Truth hath a quiet breast

All these years I have been naïve, I suppose; I did not question that democracy entailed giving those governed a say in their fate. Perhaps I was not thorough enough in my analysis of the matter, and assumed that this would be obtained when and if a sufficient majority agreed to a particular proposal. But as I grew older and more contemplative, I recognized that merely acceding to the majority’s decision might leave the remaining minority at a disadvantage – disenfranchise them in a way.

I began to appreciate the wisdom of a tripartite system of governance for at least attempting inclusivity. This consisted of the elected members of government to create and uphold laws, the courts to interpret those laws and ensure they were upheld, and a free and unfettered press to inform the governed whether that was indeed happening -holding truth to power, as we now call it.

The naïveté, though, was in believing that simply informing the public of the state of affairs would be sufficient -that the mere declaration of independently confirmed facts would allow people to decide whether or not things were proceeding as they had believed. But it seems I was wrong -starry-eyed, or at least dangerously innocent of the power of confirmation biases in this era of socially mediated information-bubbles.

I am older now, though; I have been left behind, and perhaps the mist of years is beginning to envelope me like a gauze winding sheet. But, every so often, I find a tear in the fabric so I can see the room in which I lie more clearly. And I can smile, and hope that there is a route from the labyrinth that does not pass the Minotaur -or that there is, somewhere, a modern Theseus…

An essay in the Conversation by Kamyar Razavi, a television news producer and PhD candidate at Simon Fraser University offered me a kernel of hope.

He begins by outlining the problem: ‘The news media wield tremendous responsibility over democratic discourse. Yet all too often the media are blamed for fuelling mistrust… News reports typically identify a conflict (a war), diagnose its causes (ISIS) and draw on sources (military analysts) to shed light on what’s going on. But there’s a fourth frame, identified by journalism scholar Robert Entman, that is easy to overlook in news reports — discussing remedies to problems.’ This is so-called ‘solutions journalism’.

‘Solutions journalism tries to change the journalistic equation by giving more prominence to solutions… [but, it] is not about advocating for solutions. It’s about turning a light on the remedies by making them a more prominent part of the narrative… For instance, where a typical climate change story may report on the latest doom-and-gloom statistics about forest fires, a solutions-oriented piece might explore the simple steps you can take to fireproof your backyard and your home. The solutions story still gets you thinking about climate change and forest fires, but in a way that is far more familiar and accessible.’

While disasters capture attention in the news, they seldom help us to think about how they might be avoided -especially if the next day, or even the next column, there are reports of yet another catastrophe. In other words, there seems to be ‘excessive emphasis in news reports on chaos, conflict and all that is wrong in the world —as opposed to what is actually working… It’s this constraining dynamic that can drive people into echo chambers and filter bubbles. It also makes people cynical.’

‘According to McIntyre and Gyldensted [journalism scholars], one of the ways journalists can open up a discussion about solutions is by adding a future orientation to their story — by asking, and trying to answer, the question: “What now? For example, reporters can ask their sources how problems could be solved, how people could collaborate, or what kind of progress their sources envision.” Another technique for drawing out solutions is for reporters to ask questions that get at people’s reasons for thinking a certain way — or that tap into what “the other side” thinks’.

I like this approach, because as Razavi points out, ‘solutions journalism gives people more reasons to think there are ways out of difficult problems — because there usually are.’ Hopelessness does little to encourage solutions -sometimes we need a few flowers.

I will always remember the day that my father died. I was at work at the hospital when my brother phoned, and told me of his not unexpected death at home. I had just delivered a baby, and was sitting in the nursing station writing my notes. Up to then, it had been a wonderful occasion with the husband and their four year old daughter in attendance at the birth. But after the phone call, I found I couldn’t concentrate, and the words I wrote seemed to belong to someone else -seemed, in fact, to describe something that had happened in another life. Another place…

Close to tears, the timing of the two ends of life did not escape me, but the coincidence seemed purposeless. Unfair. The nurses noticed my obvious distress, and smiled encouragingly at me as they hurried about on their never-ending duties. Some of them stopped to ask me why I seemed so sad, but I had trouble answering without giving in to uncontrolled sobs and looked away with a shrug at the questions. I had already told them his death was imminent, so I think they understood.

But as I sat there, staring at the chart with inchoate thoughts swirling about slowly in my head, I felt a tap on my leg.

“Doctor?” a little voice beside me said.

