know" or "I'm not certain but...". Given that my symptoms matched a host of things and its a 7 to 20 in 100,000 thing that only got caught because a good AE (ER) doc told me to forcefully request an MRI I've learnt which doctors to trust over time. Also if you have a rare condition don't expect your average doc to know much about it even my specialist (first one) wasn't that up on the latest research (again unsurprising, they are concerned with hundreds of patients, I'm only concerned with one). Doctors are generally excellent but they are not omniscient and the good ones own it.
- toyg 11y ago
  What is the point of voluntarily meet a mental health practitioner, if you are not going to talk to him? I agree that, in a situation with possible adversarial repercussions (e.g. social services), you should be extra-careful; and in the original post the author's fault was that she did not recognize the self-harming question was such a situation. However, resorting to silence does not seem like a practical way to solve any problem -- it works with the police only because someone else (your lawyer) will do the talking for you.
- awqrre 11y ago
  Doctors always gave me the impression that they wanted to feel useful and would rather you not telling them what's wrong... That sentiment comes from only a few visits to the hospital.
noir_lord 11y ago
Not a mathematician but a programmer and have had similar problems in the past, I've found that its all to easy to fall into the trap of thinking the world is black and white and that solutions to peoples problems are similar. Mostly people don't want you to propose a solution to a problem they just want someone to listen. It's a trap because when you really look into it you realise the world isn't absolute, I think most of us could come up with a better tax system for example in theory which looks obvious however when you start to look into it you realise the the real world is messy. It is a bit like saying WW1 was caused by some archduke getting shot I guess, a lot of humans like simple answers.
- sdegutis 11y ago
  The thing about black and white is that there are different shades of each. One thing I've learned in life is that most people are just trying to have a decent life and make it so that their lives and the lives of people they care about can remain decent. I have a lot of respect for people I firmly disagree with on philosophical, moral, and religious grounds, because they're trying to make the world a better place, even though they may be wrong about how to do just that.
- danieltillett 11y ago
  The current tax system is the best solution given the current political constraints. It is not that the world is messy (it is), but that the constraints to change are not obvious.
- Laaw 11y ago
  There was a recent podcast (Freakanomics) that went into some depth about this concept, and it focused on a story about a pencil describing how it gets made, and the millions of people who are involved. The moral given in the podcast is to "tread carefully" when attempting to fix something, because there are often many moving parts which can't immediately be observed. http://freakonomics.com/podcast/i-pencil/ http://freakonomics.com/podcast/i-pencil/
  - im3w1l 11y ago
Houshalter 11y ago
This reminds of this article, Useless Medical Disclaimers. It's about how medical disclaimers are useless because they don't include probabilities, but they can't because most people don't understand probabilities: http://lesswrong.com/lw/h4/useless_medical_disclaimers/ http://lesswrong.com/lw/h4/useless_medical_disclaimers/ >innumeracy being so widespread, no one would dare put numbers on that sheet of paper. If "amputation" is listed as a consequence with a probability of 0.0001%, patients will run screaming out of the office, crying, "Not my toe! I don't want to lose my toe!"
- DanBC 11y ago
  See also Gerd Gigerenzer's book "Reckoning with Risk". https://plus.maths.org/content/reckoning-risk https://plus.maths.org/content/reckoning-risk >The probability that one of these women [asymptomatic, aged 40 to 50, from a particular region, participating in mammography screening] has breast cancer is 0.8 percent. If a woman has breast cancer, the probability is 90 percent that she will have a positive mammogram. If a woman does not have breast cancer, the probability is 7 percent that she will still have a positive mammogram. Imagine a woman who has a positive mammogram. What is the probability that she actually has breast cancer? > Eight out of every 1,000 women have breast cancer. Of these 8 women with breast cancer, 7 will have a positive mammogram. Of the remaining 992 women who don't have breast cancer, some 70 will still have a positive mammogram. Imagine a sample of women who have positive mammograms in screening. How many of these women actually have breast cancer? His point is that it's not just patients who don't know the numbers. Doctors and nurse, who use these numbers every day, also don't understand them.
  - Houshalter 11y ago
    That's a classic problem to introduce Bayes theorem. However the more interesting fact is 95% of doctors get that question wrong.
    - incompatible 11y ago
      Surely doctors would learn to expect the numerous false positives after a while. Or does the question not really relate to reality?
