Published on January 6, 2009
Reader: Please feel free to use any of the models presented in this speech. I only ask that you give me credit when doing so. Thank you. Science, Risk, and the Tower Of Babel: Breaking Down Communication Barriers in the Post-Enlightenment World by Mark Schannon Management and Communications Consultant Presented to the Department of Environmental & Occupational Health, George Washington University School of Public Health and Health Services, January 21, 2004 I’d like to thank you for inviting me to speak before you today. It’s a pleasure to talk to scientists, to people grounded in rational discourse. In your field, in particular, you have to live with bizarre behavior everyday. When issues of environmental or health risk arise, people reject science, reason, and logic, and substitute some bizarre logic of their own devoid of all reason. Doesn’t it feel good to hear that? For all our training in risk communication, don’t we somewhere, down deep, just wish people would stop being such morons when it comes to science? Good old reliable science…such as epidemiology and toxicology. Nothing weird there. 22 epidemiological studies to prove that silicone breast implants were safe? Where were you during the first 21? Out having a smoke when the Fedex truck pulled up with the findings? Did it break some chain of custody, like in a police investigation? “Oh well, we lost the chain of custody, let’s do study number 18.” Is this the epidemiologist’s equivalent of a full-employment act? Must be. Earlier this month, on January 9th, the Food & Drug Administration rejected the findings of its own expert advisory panel and called for more studies of silicone breast implants.
Cynthia Pearson, executive director of the National Women’s Health Network said, “Today marks a great day for women…we are pleased that the FDA stood firm on the need for good science.” Good science. Sure. And toxicology. I once worked with the fiberglass manufacturers when I think it was two…no three people raised the issue of fiberglass being as dangerous as asbestos. So they did rat studies in Europe. They killed so many rats, the fleas filed suit against the industry and the toxicologists for habitat destruction. And now we’re told to worry about farm-raised salmon. The FDA’s tolerance level for PCBs in salmon is 2000 parts per billion—55 times higher than that found in the farmed fish. Irrelevant says the Environmental Working Group. Those silly environmentalists. And then there are those silly CEOs. Take for example a CEO whose company had an environmental accident. It was news. Lots of coverage. But it wasn’t a crisis. Where was our CEO? Hiding in New York under his desk, for all I know. After a week, he emerged to condemn the environmentalists for needlessly alarming people, the coast guard for incompetence, and a drunken sea captain for running his boat aground: The Valdez. The CEO, Lawrence Rawl, did more to turn the Valdez incident into the symbol of modern corporate environmental insensitivity—and a world-class crisis—than all the others players combined. Let’s face it, human behavior is one of the most inexplicable phenomenon in the world—people make quantum physics look downright logical. It’s Not People, It’s PR Theories & Models Or is it? My purpose today is to suggest that people may be fine; maybe it’s the model we’re using that’s weird. Emerging findings from fields as diverse as economics, psychology, neurology, mathematics, and even quantum and chaos theory—are shattering 300 year old cherished beliefs about people. But people, including you and me, will hold on to cherished truths long after they’ve been shown be to cherished illusions, which is what led me to set out the three objectives for my talk today. 2
First, I want to introduce these new scientific theories and how they force us to rethink much of what goes on in the business or academic world…or in our personal lives for that matter. Second, I will argue that you and I are as rational and objective as those misguided souls who panicked when that renowned epidemiologist, Meryl Streep, warned them about Alar. Remember mothers chasing after school busses to grab the apples out of their kids’ lunch boxes? And, finally, I want to introduce new models for understanding and breaking down the barriers—the resistance to scientific methods for assessing, managing, and talking about environmental and occupational health issues. The title of my speech is “Science, Risk, and the Tower Of Babel: Breaking Down Communication Barriers in the Post-Enlightenment World.” A mouthful. Science, Risk, and the Tower of Babel: We’ve all seen it. Despite the outstanding work of people like Vince Covello, Peter Sandman, and others, we often can’t break through the outrage we so often confront. How often do you feel trapped in a modern-day Tower of Babel, making sounds that you think are intelligible but that are incomprehensible to your audiences? And the Post-Enlightenment World? What this diverse body of science is telling us is that the “Age of Reason” is dead. Human beings are not rational animals. In fact, in a New York Times article by Sandra Blakeslee in February 2002, she wrote, “In navigating the world and deciding what is rewarding, humans are closer to zombies than sentient beings much of the time.” What an extraordinary statement. I don’t feel like a zombie. Anyone here feel like a zombie, raise your hand. What then does it mean to give up the fundamental belief system of the Age of Reason? At its core, we have woven into the fabric of our lives the belief that it is possible to be rational and unemotional. After all, emotions contaminate reason, which is why we get so annoyed when people act irrationally in the face of sound science. However, I will argue that rational discourse is an 18th century illusion that still plagues us in the 21st century. 3