I looked down at the sad face of the little girl who had just become a sister. She was holding a single flower from one of the bouquets in her mother’s room -a white rose, I think. She reached up and handed it to me as a tiny smile crept onto her face. Her eyes twinkled as they locked with mine, and long black curls of hair danced on her shoulders with the movement of her arm. She was dressed in a long white princess dress with silver sparkles that shimmered under the fluorescent lights, and in that moment she reminded me of a latter-day Shirley Temple come to visit.

“Mommy thought you could use this,” she said, the smile growing with each word as the nurses stood around to watch.

And yes, I needed that -it touched me more than I could guess. There is always hope when there is someone to share it with. There is always purpose, even when it seems to arrive like the shadow from a departing cloud.

The Polarization Bias

Okay, I have to admit to living an unbeknownst lie –unbeknownst to me, at any rate. Sometimes it is easy to coast, to accept help where it is offered and feel almost foolishly grateful for suggestions that foster the dependence. Advice is seductive, guidance addictive. But more importantly, it is insidious. Critical thinking -critical analysis- suggests that we process whatever information we are offered by considering its validity when compared with other sources, other viewpoints, other contexts. It is what we should do; it is not what we usually do. Time constraints, biases, laziness –they all conspire to let us float on the tide. Drift.

I suppose my awareness of the current may have started when I was casting about for a book to read. Like many of us, I have a passion for reading that is naively open to recommendations. The online Amazon book store is an almost limitless cornucopia of books. And when you click on one, a section appears just beneath your choice that says: Customers who viewed this item also viewed… And a list of similar books on similar subjects is just a click away: a topic-specific, yet unrequested bounty spilling onto the screen. And all with seemingly different approaches but eerily similar viewpoints to the book you’ve chosen. A coincidence? Or a recognition that you have a particular worldview whose advocates you are more likely to read? And buy.

At first, I was both pleased and amazed that Amazon could find so many different authors and topics that I found compelling and place them before me like a waiter with a dessert tray. So easy to choose from only what is offered –too easy… What I initially thought of as a diverse array of well-considered opinions, I began to realize was an artfully arrayed selection that fostered my already-held biases. A compass that always pointed north, no matter the coordinates.

I suspect that most of us, even offered the choice, would find no compelling reasons to change allegiance, or flirt with opinions we have been taught to mistrust. We feel uncomfortable accepting that the opposition feels the way it does on grounds that are equally persuasive for it. Rather than being open even to thought-provoking alternative ideas, we rust into positions that further restrict our ability to move.

But what if the news we so avidly ingest nowadays could be similarly sorted to our tastes and presented to us as a fair representation of what is really happening? How would we know of the manipulation? How could we become aware of the slanted viewpoint when it so closely agrees with our own –when it is what we want to hear? Confirmation bias is difficult to resist even at the best of times.

I hadn’t realized that many people actually read those snippets on Facebook that purport to inform. I had thought most of them were not terribly well disguised ‘infomercials’, but perhaps that is my bias -the boreal plain to which I am unwittingly confined. But that our serving of news should be chosen for us according to our likes and dislikes is anathema. And that our meal of information should be expurgated and mashed into a small, more easily digestible aliquot of words smacks of propaganda. Control. Handling… I would like to digest unchewed information in my own way, thank you. I can deal with heartburn; I’m not good with starvation.

The dilution of mainstream media and its as-yet relatively unfettered ability to pretend to present both sides of an argument is worrisome. Similarly, the accretion of our sources of information into a few huge monolithic blocks with their own interests to serve is dangerous. Especially when they presume to know what opinions will keep us quiet.

“Let every eye negotiate for itself and trust no agent,” says Claudio, in Shakespeare’s Much Ado About Nothing. Bravo!

Another Advantage of Breast Feeding?

As Mark Twain observed: What a good thing Adam had- when he said a good thing, he knew nobody had said it before. I don’t know about you, but I am getting tired of the media reporting on studies that contain nothing new and passing them off as fresh and enlightening. Even more upsetting is the fact that we often don’t even notice -or care… Studies that say nothing fresh or merely recycle what we already know, do not contain information so much as noise.