sampo 11y ago
Feynman gets a psychiatric exam: http://physicshead.blogspot.com/2007/09/feynman-gets-psychiatric-exam.html http://physicshead.blogspot.com/2007/09/feynman-gets-psychia...
- DrScump 11y ago
  The full version: http://surelyyouarejokingmrfeynman.blogspot.com/2015/01/unclesamdoesntneedyou.html http://surelyyouarejokingmrfeynman.blogspot.com/2015/01/uncl...
  - shrikant 11y ago
    (Even though I'm reading this again) what a great read!
- hcrisp 11y ago
  Reminds me of a colleague who was filling out a medical form for his son. He got stuck on one question, so he took it up to the front desk. "This question," he said, "asks, 'Are you concerned about your child's health?' Well as a parent I am concerned, but I'm not _real_ concerned." To which the receptionist responded, "Are you an engineer?" "Yes." "Just put 'no'."
ianamartin 11y ago
I had this experience in undergrad. And I had to stay for several days because I had no therapist for the staff psychologist to call. Being surrounded by genuinely crazy people for three days almost made me crazy. Coming from a music, then music theory, then philosophy, then technology background, it's an understatement to say that being precise in my language is extremely important. Most people just don't care that much about the exact meanings of what the say or the chain of logical implications implied by certain types of careless wording. It's a constant challenge for me to interact with people in a casual social way, so I mostly just don't. I probably come across as a pedant in many cases, but that's not my intent. I just have a hard time intuiting what people mean when it's something other than what they say.
- scardine 11y ago
  Now that my 2 years old son is officially diagnosed in the spectrum, I wonder if I have a toe in autism as well. I have to spend a lot of mental energy to get all the social clues and body language and all the things that seems natural to most people. No matter how much effort I put on social interactions people see me as arrogant or pedantic or a plain jerk. My son is my best friend, and the way he thinks make more sense for me than the rest of mankind.
  - hugozap 11y ago
    >No matter how much effort I put on social interactions Too much effort gets the opposite effect. Others feel the interaction forced and weird. I used to be guilty of this too. A more relaxed attitude helps a lot, but is not easy when my mind is optimised to analyse everything...
  - Laaw 11y ago
    Yeah, I'm reading this story (and some of these comments), and I have been in language comprehension mishaps before, but only because I was being obstinate (and was aware of it). I can't think of a situation like this where I couldn't intuit the desired answer the authority questioning me was looking for. I've often chosen not to give that answer for various reasons (I can be a prick, usually), but there's never been a situation to my recollection that I've been genuinely stumped.
nsxwolf 11y ago
This is really "The peril of talking to psychiatrists" and it's a trap normal people fall into also. Life is full of little spring loaded legal traps like this.
- cname 11y ago
  As someone else in this thread noted, this also includes police and other authority figures, but it can also include family and friends.
  - Normal_gaussian 11y ago
    > can also include family and friends. This is, unfortunately, very true. Once a few people have decided there is a problem there is often very little you can do about it, confirmation bias will set in and external influences often err on the side of "caution" - do not contradict the current widespread opinion.
shmageggy 11y ago
Unfortunately, Dr. Safe Side was just doing her job. Therapists are often explicitly instructed to do this check and to err on the side of ambulance, of course for liability and legal reasons. Which is IMO ridiculous; what better way could there be to make someone who is having suicidal thoughts feel more alientated and stressed.
afarrell 11y ago
The opposite end of this is why it annoys me when people complain about politicians being liars. Of course politicians lie: a strong commitment to truth is very much against social norms and causes people to be bored at best and angry or creeped-out at worst. Politicians by the nature of their jobs must conform very strongly to social norms and so have to lie more egregiously when forced to answer "simple questions" on complex topics by people (journalists) whose profession incentivized them to create drama.
- afarrell 11y ago
  The right way (to the degree that I've figured things out. Please please pop in with suggestions on how to approach this in a more ethical way) to handle the conflict between wanting to tell the truth and wanting to conform to social norms is to think of it as a UX problem: try to predict what your listener's mental model will be as a result of hearing something. Given that mental models are always imperfect reflections of reality, try to determine if what you say would add or remove flaws in their mental model. If it clears up some flaws and adds others, make a guess at which ones are going to be impactful and which ones aren't. This has the failure mode that you tell someone what you think is an inconsequential lie, and it turns out to hurt them. Unfortunately, it turns out that it is usually better to err on the side of lying than on the side of being pedantic. Gauge people's receptiveness to truth-seeking as you get to know them. Actively seek out people whom you can trust to have the patience to listen to more true explanations. If you can do that, you can build for yourself the privilege of lying less severely.