Two caveats before we dive in: This science is new and it’s controversial. The value is that it explains behavior—including my own—that I previously simply could not understand, such as why change is so hard, what really causes people to have tin ears, why businesspeople acknowledge that their approach to crisis management is flawed but continue it anyway…among others. I had no frame of reference in which to make sense out of it. My frame isn’t complete, but it’s getting there. The second is that I can only introduce some of these findings and sketch out their implications. There’s simply too much information. So my goal is to whet your appetitive, get you to consider that there may be another way to look at the world, and set you off on your own journey of discovery. The Illusion of Rational Thought Driving Behavior Let me return to the illusion of rationality, to the fundamental assumptions we make about how we take in and process information, how we form opinions, values, emotions, and behaviors, why we resist change, and how we react to risks and rewards. What are these assumptions? • People can consciously make rational decisions about important things in their lives. • We know why we have specific beliefs, emotions, and opinions. • With the right motivation, people will consciously decide to change their behavior. • Reason and emotion are separate brain functions. • One of the worst is that the world is fundamentally linear and that human interactions obey the law of cause and effect. All of these are false. The problem is that behavioral change can precede conscious awareness. In fact, we may go on for years not even knowing our behavior has changed. 4
Dr. Timothy Wilson of the University of Virginia, has said, “This unconscious part of us processes data, sets goals, judges people, detects danger, formulates stereotypes and infers causes, all outside our conscious awareness.” Freud and Jung must be dancing in their graves. It gets worse. Daniel Kahneman, the co-winner of the 2002 Nobel Prize in economics, has said, “When asked why they have certain attitudes or behavior, people will create a logical chain leading to the attitude or behavior, but it is likely to be wrong.” When we were working with Firestone during the Explorer rollover crisis, consider that about 150 people died over a ten year period, compared to over 40,000 dying every year of traffic accidents. And yet, many people wouldn’t put Firestone tires on sedans, arguing that it just wasn’t worth the risk. They would create a logical explanation for their behavior, but, as Kahneman and others would argue, it wasn’t the real reason. Here’s the hard part. He’s talking about you and me as well. I was once speaking to a medical devices management committee just after the worst of the Firestone crisis, and I conducted a thought experiment. I said, let’s assume that after my talk, you all suddenly are consumed with this need to go out and buy a car. Raise your hands if you’d specify Firestone tires for that car? Not one person, including the scientists, raised a hand…then they all looked at each other sheepishly and started to laugh. New Hypotheses Based on New Science Let’s turn to some of these new truths—well, perhaps we’d better call them theories or propositions. Kahneman has uncovered three important unconscious factors that shape the formation of our judgments: First, people fear losses much greater than they desire gains. For example, when faced with a risky medical procedure, if people are told, “90% survive this procedure,” many more will select it than if they’re told “There’s a 10% chance you won’t survive the procedure.” 5
Irrational? No. It’s how our unconscious is wired. Think about the implications for risk communication. How often when a product is under attack does a company promote the benefits rather than directly address the risks? And how often is that successful? Firestone tried it for a while, and it backfired, making people even more angry. Imagine that you’ve been giving your child vitamin supplements, and an article appears linking the vitamins to liver damage. You haven’t seen the study. It’s the first you’ve heard of it. What do you want to hear from the manufacturer? How the vitamins build strong bodies 12 ways—or credible information about the allegations? How would react if the company issued a statement saying there was nothing to worry about? Would you keep giving your kid the vitamins? The second finding: Vivid examples are more powerful in shaping opinion than less dynamic, but more accurate, information. We know this. Corporate executives know this, but they’re programmed to be calm and unemotional which comes across as insensitive, arrogant, and suspicious. During the chlorine wars in the early to mid ‘90s, the environmentalists showed pictures of deformed frogs, they cited studies of decreased sperm counts, recounted stories of