Time, then, to ask a more searching question: why is it important that we study this? And this is not to denigrate pure science, nor to suggest that investigations that are not directly goal-oriented are worthless. There is much value in answering the question by asserting that we were simply curious how it worked. Or why. Or under what circumstances -all of which are adding to our understanding of the world. Curiosity, after all, is merely a yet-unaswered question. A piece of the knowledge jigsaw puzzle. And its answer may well be worthy of reportage…

But to investigate the wheel and then conclude that it likely works by rolling, does nothing to inform. Indeed, publication of the results does little even to entertain, let alone educate… Or perhaps it does entertain -like those endless cat videos on Youtube, maybe there is value to a mindless occupation of the time that stretches between otherwise meaningful events. But the whole endeavour smacks more of playing cards until someone turns out the lights…

What is it that has me so vexed? So frustrated at banality uncleverly disguised as news? Well, I happened upon an article in the BBC ‘News’ about breast feeding and how it decreased the risk of depression.   It seemed a reasonable hypothesis; almost 14,000 mothers were studied and the results published in the online journal Maternal and Child Health (Aug. 21/14).

It’s a rather complicated statistical paper, but in summary it suggests that the risk of depression after delivery decreases considerably  if the mother was healthy to start with, intended to breast feed and found that she could. Okay, I could have predicted that. But, if she had been healthy, intended to breast feed, but found she couldn’t for some reason, her risk of depression more than doubled. Oh yes, and they found that  “the beneficial effects of breast feeding were strongest at 8 weeks after birth and that the association was weaker at  8 months and onwards.”  Uhmm… am I missing something here? Has something hitherto unsuspected slipped past me? Something, at least, that would change attitudes to breast feeding, or management plans for pregnancy?

Post partum depression is a serious problem in our society, with up to 10% (or more) of women at risk. That’s why we screen women during early and mid pregnancy to anticipate that risk and attempt to set up support systems for those who we judge are on that path. Anything that might ameliorate the danger is therefore a valuable addition to our management strategies. I’m not sure this study has even re-invented the wheel, however. It seems to demonstrate that if a mother’s plans work out, she is happy, if they don’t, she isn’t… Is it helpful to know this? Perhaps -but does it change anything? I suspect we will all continue to encourage mothers to breast feed and regard the oxytocin it engenders -the bonding hormone- a plus. But not an unanticipated one. Nothing has changed…

But then again, maybe constant reiteration –permananent recycling- is what we want. What we deserve…Maybe a society that tolerates laugh-tracks on comedy programs to help them to know what is funny, and that thinks apparently spontaneous applause in a talk show demonstrates the merit of the discussion, needs to be apprised of the obvious.

Am I being too cynical? Too arrogant? Well, perhaps. And yet…

It was early Thursday evening, and I was sitting in the OR lounge waiting to do an emergency operation. A surgeon and her resident were sitting nearby, their faces glued to the ever-changing TV images in front of them. I thought at first it was a talk show but they were staring at the screen as if it were a parental avatar, their expressions religious, their attention rapt.

I had been too preoccupied until that point to notice, but they seemed so intense I suspected something of profound significance was being discussed so I turned to watch. It was actually a cooking show and some celebrity that I didn’t recognize was being shown the basics of barbecuing a hamburger. “First, you want to get the grill good and hot,” the serious looking man in the chef’s hat was saying, pointing at the thermometer on the hood. “Then, you carefully place the patty on the grill –use a spatula with a long handle so you don’t burn yourself- and sear one side just enough to keep the juices sealed in…” He said this in a hushed and reverent tone as if it were one of the Ten Commandments. The studio audience clapped in delight at this little pearl of wisdom, and I noticed the surgeon restraining herself from doing the same. Her resident, ever mindful of imitative protocol, actually did manage a clap after glancing furtively at her mentor.

The surgeon suddenly became aware of my presence in the room and smiled with an expression I used to see in church after a sermon. She seemed surprised at my composure in the face of the Revelation. Or maybe annoyed that I hadn’t understood. Actually, I was disappointed; I felt as if I’d just been told the earth was round.

And it wasn’t even the vapidity of the program that made me remember the incident –maybe some people don’t know how to barbecue hamburgers, so maybe the show deserved prime time. Maybe the information it contained truly was important and not just another example of mildly entertaining celebrity fluff. Not having watched what went before, perhaps it was just an inter regnum… But no, it was more the reaction to it. The surgeon and her acolyte seemed overly awed by its significance -as if they wouldn’t have been at all surprised if it were the subject of a research paper in a prestigious journal.

I suppose the depressing reality is that it is me who is so far off-kilter that I cannot appreciate something of value. That I mistake the important for the banal. Knowledge for noise. But I can’t help wondering who decided that a celebrity learning how to cook a hamburger should occupy prime time. Or wondering why a study showing that people may get depressed if things don’t work out as they planned surprises anyone.

We all need a time out, for sure: a time when we just unbutton the brain and let it sit on the couch beside us eating popcorn. But surely we also need a time in. I’m with Shakespeare on this: We know what we are, but know not what we may be.