mightybyte 11y ago
I've noticed a similar thing about myself when I'm making plans with friends. They'll say, "Are you coming to XYZ event tomorrow?" I've noticed that I very rarely answer with "Yes" or a common equivalent even when I fully intend to go. In the back of my mind I'm thinking, "How could I possibly know whether I will be there tomorrow." I could die, be involved in an accident, or my transportation could be severely delayed. I usually respond with something like "Probably" or "I'll definitely try to make it". It doesn't have the dramatic impact that this story did, but it echoes the same way of thinking.
- Falkon1313 11y ago
  One that I notice is "Where should we go to dinner tonight?" Which naturally begins as SELECT * FROM All_Restaurants, too big of a result set, so I have to start adding filters. 'Too far away' is a nebulous variable, and 'likely to have a long wait time' is a guess at best. By the time I narrow it down to a reasonable subset, we have long since eaten cereal for dinner, she's gone to bed, and all the restaurants are closed. Not a fun experience for either of us. I try to mix it up with just randomly saying "Hey, let's go try this new place that we've know nothing about!"
- Normal_gaussian 11y ago
  Phrases like "that's the plan" or "unless the universe conspires against me" help here.
PakG1 11y ago
This story and the comments here really strike home to me. I too am used to talking in very precise language and when I choose words to say, I choose them with carefully thought-out intent. However, this all happens naturally and very fast in my brain, so it doesn't look to other people like I'm thinking carefully about what I'm saying. I am now a manager of people. I have discovered that I suck at it. I have discovered that it's because so-called normal people don't talk precisely. They rely on emotions, interpreting the unsaid, and so on, especially in Asia where I am currently located. I've had a ton of these communication issues with friends, family, co-workers, etc, at various points in my life. I've learned to adjust for other people, and some people have learned to adjust for me. But wow, does it take effort from both sides. If only one side is willing to make an effort to achieve understanding, my experience is that it usually doesn't resolve fully. One story still rings for me. My family had a condo that we were renting out to people. The tenant moved out, so we were looking for a new tenant. I suggested Craigslist, but my father also wanted to put an ad in the local newspaper website's Classified section. I can't remember the exact cost, but it was ~$200 to put up the ad for a certain amount of time. What the heck. No Dad, let's not do that. Try Craigslist first, see whether you can get a tenant that way that would satisfy you. Mom hears us arguing, she asks what's going on. I say that Dad wants to pay the newspaper for an ad on their website to find a new tenant. Mom says, "Well, if it's to find a new tenant, why not? Even if it's $300, that's a great idea!" At that point, I threw up my hands and said OK, whatever. A little while later, Mom receives the credit card bill. She freaks out over this ~$200 charge, why did we pay so much for whatever this thing is? I blew up because she's the one who had said it was OK to pay over $300 if necessary. She was so confused and said, "But that was just an expression! I didn't mean actually pay over $300!" We had a long talk about how to communicate. And now as a people manager, I discover that I must have this type of conversation every day. It was much easier when I didn't have to deal with ambiguity directly. Before, I could just wash away the ambiguity with detailed requirements documents, contracts, project schedules, knowledge bases, and the like. I am finding that I suck at talking with people. It was much easier when I was a project/program manager or a developer. It's odd because I was great at talking with people when they're simply my client. I can provide amazing customer service, especially for difficult customers. The dynamic is completely different as a people manager. I think in my previous situations, I was driving the conversation to dig out problem details regarding technical stuff and working towards solutions with others. Much more black and white. Whereas currently, I'm trying to dig out problem details regarding feelings and personality disputes. So not black and white.
suneilp 11y ago
I'd say this story is the peril of talking to people who prefer to err on the safe side. Feel free to read deeply into that.
executesorder66 11y ago
