Two things got me thinking about certainty, uncertainty and risk on the way to work today.
First off, as I started to descend the two flights of concrete steps to the low-level platform at Queen Street Station, I heard this disembodied voice of a Scotrail employee saying “Customers are reminded to take care on the stairs and use the handrail provided”. I realised that they’d installed an automatic system which would play this message repeatedly every time somebody stepped onto the staircase. AAAAAARRRGGGHHH! I felt like shouting! “Thankyou for reminding me! I was just about to throw myself recklessly head-first down your concrete steps cocking a snoot at your shiny metal handrail! I won’t do it now! You reminded me just in time!” Good grief! What next? What with hot water taps that have warnings that say “This water is hot” (!!! Really???!!) So, that was my first thought. What is all this about warnings of all the terrible things that might happen these days? A variation of this same theme is surely those government bods who reckon they can keep us safe from terrorism by confiscating toiletries and baby milk before people get on planes!
Then I get on the train (having successfully managed yet again to negotiate a whole flight of stairs without falling down!) and I pick up a copy of the free newspaper “Metro”. My eye is caught by a piece about genetic tests to predict what diseases we might get, and here’s this quote from a woman in England who has a family history of breast cancer and she’s saying how great it would be to have genetic tests that told us exactly what diseases we were going to get and goes on to express her preference for the development of tests that would tell you exactly when you are going to die too!
What do you think about that?
Would you like to have a test that would tell you exactly what disease you were going to get and your exact time and date of death? (Of course, no test in the world will ever predict the chances of you dying in an accident – make sure you pay attention to that Scotrail message when negotiating stairs!)
But, seriously, do we want such certainty? Do you?
In Reckoning With Risk, Gerd Gigerenzer, repeatedly returns to Benjamin Franklin’s aphorism
In this world nothing can be said to be certain, except death and taxes.
But this really is at the core of a tricky issue. As far as I’m aware, human beings are the only creatures endowed with an imagination capable of enabling them to imagine their own deaths. Psychologists say that all fears are, at source, ‘existential’ fears (the fear of death, of ending, of non-existence). This knowledge of this one certainty can make life difficult for people. Many people consult doctors because they are afraid that a symptom is a feature of a mortal disease. Many people are trapped in routines because they fear what might happen if they try something different, or stray into previously unexplored territory. We even have a certain type of “scientist” who seeks to present every one of their findings and opinions as the certain Truth, and there are goodness knows how many experts who reckon they know for sure what is best for us!
OK, I accept that I need security in life. We all do. If I really couldn’t reasonably expect to travel to work tomorrow why would I even set out? But these things are variables and probabilities. There really are no guarantees – well, except death and taxes (Benjamin was right again)
Tell me what you think.
How much do you want certainty? What kind of risks are you prepared to take?
Heroes Not Zombies 
“Would you like to have a test that would tell you exactly what disease you were going to get and your exact time and date of death?”
Interesting—a short while ago somebody held a fiction writing contest where the premise was that all stories had to feature a machine that would tell you the nature of your death (although not the date nor time).
Personally I think I’m okay with uncertainty. Often I think that “security” is often something of an illusion, or at the very least an incredibly fragile state of affairs.
To a certain extent I think an increased awareness of uncertainty isn’t such a bad thing; people get used to security and they think they will be secure forever. This makes them perhaps somewhat careless and even perhaps somewhat calous. I think arguably even the way we mistreat the environment is due to a (false) sense of “security”, i.e. “We’ve pretty much mastered Nature, and it will be there for us forever.”
Not knowing, say, the time and method of your demise seems preferable if what you’re after is just keeping everybody happy – knowing you’re going to die and that you can’t prevent it tends to make you kind of depressed. But if you have the ability to learn it, it seems kind of dishonest not to find out. You pretend to yourself that you have control over something that you don’t have control over. Of course, this all assumes that it would be possible to have a machine that gave the time and method of your demise, rather than just probabilities.
gukseon, I agree with you that security is to some extent an illusion, but, actually, I guess you could argue that security is secure and real until its not! OK, that sounds odd, doesn’t it? What I mean is that security is probably nothing other than a state of mind – but its a real experience – if you feel secure you are secure – until, of course, something comes along and takes that state away……but once that happens you are now in a different state of mind – insecurity. Both are real and both are illusions so to speak. I’m OK with uncertainty too. In fact, in my General Practitioner training it was made clear to to me that a core skill a GP needs is the ability to handle uncertainty…..so I guess my training worked! Your last comment reminds me of some of the writings of Mary Midgeley, the English philosopher who makes the very clear point that our thought processes which lead us to think of ourselves as apart from Nature rather than an integral part of it are what lead us as a race to believe we can control or dominate the rest of existence.
Ah, Turin, you make such a good point here – the thing about being dishonest not to find out. This is such an interesting issue. See, I reckon that anyone who claims to be able to accurately predict your future is kidding themselves – whether they use genetic analysis or read tea leaves – so really nobody should be at all worried about NOT “finding out” (I just don’t think it’s something that CAN be found out!)
Hmmm…I think you’re exactly right about security, Bob. I suppose it’s very similiar to (perhaps directly linked to?) confidence: feeling confident is being confident, just as it is for security. I’m sure as a GP, how one handles security is a skill that could make or break you.
