Perception and Paradigms
“In the long run men hit only what they aim at. Therefore, though they should fail immediately, they had better aim at something high.”
- HENRY DAVID THOREAU
Making Perception and Paradigms Real
Perception is the meaning we attach to what we see, hear, touch, taste, or smell. If we smell smoke, we assume something is hot or burning nearby. We know that someone is at the door when we hear the doorbell. When driving, our time to cross the intersection comes when the stoplight turns green. If we get cold, we know to put on a jacket. This is how perception via the five senses informs us of the world.
We rely on the senses to inform us about our surroundings, but we use our intellect to attach meaning to the information. When we have the same experience, over time, we come to assume that certain facts are true. In medicine, we assume a fever indicates an infection. Pale, cold, and clammy skin may indicate blood loss or shock. A certain rash indicates chicken pox, and a red and coated throat suggests tonsillitis.
There are many facts that nearly everyone accepts as truth. We assume that aging is inevitable. We assume we cannot avoid stress-related diseases like high blood pressure and ulcers. We assume that high cholesterol, obesity, lack of exercise, or high-risk behaviors are unavoidable. Conventional popular wisdom – and often medical wisdom - teaches that the best we can do is cope with these problems.
The sum of all our assumptions defines our view of the world - and how it works. We call this world view our paradigm. Our paradigm thus depends upon the assumptions we hold to be true. Our paradigm affects us deeply in how we think about ourselves, other people, the environment, and decisions we make every day.
If we assume that anyone we do not know is potentially dangerous, our behavior will reflect that paradigm. Someone seeing the world that way will not speak with or even look at strangers. That person will be unlikely to offer assistance to a stranger, who they see as a potential threat. If enough people adopt this paradigm, human relations will be chilly and distant.
The opposite world view or paradigm has equal implications. If we assume that other people – strangers or not - are generally trustworthy and potential friends, behavior will reflect that paradigm. Such a person will readily engage in eye contact and verbal exchange with other people. They will also be more likely to help others when needed. If enough people adopt this paradigm, human relations will be warmer and more positive.
Our paradigm thus defines how we see ourselves, other people, and how the world works. Examining the current paradigm of medical care is critical to understanding the problems we face today. Through examining today’s medical paradigm, we will better understand where we are and how we got there.
Changing Paradigms for the Better
The paradigms of patients, doctors, and scientists are no different from those held by any group of people. Human beings establish paradigms slowly, over time, through the experience of people facing similar situations.
In business, industry, and medicine we often say, “there is no point in reinventing the wheel.” That phrase makes it clear that people – if they are smart – learn from the experiences of others. They learn what works to achieve goals – and they learn what does not work. The application of this principle is common knowledge. Would anyone want to ride a horse coast to coast when they can take a plane and complete the trip in hours?
Breakthroughs in science, technology, or thought make big changes in our paradigm. When Thomas Edison invented the electric light bulb, it lit up the night. Suddenly we could read at night, work at night, and even attend baseball at night. When Henry Ford made the automobile available to the public, people could travel anywhere - even coast to coast. When the Wright brothers flew their airplane at Kitty Hawk, they set the stage for easy travel throughout the world. All these breakthroughs made things possible that were previously impossible. The world changed, and so did the paradigms associated with those advances.
Thomas Kuhn wrote about changes in the paradigm of scientists in his book The Structure of Scientific Revolutions. Kuhn argues that scientists share common assumptions about the world. They agree how the world works, no matter what their area of science. The physicist, astronomer, and geologist have very different fields of study - but they share the same common knowledge about the properties of matter, energy, chemical reactions, and similar principles.
Kuhn points out fundamental changes in paradigms through the course of history. Breakthrough discoveries change basic assumptions. Before modern astronomy, the Ptolemaic view of the universe held that the sun, moon, stars, and planets revolved around the Earth. This view was the dominant paradigm of astronomy until the sixteenth century. Galileo, Kepler, and Copernicus proved that the sun was the center of the solar system.
Only after a lot of religious and political struggle did the world’s paradigm change. Kuhn calls this kind of radical change in thought a paradigm shift.
Changing paradigms are the foundation of Stephen Covey’s best-selling book The 7 Habits of Highly Effective People. This book continues to revolutionize the business world. Covey teaches that reexamining our most deeply held values is very important. Only by changing our way of thinking can we improve our lives, our families, our businesses, and our world. Covey shows how our paradigms define how we structure and live our lives. He writes:
“The United States today is the fruit of a paradigm shift. The traditional concept of government for centuries had been a monarchy, the divine right of kings. Then a different paradigm was developed - government of the people, by the people, and for the people. And a constitutional democracy was born, unleashing tremendous human energy and ingenuity, and creating a standard of living, of freedom and liberty, of influence and hope unequaled in the history of the world .”
These are stirring ideas. We need to connect with all this and apply it to the paradigm of medical care. Stay with me and we will take these ideas further.