> she would laugh at our jokes, use words like “trivial”, “modulo” and “orthogonal” in casual conversation, and even get their meaning right. She became, for all non-work purposes, a mathematician. Is trivial not a word normal people use in conversation? Many people I know who are not Mathematicians or even in the STEM fields use this word in casual conversation. And even the ones that don't use it at least know what it means. ------- >“Is anyone else concerned about your child’s hearing?” I was about to check “No” when Pink objected: “How would we know that no-one is? We can’t read everyone’s minds.” So it looks like the author can actually think in a way that is not 100% logically correct. So answering “How could I be sure?” to “Are you absolutely sure that you will not hurt yourself today?” is obviously a bad idea, and was not a result of the author only being able to think and respond in a 100% logical way. She totally brought this on herself.
- grayclhn 11y ago
  Most normal people don't use "trivial" to mean "probably not impossible."
- lgessler 11y ago
  The author didn't say this, but I definitely associate "non-trivial" with the more mathematically inclined among my friends and acquaintances.
alexashka 11y ago
The author is a classic case of a smart person who has not quite cracked how humans work and why and is as a result frustrated. The psychiatrist did what he/she did to cover their own ass. Those questions are mandatory procedure and if someone is potentially going to hurt themselves and you knew and decided 'ah probably not', then it is YOUR fault. Nobody's going to take that chance. That's simply knowing how the game works - the same way you're supposed to pretend you've gotten along with every workplace you've ever been in during an interview to avoid raising red flags. There are many many more examples of unspoken social rules you simply have to learn. Being smart has the advantage of having the capacity to catch up and make up for traits you naturally aren't good at. An average person does not have that luxury - if they're born unattractive, they have almost no way to overcome that as one simple example.
- kpil 11y ago
  I am convinced that 'smart' is something else entirely. There is an awful lot of brainpower dedicated to skills like walking into a party where you know noone, meeting with annoyed customers, or even polite conversation, etc.
  - socket0 11y ago
    A lot of people (most people?) seem to have that built into their BIOS. Or at least the most basic functionality needed to do that. That's not to imply they all like those situations, just that they don't freeze up and experience the human equivalent of a BSOD when confronted by one.
    - tribune 11y ago
      Some certainly do, but I highly doubt it's "most" people. There's probably a significant self-selection bias for people who frequently end up in these situations.
  - alexashka 11y ago
    I think you're making the point that there's different kinds of smart - I couldn't agree with you more. What I meant by smart and what I got from the original article is someone who is a systemic thinker who likes to categorize things. That's a very valuable skill. Learning to get along with people who don't naturally do that (most people) is a skill you can expedite by using systemic thinking and figuring out how emotion-based conversations go :)
proc0 11y ago
OH FFS. This person is pedantic at best, if not dumb. How can you call yourself academic and then proceed to completely mis-communicate with people. When the therapist asks, "Are you absolutely sure you're not going to hurt yourself later today?", she's asking it within a certain context. The therapist is obviously excluding out of the ordinary incidents that may happen. Apparently the author is completely missing the context because she's either a pedantic nerd, a foreigner still learning English, or just dumb, not because she's in her "academic" circle.
- SilasX 11y ago
  If you haven't been "trained" on what a psychiatrist's context is, how can you be expected to know what they "obviously" meant? I would think that it's the opposite: to the extent that the psychiatrist is unable to clarify their questions to arbitrary precision, spell out implications, etc, then s/he is the one with insufficient mastery to be taking on such a role (not that it matters in our "fake it till you make it" world).
  - NamTaf 11y ago
    Saying 'if you are then I am obliged to have you taken to a psych ward' is incredibly threatening to people who need that supervision and can drive them to lie. This is why they ask the way they do.
    - SilasX 11y ago
      I meant clarifying what being "absolutely sure you're not going to kill yourself" means as a mental state, not what it would imply for their later treatment of you.
  - deleted 11y ago
    [deleted]
- theparanoid 11y ago
  She was a foreigner learning English.
- 11y ago
tn13 11y ago
This is also classic case of a society which does not trust individuals or let them mind their own business but needlessly interferes int their lives in the name of protecting them.
chillingeffect 11y ago
I relate totally, but Just a thought: why is the doctor considered the "normal" one? Just because they're in the majority? It's certainly possible that the majority is a temporary abberation. Even Homo Sapiens could be considered an abnormal mammal with a pesky, self-defeating, super-sized pre-frontal cortex.

