Monday, September 21, 2009

'Why We Make Mistakes’ – A Provocative Look at the Causes of Human Error, or Why There’s a 1-in-5 Chance That a Doctor Will Misdiagnose Your Final Illness

If you drink while studying for a test, hope the exam will be held in a bar

Why We Make Mistakes: How We Look Without Seeing, Forget Things in Seconds, and Are All Pretty Sure We Are Way Above Average. By Joseph T. Hallinan. Broadway, 283 pp., $24.95.

By Janice Harayda

A few days before Halloween in a small town in Delaware, a 42-year-old woman hanged herself from a tree across from a moderately busy road. Her body dangled about 15 feet above the ground and could easily be seen from passing cars, but no one called the police for more than 12 hours.

“They thought it was a Halloween decoration,” the mayor’s wife said as a crowd gathered at the scene in 2005.

Joseph Hallinan uses the tragedy to make a point: Context affects our perceptions of events more than we imagine. Its importance helps to explain why we often can’t quite place somebody we’ve run into: Is he a barista at the local Starbucks? A volunteer at the library? It’s easier to recall who a person is when you know where he belongs. And context involves more than time and place, Hallinan says in Why We Make Mistakes, a fascinating survey the causes of human error. One study found that people who learned while slightly drunk remembered better if they were tested while tipsy.

Hallinan focuses on cognitive or perceptual errors that affect behavior, or factors such as change blindness (an inability to notice shifts in what we see) and overconfidence (a trait that shows up more in men than women and influences the mistakes of each sex). But he writes at times about behavior that affects perceptions, such as not getting enough sleep. And this dilutes slightly the focus of his book, which draws on research in psychology, economics, and other fields. Why deal with fatigue but not with such physical conditions as chronic pain or stress that can also cause errors?

A larger issue is whom the “we” in the title of the book refers to. Hallinan seems to draw mainly on the work of American researchers, and this raises questions when he deals with a topic such as overconfidence. He makes a strong case that “we” are overconfident. But that’s what Europeans have said for decades about Americans, and it makes you wonder if his conclusions would have differed if he’d drawn on more studies of, say, Scots or Hungarians. You don’t know whether this is a book about why people make mistakes or about why Americans make mistakes.

Even so, Why We Make Mistakes is as sobering – and potentially helpful — as it is lively. If you can’t decide whether to get a second opinion about a recommended medical treatment, here’s a fact that could help you make up your mind: Studies of autopsies have shown that “doctors seriously misdiagnose fatal illnesses about 20 percent of the time.”

Best line: No. 1: “Memory, it turns out, is often more of a reconstruction than a reproduction.” No. 2: “Wrong-site surgery continues to afflict untold numbers of patients each year. … One recent survey, for instance, asked hand surgeons about operating on the wrong place; 20 percent of them revealed that they had operated on the wrong site at least once in their careers.”

Worst line: “On the kinds of sophisticated tasks that economists are most interested in, like trading in markets or choosing among gambles, the overwhelming finding it that increased incentives to do not change average behavior substantially. Generally, what incentives do is prolong deliberation or attention to a problem. People who are offered them will work harder on a given problem … though they will not necessarily work any smarter.” This passage seems self-contradictory and an oversimplification of the effect of incentives. If people work harder on a problem, isn’t that a change in their “average behavior”?

Recommendation? Why We Make Mistakes may appeal to fans of the books of Malcolm Gladwell, though there’s some overlap of information with them.

Published: February 2009

Editor: Kris Puopolo

About the author: Hallinan is a Pulitzer Prize–winner and former Wall Street Journal reporter. He lives in Chicago.

One-Minute Book Reviews posts short reviews by Janice Harayda, former book editor of the Plain Dealer in Cleveland. The site is also the home of the “Backscratching in Our Time” series that calls attention to authors who praise each other’s books. The next installment in the series will appear Friday.

© 2009 Janice Harayda. All rights reserved.

www.janiceharayda.com and www.twitter.com/janiceharayda

No comments:

Post a Comment