Blink

Long time readers know that I am a huge fan of Malcolm Gladwell. I just finished listening to his new book – Blink! and can recommend it highly.

1. What is “Blink” about?

It’s a book about rapid cognition, about the kind of thinking that happens in a blink of an eye. When you meet someone for the first time, or walk into a house you are thinking of buying, or read the first few sentences of a book, your mind takes about two seconds to jump to a series of conclusions. Well, “Blink” is a book about those two seconds, because I think those instant conclusions that we reach are really powerful and really important and, occasionally, really good.

You could also say that it’s a book about intuition, except that I don’t like that word. In fact it never appears in “Blink.” Intuition strikes me as a concept we use to describe emotional reactions, gut feelings–thoughts and impressions that don’t seem entirely rational. But I think that what goes on in that first two seconds is perfectly rational. It’s thinking–its just thinking that moves a little faster and operates a little more mysteriously than the kind of deliberate, conscious decision-making that we usually associate with “thinking.” In “Blink” I’m trying to understand those two seconds. What is going on inside our heads when we engage in rapid cognition? When are snap judgments good and when are they not? What kinds of things can we do to make our powers of rapid cognition better?

Blink features 2 physicians who I know well – Wendy Levinson (she has very interesting data on why some surgeons get sued – and it is not about errors), and Lee Goldman (who developed a decision algorithm for chest pain in the ER). Their work makes important points about how we make decisions, and who we can err.

Blink provides a different view of decision making. It explains why experienced physicians can perform admirably in crisis situations – and why novices cannot (it is not about knowledge). It discusses our “intuition” – or the skill of recognizing that someone is sick just by looking at them for a second.

I would highly recommend reading this book to better understand the principle of complex quick decision making. I was entertained and believe that I learned important new ways of looking at how we function as physicians (although that depends on personal inference).