156 points by mjirv 11y ago

This reminds me a lot of the chapter in "Surely you're joking, Mr. Feynman" where he enlists in the military and walks away with a 4f exemption. Same precision and honesty in his answers and the same misinterpretation by the doctor. You can find it online, the chapter is titled "Uncle Sam Doesn't Need You!"

douche 11y ago

Distressingly, this is why you should probably use the same rules talking with mental health and social service personnel that you would use with the police. Tell them nothing. Honesty does you no good, and can get you in a world of hassle. Works well with doctors as well. Tell them what is wrong with you, so they'll give you the right treatment without jerking you around and wasting your time.

anonymous484 11y ago
Yep. This guy was actually pretty lucky, as he could have gotten a tranquilizer shot and wouldn't have been able to argue his point for a while. With the hospital happily charging $10k/day :)
- noobie 11y ago
  The author is actually a woman.
- incompatible 11y ago
  Don't you generally have to give consent for medical treatment?
  - milkey_mouse 11y ago
    Not if they think you're mentally unstable enough to warrant them administering treatment, regardless if that treatment ends up being necessary or not.
    - suneilp 11y ago
      Does that open up the possibility of suing the psychiatrist.
      - NamTaf 11y ago
        No they're exercising their duty of care with valid reason to believe it's the right course of action.
noobie 11y ago
>Tell them what is wrong with you, so they'll give you the right treatment Yeaaah about that, am I the only one concerned about the state of medicine, i.e. diagnosis? There always seems to be a myriad of symptoms that are common between various diseases/conditions. I honestly don't see how to blindly trust doctors. inb4 edit: I am not saying we shouldn't trust doctors.
- DanBC 11y ago
  You can always ask your doctor why they think you have X and not Y. And whenever they recommend treatment it's always good to ask "What happens if we don't do this? What happens if we just watch and wait?"
  - Swizec 11y ago
    > And whenever they recommend treatment it's always good to ask "What happens if we don't do this? What happens if we just watch and wait?" And then you don't do that and spend $1400 in vet bills to find out your bird had a tummy ache. Thanks overly worried girlfriend.
    - thedaemon 11y ago
      There is only 1 thing that dog people and cat people can agree on. That is: bird people are really weird.
- noir_lord 11y ago
  As someone who sees a lot of doctors the ones I really trust are the ones who say "I don't know" or "I'm not certain but...". Given that my symptoms matched a host of things and its a 7 to 20 in 100,000 thing that only got caught because a good AE (ER) doc told me to forcefully request an MRI I've learnt which doctors to trust over time. Also if you have a rare condition don't expect your average doc to know much about it even my specialist (first one) wasn't that up on the latest research (again unsurprising, they are concerned with hundreds of patients, I'm only concerned with one). Doctors are generally excellent but they are not omniscient and the good ones own it.
toyg 11y ago
What is the point of voluntarily meet a mental health practitioner, if you are not going to talk to him? I agree that, in a situation with possible adversarial repercussions (e.g. social services), you should be extra-careful; and in the original post the author's fault was that she did not recognize the self-harming question was such a situation. However, resorting to silence does not seem like a practical way to solve any problem -- it works with the police only because someone else (your lawyer) will do the talking for you.
awqrre 11y ago
Doctors always gave me the impression that they wanted to feel useful and would rather you not telling them what's wrong... That sentiment comes from only a few visits to the hospital.

noir_lord 11y ago

Not a mathematician but a programmer and have had similar problems in the past, I've found that its all to easy to fall into the trap of thinking the world is black and white and that solutions to peoples problems are similar. Mostly people don't want you to propose a solution to a problem they just want someone to listen. It's a trap because when you really look into it you realise the world isn't absolute, I think most of us could come up with a better tax system for example in theory which looks obvious however when you start to look into it you realise the the real world is messy. It is a bit like saying WW1 was caused by some archduke getting shot I guess, a lot of humans like simple answers.

sdegutis 11y ago
The thing about black and white is that there are different shades of each. One thing I've learned in life is that most people are just trying to have a decent life and make it so that their lives and the lives of people they care about can remain decent. I have a lot of respect for people I firmly disagree with on philosophical, moral, and religious grounds, because they're trying to make the world a better place, even though they may be wrong about how to do just that.
danieltillett 11y ago
The current tax system is the best solution given the current political constraints. It is not that the world is messy (it is), but that the constraints to change are not obvious.
Laaw 11y ago
There was a recent podcast (Freakanomics) that went into some depth about this concept, and it focused on a story about a pencil describing how it gets made, and the millions of people who are involved. The moral given in the podcast is to "tread carefully" when attempting to fix something, because there are often many moving parts which can't immediately be observed. http://freakonomics.com/podcast/i-pencil/ http://freakonomics.com/podcast/i-pencil/
- im3w1l 11y ago

Houshalter 11y ago

This reminds of this article, Useless Medical Disclaimers. It's about how medical disclaimers are useless because they don't include probabilities, but they can't because most people don't understand probabilities: http://lesswrong.com/lw/h4/useless_medical_disclaimers/ http://lesswrong.com/lw/h4/useless_medical_disclaimers/ >innumeracy being so widespread, no one would dare put numbers on that sheet of paper. If "amputation" is listed as a consequence with a probability of 0.0001%, patients will run screaming out of the office, crying, "Not my toe! I don't want to lose my toe!"

