A World without Reflection

I really appreciate the fact that Truthdig carries Ellen Goodman's columns; but I was particularly impressed with today's piece, "The Benefits of Slow Journalism." Usually I can count on Ms. Goodman to bring my attention to a matter I had not previously considered, but this time she took on a topic that has occupied me for the last several years, the state of the world that the Internet has made (a topic whose significance is now being recognized by other columnists, such as Libby Purves). As always seems to be the case, she did it with a keen sense of perception; and she did it from a pulpit that commands so much more authority than my own meager blogging efforts.

As is often the case on Truthdig, I responded with a comment expressing my own take on these matters. What follows is a somewhat enhanced transcription of what I submitted to Truthdig. The focus of the comment was what I call the how-did-we-get-into-this-mess question, which Neustadt and May analyzed so well in their book, Thinking in Time, about decision-making in times of crisis.

Ms. Goodman's point of departure concerned the problem of inaccuracies in "news" reported through the blogosphere due to the problem of blog time trumping checking time. What made her column most interesting, however, was her recognition of these inaccuracies as a symptom of a much greater problem:

You don’t die from a journalistic mistake. The worst thing you can kill is a reputation. I might not have even noted these errors of speed-blogging (is that redundant?) if I hadn’t been reading Jerome Groopman’s disturbing and thoughtful book of essays on “How Doctors Think.”

It turns out that most mistakes in medicine are not a matter of operating on the wrong leg or leaving a sponge in the stomach. “The majority of errors are due to flaws in physician thinking, not technical mistakes,” writes Groopman. As many as 15 percent of all diagnoses are wrong.

These mistakes in thinking, says Groopman, are mostly due to cognitive shortcuts, what are called “heuristics.” In real life, for example, doctors are likely to judge the case before them by others that come readily to their minds. They are then likely to latch onto a diagnosis, anchor it, and cherry-pick the symptoms that confirm their belief rather than revisiting or expanding the list of possibilities.

Such heuristic thinking is very much a product of the progress artificial intelligence (AI) made in moving from the research laboratory to the "real world." It is an interesting note of history that one of the first "successful" steps in that direction was in the area of medical diagnosis. Now it is important to remember that the AI technology would not have emerged had the researchers not been able to recognize the heuristic element in medical diagnosis and see how that element could then be rendered in software, but the result was the formation of a culture that believed that heuristics were all that you needed. One of the worst parts of that result was the extent to which it reflected back on the practices of the medical community itself. There were, of course, plenty of researchers demonstrating that, in just about any discipline, expertise was not a simple matter of heuristics; but they did not stem the growth of a cottage industry based on translating heuristics into software.

There was another factor that encouraged that growth, though, which was a long-standing preference in the business world for efficiency over effectiveness. The reason was simple: You can always measure efficiency. Evaluating effectiveness requires much more human judgment and often entails considerable disagreement. Software can do wonders for efficiency, but effectiveness will always be a matter of the mind sitting behind the computer terminal. Nevertheless, the world of work has been gulped down and masticated to a pulp by the obsession with efficiency. Health care is now an industry where doctors have to "process" their patients, rather than care for them. Public education has a long history of obsession with efficiency that goes all the way back to the early days of Taylor-style efficiency experts with their stopwatches. Now, thanks to the blogosphere, journalists are as much under the efficiency gun as is the kid who takes your order at McDonald's.

I was once at a trade show at which I heard one of the "knowledge management" gurus talking about the need to "process more knowledge more efficiently." All I could think of was how little this guy knew about knowledge. Ms. Goodman interpreted Groopman's findings with proposition that "the enemy of thinking is speed;" but I would like to refine that conclusion. The point that this guru was missing was that you cannot have knowledge without reflection. RSS can now pour all sorts of sources (even credible and reliable ones) onto your screen at a prodigious rate; but, if you do not reflect on what those sources are asserting, you are no wiser that you would have been had you never seen all that stuff. So, the bottom line is that "the world the Internet has made" is a world in which doctors can no longer reflect on their patients' conditions, teachers can no longer reflect on their students' progress, and journalists can no longer reflect on what they read. Good luck, world!