Reflections on the Bell Curve


We -many of us in the Western world at any rate- live our lives on a Bell Curve, thinking -hoping- we occupy a place near an out-lying position: the 5% area that presumes we are not just normal,  but rather, exceptional… And given the population numbers, there is time spent worrying that we are inadvertently drifting towards the center -the average- and hoping that we are somehow firmly anchored on an edge where interesting things happen. We seem to aspire to live in interesting times, despite the doom that these times apprehend in the apocryphal Chinese curse.

It is a mild conceit, perhaps, but one that is not without ramifications: to discover that one is, in fact, quite average is inevitable as one travels through an otherwise eventful life, but to realize it too soon, may be to hold an imperfect mirror up to what had hitherto been seen as important and to distort an otherwise perceptible, measurable -believable- reality. It may denigrate the path, impute the incentives that had determined the choice.  Purpose maligned is purpose denied. We are, to an extent, our choices and we choose what we hope -or expect… 

Or do we? My interest was stirred by an otherwise banal finding in a study reported in the Huffington Post: that ‘dreading pain may be more unpleasant than the pain itself’.( http://www.huffingtonpost.com/2013/11/24/dreading-pain_n_4318114.html ) Uhmm, okay… I mean, how new is this? Let me quote from a 16th century poem (Sir Philip Sidney) that already recognized that: Fear is more pain than is the pain it fears. Plus ca change, eh? But it made me think that how we perceive things is highly conditioned by our expectations of them. Or dread of them.

Think of an impending biopsy, for example, where the result -not volition- may determine the direction of the road ahead. It is when the Bell Curve becomes an albatross, and not a presumption. Although pain and the anticipation thereof was what was examined, it seems to me not a large step to posit that the study would also suggest that we often see ourselves on the wrong end of the 5% -the wrong side of the curve- and the pain varies according to how anxious we are about the result of the test. Even though the likelihood is one of benignity and we have been reassured to that effect, that is not how we feel it beforehand.

Or consider childbirth, with all its attendant myths and worries -pain not being the least of these, of course. That it is a process which has been enacted countless times without incident, or that -hopefully- it will be supervised with expertise and thoughtful care seems of little import until it has happened.  One’s Bell Curve position, in other words, is only of value in retrospect and seems not at all meaningful until it is history.  As a result, we may enact the expected pain or imagined problems over and over in our heads until it clouds our judgement,  or engenders choices that might otherwise have lain fallow.  I’m thinking here of the woman opting for an elective primary caesarian section for the delivery of her first baby, for example -chosen largely through fear of the unknown, fear of the unexperienced, fear generated by the uncontextualized tales of friends. Or even the decision to forego an attempt at a trial of labour after a previous caesarian section because of an anticipated repeat of similar circumstances.

And yet, is this telling us anything new? Well, probably not, except that much of our anticipated discomfort may be misplaced, or at least magnified more than necessary. Of course some of it stems from nescience -a rather obtuse, but kinder term for ignorance -a state that a doctor, say, might hope to ameliorate through patient explanation and reassurance and an exploration of the person’s reason for the anxiety. Spending time with them, in other words…

But sometimes -often, in fact- the anodyne seems to be in getting on with whatever needs to be done -and sooner rather than later, according to the study. Of course this is not always possible -and not even usually possible in obstetrics- but the concept, where feasible, still seems both appropriate and preferable: scheduling the surgery or other treatment at the earliest opportunity, putting the person on a cancellation list to expedite the procedure if there is not a more proximate possibility, triaging operative timing to take into account other factors than merely when they were first examined in the office. Even to be seen to be trying to take her worries into consideration may be anxiolytic… Although I am not overly hopeful; we are who we are: There was never yet philosopher that could endure the toothache patiently -an observation from an earlier but likely more widely read study: Shakespeare’s Much Ado About Nothing...

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