DanBC 11y ago
See also Gerd Gigerenzer's book "Reckoning with Risk". https://plus.maths.org/content/reckoning-risk https://plus.maths.org/content/reckoning-risk >The probability that one of these women [asymptomatic, aged 40 to 50, from a particular region, participating in mammography screening] has breast cancer is 0.8 percent. If a woman has breast cancer, the probability is 90 percent that she will have a positive mammogram. If a woman does not have breast cancer, the probability is 7 percent that she will still have a positive mammogram. Imagine a woman who has a positive mammogram. What is the probability that she actually has breast cancer? > Eight out of every 1,000 women have breast cancer. Of these 8 women with breast cancer, 7 will have a positive mammogram. Of the remaining 992 women who don't have breast cancer, some 70 will still have a positive mammogram. Imagine a sample of women who have positive mammograms in screening. How many of these women actually have breast cancer? His point is that it's not just patients who don't know the numbers. Doctors and nurse, who use these numbers every day, also don't understand them.
- Houshalter 11y ago
  That's a classic problem to introduce Bayes theorem. However the more interesting fact is 95% of doctors get that question wrong.
  - incompatible 11y ago
    Surely doctors would learn to expect the numerous false positives after a while. Or does the question not really relate to reality?

sampo 11y ago

Feynman gets a psychiatric exam: http://physicshead.blogspot.com/2007/09/feynman-gets-psychiatric-exam.html http://physicshead.blogspot.com/2007/09/feynman-gets-psychia...

DrScump 11y ago
The full version: http://surelyyouarejokingmrfeynman.blogspot.com/2015/01/unclesamdoesntneedyou.html http://surelyyouarejokingmrfeynman.blogspot.com/2015/01/uncl...
- shrikant 11y ago
  (Even though I'm reading this again) what a great read!
hcrisp 11y ago
Reminds me of a colleague who was filling out a medical form for his son. He got stuck on one question, so he took it up to the front desk. "This question," he said, "asks, 'Are you concerned about your child's health?' Well as a parent I am concerned, but I'm not _real_ concerned." To which the receptionist responded, "Are you an engineer?" "Yes." "Just put 'no'."

ianamartin 11y ago

I had this experience in undergrad. And I had to stay for several days because I had no therapist for the staff psychologist to call. Being surrounded by genuinely crazy people for three days almost made me crazy. Coming from a music, then music theory, then philosophy, then technology background, it's an understatement to say that being precise in my language is extremely important. Most people just don't care that much about the exact meanings of what the say or the chain of logical implications implied by certain types of careless wording. It's a constant challenge for me to interact with people in a casual social way, so I mostly just don't. I probably come across as a pedant in many cases, but that's not my intent. I just have a hard time intuiting what people mean when it's something other than what they say.

scardine 11y ago
Now that my 2 years old son is officially diagnosed in the spectrum, I wonder if I have a toe in autism as well. I have to spend a lot of mental energy to get all the social clues and body language and all the things that seems natural to most people. No matter how much effort I put on social interactions people see me as arrogant or pedantic or a plain jerk. My son is my best friend, and the way he thinks make more sense for me than the rest of mankind.
- hugozap 11y ago
  >No matter how much effort I put on social interactions Too much effort gets the opposite effect. Others feel the interaction forced and weird. I used to be guilty of this too. A more relaxed attitude helps a lot, but is not easy when my mind is optimised to analyse everything...
- Laaw 11y ago
  Yeah, I'm reading this story (and some of these comments), and I have been in language comprehension mishaps before, but only because I was being obstinate (and was aware of it). I can't think of a situation like this where I couldn't intuit the desired answer the authority questioning me was looking for. I've often chosen not to give that answer for various reasons (I can be a prick, usually), but there's never been a situation to my recollection that I've been genuinely stumped.

nsxwolf 11y ago

This is really "The peril of talking to psychiatrists" and it's a trap normal people fall into also. Life is full of little spring loaded legal traps like this.

cname 11y ago
As someone else in this thread noted, this also includes police and other authority figures, but it can also include family and friends.
- Normal_gaussian 11y ago
  > can also include family and friends. This is, unfortunately, very true. Once a few people have decided there is a problem there is often very little you can do about it, confirmation bias will set in and external influences often err on the side of "caution" - do not contradict the current widespread opinion.

shmageggy 11y ago

Unfortunately, Dr. Safe Side was just doing her job. Therapists are often explicitly instructed to do this check and to err on the side of ambulance, of course for liability and legal reasons. Which is IMO ridiculous; what better way could there be to make someone who is having suicidal thoughts feel more alientated and stressed.

afarrell 11y ago

The opposite end of this is why it annoys me when people complain about politicians being liars. Of course politicians lie: a strong commitment to truth is very much against social norms and causes people to be bored at best and angry or creeped-out at worst. Politicians by the nature of their jobs must conform very strongly to social norms and so have to lie more egregiously when forced to answer "simple questions" on complex topics by people (journalists) whose profession incentivized them to create drama.

