Fluency and Its Illusions

Although we think of information overload as a contemporary phenomenon, throughout evolutionary history organisms have always had to grapple with a world brimming with noisy data. Ever present and life threatening features such as camouflaged prey, lurking predators, strategizing competitors, invasive species, weather changes, and insecure food supply have always been part of the challenges… Continue reading Fluency and Its Illusions

Plastic Brains

To qualify as a licensed London taxi driver, trainees require comprehensive training and testing that typically takes three to four years. Drivers need to commit to memory and learn the mishmashed layout of approximately 25,000 streets, the location of thousands of landmarks, and the quickest way to navigate between any points in the city. In… Continue reading Plastic Brains

(Mis)matched

The 300,000 year old history of our species is one of migrations made possible by our biological and cultural adaptations. From their East African cradle, homo sapiens now occupy every longitude and latitude of the world. As a generalist species with a penchant for story-telling, socializing, teaching, learning, technology, and engineering, we have transformed our… Continue reading (Mis)matched

The Study of Others

As fundamentally social primates living in and dependent on exceptionally large and heterogeneous groups, other humans are among the most important features of the environment for humans. For humans, having the capacity to infer the intentions, goals, and feelings of others is essential for the Darwinian goals of survival and reproduction. In fact, the networked… Continue reading The Study of Others

The Foggy Road

In his book Surfing Uncertainty: Prediction, Action, and the Embodied Mind, Andy Clark used the metaphor of driving on a foggy but familiar road versus driving on a similarly foggy but unfamiliar road, to the tension between the top-down predictions and bottom-up sensory data. When navigating the familiar but foggy road, memory of that road… Continue reading The Foggy Road

Great Expectations

Visual illusions (see below) provide unique insights into the generative aspects of perceptions and the gaps between perception and reality. They not only illustrate the disproportionate impact our learned and innate knowledge of the world - our priors - have on our perceptions, but also that perception is not a direct reflection of the world… Continue reading Great Expectations

Feelings Felt

We learn early in our education about the five senses - visual, auditory, gustatory, tactile, and olfactory. This processing of information from the “external environment” is termed exteroception. Intermittently, salient sights, sounds, tastes, smells, or touches enter our awareness but for the most part exteroception happens subconsciously. However, the brain not only monitors the external… Continue reading Feelings Felt

Intuitions in the Wild

In reality, there are probably no wild places remaining. The watering hole has a water tank and fences, the lions have identification tags, and are largely habituated to the gawking tourists with binoculars. Analogously, the emergency department has protocols, clinical guidelines, and triage scores. Both environments are semi-wild; neither completely open and wild nor fully closed… Continue reading Intuitions in the Wild

Wild Places

In the Tale of a Springbok, I narrated the story of a springbok approaching an empty but hot desert watering hole in Etosha National Park, unaware of the two lionesses sitting underneath the bush in the periphery. As the scene unfolded, I anthropomorphized and looked on with mixed feelings vacillating from suspense and excitement to… Continue reading Wild Places

Fisheries, forests, & emergency care

In my last essay, I made the case that emergency care in the United States is better classified as a common rather than a public good. Due to the passage of the Emergency Medical Treatment & Labor Act (EMTALA), emergency care became non-excludable and because it is resource constrained, it is rival. Patients are streaming… Continue reading Fisheries, forests, & emergency care

Tragedy of the ED Commons

In his landmark article, Tragedy of Commons (1968), Garrett Hardin asks, “Is ours a finite world? [If so], a finite world can only support a finite population.” In Hardin’s parable, a single group of herders shares a common pasture. The pasture is large enough to support many animals, but not infinitely many. Rationally, each herdsman… Continue reading Tragedy of the ED Commons

The Map is not the Territory

It is hard to even fathom let alone comprehend the size, scale, and complexity of the universe. It takes light 91 billion years to traverse the diameter of the observable universe. That is approximately six times longer than the age of the universe itself. Similarly, the amount of information in the world vastly overwhelms the… Continue reading The Map is not the Territory

The Suitcase of Empathy

Marvin Minsky called words that carry a variety of meanings "suitcase words." Empathy is such a word. Over the last ten years, research into empathy has exploded. The number of research papers in psychological journals, on the topic, has increased dramatically and popular interest in the concept matches what is found in these journals. A… Continue reading The Suitcase of Empathy

Stereotypes

Humans are natural pattern recognition machines. We have an evolved instinct not only to recognize different patterns but also to categorize and store these patterns in order to make future predictions. In fact, this ability to recognize and represent patterns to draw a variety of intuitive inferences could be the defining and most original characteristic… Continue reading Stereotypes

Thrashing in the Emergency Department

The work of an emergency physician is an exercise in multitasking. We see multiple patients in parallel and respond to all the responsibilities that come with this patient care in addition to being aware of new, potentially sick patients. A typical workflow includes signing EKGs of new patients, documenting on a patient encounter, responding to… Continue reading Thrashing in the Emergency Department