I haven’t heard of Mary Midgeley, but I’m something of a proponent of that view of Nature myself… 🙂
For that matter, re: Hurin’s comment, I’m reminded of people who are informed “You have six months to live” and manage to hold on for another year (at least). I suppose any field, we are always dealing only in probabilities…?
Most of us live in a fear based society, with media and marketing targeting our greatest vulnerabilities, and bombarding our subconscience with ‘what ifs’. ‘doctors warn…’, ‘researchers say…’, etc. Uncertainty sells everything from vitimins, to newspapers, to tummy tuckss. It’s no wonder that so many people struggle with anxiety related disorders and associated illnesses.
I once went to see an old psych. teacher upon struggling with some post traumatic type issues after caring for my father during his terminal illness, and after witnessing his death. The death haunted me, and fears and anxiety started controlling my existence. I’ll never forget his first words. “I hate to be the one to tell you this, but I have some news for you. You’re going to die.” We laughed about it, but we got into great convos about uncertainty how it can torment souls. It’s just one of those animals that can be gentle and tame or viciously wild and dangerous, depending on how we approach it.
gukseon, oh absolutely I agree about the probabilities. I FREQUENTLY see patients whose lives are much longer than predicted by by some “expert”. Actually, think about the great Stephen Hawking – he has Motor Neurone Disease – usual predictions are an average life span of TWO years after diagnosis – he was diagnosed over FORTY years ago!
Hey, damewiggy, I was just thinking about you earlier today! How nice to see you back. I hope you’re doing well (must pop over this evening and peruse your blog!) Thankyou for this comment. As insightful and wise as ever! How lucky you were to meet that teacher after your father’s death. Actually his “bad news” reminds me of graffiti I once saw in the toilets at Med School in Edinburgh –
“Life is a sexually transmitted disease – and it’s fatal!”
[…] 16th, 2007 by bobleckridge Having just blogged about living with uncertainty, I stumbled across this […]
scary future if we all have the doom future told to us before we even have a chance to prove it wrong. Reminds me of the Gattaca movie, “discrimination down to a science”.
First of all, let me say your (minor) conniption over the safety message had me giggling. I use the term “That makes me bitey!” for such annoyances. (Picture a fed up cat, tired of being harassed/teased. I wouldn’t really bite, but I sure feel as grouchy as I imagine the cat to be.) I think it is fear of litigation actually, that causes such warning signs and audio messages to appear. Somewhere, someone was *that* stupid, and they sued. *sad* I read a stellar example of this some years ago. A receptionist had a prickly pear type cactus on her desk/counter area. One of her co-workers grabbed the cactus. Later, they came to the receptionist claiming the cactus ATTACKED THEM! (The disconnect displayed there amazes me.) The receptionist responded by making a sign, warning about the cactus. I’ll upload it and put a link to the image here. It’s funny, but sad and scary at the same time.
Re: Wanting to know how and when I will die.
Absolutely not! I’ve been explaining to people that, due to the fact that my mother had congenital (sp?) cerebral aneurisms, I *DO NOT* want to know if I also have them. (I was a late life child, she was 40 when she had me, and she was born in the Great Depression and didn’t get enough nutrition to thrive as a baby.) I’ll add a proviso. If the doctor is ABSOLUTELY CERTAIN that the aneurism can be operated on, with a good success rate of fixing the problem, then I’d want to know. My mother suffered forty years of anxiety not knowing if “today” would be her last day.
For most of those years, they were considered inoperable. Only recently did technology allow for surgical repair measures. One of them was repaired with a stent successfully. The other two (behind each eye) also had repair attempts made. I cannot say how successful the measures were. They put a clip on her right aneurism, and occluded her left carotid artery. (She had good enough circulation to allow this.) But, the day after getting out of the hospital, her right cerebral aneurism gave. (I think the aneurism would have given, no matter what. It was very delicate, and very distended. I could tell the doctor was anxious about it.)
She had a day of laughing, going to Cheyenne Bottoms with my big brother, my parent’s dog, and my brother’s dog, listened to a new classical music CD I’d given my parents, had chocolate cake for dessert, then the aneurism burst. She also got to see her beloved first cousin on the way home from the hospital as well. Mom also said she had no more incurable headaches, which is why she opted for the surgery in the first place, and she was able to “take” a lot of pain.
Ester, I agree with you – I don’t like the idea either. Thank you for reminding me about Gattaca – haven’t watched it for ages but I did enjoy it. Actually I’ve just finished reading a book called Links about the science of networks which I really enjoyed and which makes it clear that those who think they can make accurate predictions from the presence or absence of certain genes are somewhat deluded!
Kat, the litigation thing is such a phenomenon isn’t it? Once on holiday in the US I saw a bumper sticker that said “Do a lawyer a favor, send your son to Med School” …..ho, hum! I love this whole thing about “warning messages” though – we have motorway signs which are LED display messages to tell you about road works, accidents and so on, but when they’ve nothing else to tell you they have these really stupid messages like “Don’t take drugs and drive” and I think who ever saw that message and changed ANYTHING? Was there ever some junkie speeding down the motorway who saw that and thought “Oh my God! This is such a stupid idea! I’ll stop taking drugs straight away!”
That’s quite a story, Kat, thanks for sharing it. I think it illustrates beautifully how every person’s experience is unique and how we should always do our best to facilitate a patient’s choices. That last day sounds very, very special.
I think your point about living with the anxiety which knowledge of a hidden pathology can cause is well made and, I fear, is not considered nearly often enough by the medical profession
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