afarrell 11y ago
The right way (to the degree that I've figured things out. Please please pop in with suggestions on how to approach this in a more ethical way) to handle the conflict between wanting to tell the truth and wanting to conform to social norms is to think of it as a UX problem: try to predict what your listener's mental model will be as a result of hearing something. Given that mental models are always imperfect reflections of reality, try to determine if what you say would add or remove flaws in their mental model. If it clears up some flaws and adds others, make a guess at which ones are going to be impactful and which ones aren't. This has the failure mode that you tell someone what you think is an inconsequential lie, and it turns out to hurt them. Unfortunately, it turns out that it is usually better to err on the side of lying than on the side of being pedantic. Gauge people's receptiveness to truth-seeking as you get to know them. Actively seek out people whom you can trust to have the patience to listen to more true explanations. If you can do that, you can build for yourself the privilege of lying less severely.

mightybyte 11y ago

I've noticed a similar thing about myself when I'm making plans with friends. They'll say, "Are you coming to XYZ event tomorrow?" I've noticed that I very rarely answer with "Yes" or a common equivalent even when I fully intend to go. In the back of my mind I'm thinking, "How could I possibly know whether I will be there tomorrow." I could die, be involved in an accident, or my transportation could be severely delayed. I usually respond with something like "Probably" or "I'll definitely try to make it". It doesn't have the dramatic impact that this story did, but it echoes the same way of thinking.

Falkon1313 11y ago
One that I notice is "Where should we go to dinner tonight?" Which naturally begins as SELECT * FROM All_Restaurants, too big of a result set, so I have to start adding filters. 'Too far away' is a nebulous variable, and 'likely to have a long wait time' is a guess at best. By the time I narrow it down to a reasonable subset, we have long since eaten cereal for dinner, she's gone to bed, and all the restaurants are closed. Not a fun experience for either of us. I try to mix it up with just randomly saying "Hey, let's go try this new place that we've know nothing about!"
Normal_gaussian 11y ago
Phrases like "that's the plan" or "unless the universe conspires against me" help here.

PakG1 11y ago

This story and the comments here really strike home to me. I too am used to talking in very precise language and when I choose words to say, I choose them with carefully thought-out intent. However, this all happens naturally and very fast in my brain, so it doesn't look to other people like I'm thinking carefully about what I'm saying. I am now a manager of people. I have discovered that I suck at it. I have discovered that it's because so-called normal people don't talk precisely. They rely on emotions, interpreting the unsaid, and so on, especially in Asia where I am currently located. I've had a ton of these communication issues with friends, family, co-workers, etc, at various points in my life. I've learned to adjust for other people, and some people have learned to adjust for me. But wow, does it take effort from both sides. If only one side is willing to make an effort to achieve understanding, my experience is that it usually doesn't resolve fully. One story still rings for me. My family had a condo that we were renting out to people. The tenant moved out, so we were looking for a new tenant. I suggested Craigslist, but my father also wanted to put an ad in the local newspaper website's Classified section. I can't remember the exact cost, but it was ~$200 to put up the ad for a certain amount of time. What the heck. No Dad, let's not do that. Try Craigslist first, see whether you can get a tenant that way that would satisfy you. Mom hears us arguing, she asks what's going on. I say that Dad wants to pay the newspaper for an ad on their website to find a new tenant. Mom says, "Well, if it's to find a new tenant, why not? Even if it's $300, that's a great idea!" At that point, I threw up my hands and said OK, whatever. A little while later, Mom receives the credit card bill. She freaks out over this ~$200 charge, why did we pay so much for whatever this thing is? I blew up because she's the one who had said it was OK to pay over $300 if necessary. She was so confused and said, "But that was just an expression! I didn't mean actually pay over $300!" We had a long talk about how to communicate. And now as a people manager, I discover that I must have this type of conversation every day. It was much easier when I didn't have to deal with ambiguity directly. Before, I could just wash away the ambiguity with detailed requirements documents, contracts, project schedules, knowledge bases, and the like. I am finding that I suck at talking with people. It was much easier when I was a project/program manager or a developer. It's odd because I was great at talking with people when they're simply my client. I can provide amazing customer service, especially for difficult customers. The dynamic is completely different as a people manager. I think in my previous situations, I was driving the conversation to dig out problem details regarding technical stuff and working towards solutions with others. Much more black and white. Whereas currently, I'm trying to dig out problem details regarding feelings and personality disputes. So not black and white.

suneilp 11y ago

I'd say this story is the peril of talking to people who prefer to err on the safe side. Feel free to read deeply into that.

executesorder66 11y ago

> she would laugh at our jokes, use words like “trivial”, “modulo” and “orthogonal” in casual conversation, and even get their meaning right. She became, for all non-work purposes, a mathematician. Is trivial not a word normal people use in conversation? Many people I know who are not Mathematicians or even in the STEM fields use this word in casual conversation. And even the ones that don't use it at least know what it means. ------- >“Is anyone else concerned about your child’s hearing?” I was about to check “No” when Pink objected: “How would we know that no-one is? We can’t read everyone’s minds.” So it looks like the author can actually think in a way that is not 100% logically correct. So answering “How could I be sure?” to “Are you absolutely sure that you will not hurt yourself today?” is obviously a bad idea, and was not a result of the author only being able to think and respond in a 100% logical way. She totally brought this on herself.

grayclhn 11y ago
Most normal people don't use "trivial" to mean "probably not impossible."
lgessler 11y ago
The author didn't say this, but I definitely associate "non-trivial" with the more mathematically inclined among my friends and acquaintances.

alexashka 11y ago

The author is a classic case of a smart person who has not quite cracked how humans work and why and is as a result frustrated. The psychiatrist did what he/she did to cover their own ass. Those questions are mandatory procedure and if someone is potentially going to hurt themselves and you knew and decided 'ah probably not', then it is YOUR fault. Nobody's going to take that chance. That's simply knowing how the game works - the same way you're supposed to pretend you've gotten along with every workplace you've ever been in during an interview to avoid raising red flags. There are many many more examples of unspoken social rules you simply have to learn. Being smart has the advantage of having the capacity to catch up and make up for traits you naturally aren't good at. An average person does not have that luxury - if they're born unattractive, they have almost no way to overcome that as one simple example.

kpil 11y ago
I am convinced that 'smart' is something else entirely. There is an awful lot of brainpower dedicated to skills like walking into a party where you know noone, meeting with annoyed customers, or even polite conversation, etc.
- socket0 11y ago
  A lot of people (most people?) seem to have that built into their BIOS. Or at least the most basic functionality needed to do that. That's not to imply they all like those situations, just that they don't freeze up and experience the human equivalent of a BSOD when confronted by one.
  - tribune 11y ago
    Some certainly do, but I highly doubt it's "most" people. There's probably a significant self-selection bias for people who frequently end up in these situations.
- alexashka 11y ago
  I think you're making the point that there's different kinds of smart - I couldn't agree with you more. What I meant by smart and what I got from the original article is someone who is a systemic thinker who likes to categorize things. That's a very valuable skill. Learning to get along with people who don't naturally do that (most people) is a skill you can expedite by using systemic thinking and figuring out how emotion-based conversations go :)

proc0 11y ago

OH FFS. This person is pedantic at best, if not dumb. How can you call yourself academic and then proceed to completely mis-communicate with people. When the therapist asks, "Are you absolutely sure you're not going to hurt yourself later today?", she's asking it within a certain context. The therapist is obviously excluding out of the ordinary incidents that may happen. Apparently the author is completely missing the context because she's either a pedantic nerd, a foreigner still learning English, or just dumb, not because she's in her "academic" circle.

SilasX 11y ago
If you haven't been "trained" on what a psychiatrist's context is, how can you be expected to know what they "obviously" meant? I would think that it's the opposite: to the extent that the psychiatrist is unable to clarify their questions to arbitrary precision, spell out implications, etc, then s/he is the one with insufficient mastery to be taking on such a role (not that it matters in our "fake it till you make it" world).
- NamTaf 11y ago
  Saying 'if you are then I am obliged to have you taken to a psych ward' is incredibly threatening to people who need that supervision and can drive them to lie. This is why they ask the way they do.
  - SilasX 11y ago
    I meant clarifying what being "absolutely sure you're not going to kill yourself" means as a mental state, not what it would imply for their later treatment of you.
- deleted 11y ago
  [deleted]
theparanoid 11y ago
She was a foreigner learning English.
11y ago

tn13 11y ago

This is also classic case of a society which does not trust individuals or let them mind their own business but needlessly interferes int their lives in the name of protecting them.

chillingeffect 11y ago

I relate totally, but Just a thought: why is the doctor considered the "normal" one? Just because they're in the majority? It's certainly possible that the majority is a temporary abberation. Even Homo Sapiens could be considered an abnormal mammal with a pesky, self-defeating, super-sized pre-frontal cortex.