developmentally disabled children—all tied to exposure to chlorinated compounds. Industry responded with typical business babble, citing science, hiring third-party experts, and being as interesting as dried lava. Thankfully, some companies rise to the challenge. When we were working with Dow Chemical on the breast implant crisis, we found a female medical doctor who had had very serious medical problems similar to those of the women with implants. Except she never had implants. She was one of our best spokespeople. She never argued the pros and cons of breast implants. She simply told her story. She and her husband, who was also a medical doctor, went to 13 different specialists before they finally diagnosed her problem: Lyme disease. Her message: Don’t stop looking for the cause and don’t let your lawyer be your doctor. It was vivid, real, and compelling. But that example is all too rare. In fact, if all the world’s a stage, business people are some of the worst actors on it. 6
Kahneman’s third discovery was that first impressions shape subsequent judgments regardless of the evidence against them. I won’t go into this in detail, but think of the legal implications. In the court of public opinion, you’re guilty until proven innocent, and it’s those people who have already found a company guilty who make up the jury. Timothy Wilson has written, “We often unconsciously bend new information to fit our preconceptions, making it next to impossible to realize that our preconceptions are wrong.” Remember the Monarch butterfly/genetically engineered BT corn controversy? As Val Giddings of the Biotechnology Industry Organization noted, “By the time a good study came out demonstrating that the butterflies were fine, it was too late. My guess is that people will forever cite the toxic effect on Monarch butterflies.” We’re now faced with the challenge: Given these barriers that people unconsciously or consciously erect, how do we break through them? I want to discuss three concepts:, Understanding Ourselves, Understanding our Audiences, and New Dynamics in Risk Management and Communication. Understanding Ourselves Let’s turn to what it means to understand ourselves when dealing with risk management or communication. What’s your reaction to being told that you must wave goodbye to “The Age of Reason,” and come to grips with whatever age we’re entering? To me, it’s been somewhat unnerving. Andre Gide once wrote that “One doesn’t discover new lands without consenting to lose sight of the shore for a very long time.” To be honest, I haven’t found the new lands yet, but I’m seeing a lot of seagulls. On the other hand, Mark Twain once wrote, “Why shouldn’t truth be stranger than fiction. Fiction, after all, has to make sense.” There’s a small part of the brain called the amygdale which seems to control the fight or flight syndrome, which comes into play when we or our organization are attacked. Innocent or not, our conscious minds are literally frozen until the threat is analyzed, processed, and a response is determined—all by the unconscious. 7
Unfortunately, a lot of that processing is reasonably primitive, which is why initial first responses are so often counter-productive. I.Q. doesn’t matter. Number of Ph.D.s doesn’t matter. Corporate title doesn’t matter. Understanding ourselves means recognizing that our initial reactions to attacks are likely to be ineffective. I’ve identified eleven initial responses (I’m sure they’re more) almost guaranteed to make things worse. I’m not going to go over all of them, buy I’m sure you’ve seen most, and a few examples will demonstrate how dangerous they are. In a crisis or a serious issue, emotions trump logic every time. Firestone’s initial response to the problem was factual, accurate, and ethical. Look how far it got them. And never, never, never blame the victims, even if they were wrong. Tell that to Audi who blamed little old ladies with lead feet on accelerators. One of my favorite initial responses is called the Labrador Syndrome. Did you ever train a dog to stay off the couch, leave, and then return to find the dog with his head under the coach. The dog obviously is thinking, “Well, I can’t see them so they can’t see me. This behavior usually manifests itself in thundering silence, such as that lack of sound emanating from the mutual fund industry, the surprising lack of an aggressive response to “Mad Cow” disease from the cattle industry, and the failure of AARP to either prepare its members or explain their behavior after they supported the BUSH Medicare Plan. Compare that to comments by Roger Enrico, former CEO of Pepsi, “The rule was when you run into bad news, get to the bottom of it quickly as possible and get it out right away” so the company could move on. That’s how Pepsi responded to the syringe in the Pepsi can incident, and they averted what could have been a major crisis. Another is the “buzzing gnat” syndrome, which turned Lois Gibbs from a scared housewife to a raging environmental activists—simply because no one would take her seriously…and she’s the one who tells that story. Perhaps my favorite example of a company responding quickly and effectively occurred about a year after Valdez. In February of 1990, British Petroleum had an oil spill off the coast of Los Angeles that threatened a 20-mile stretch of shoreline. It was clear that it wasn’t their fault. It was their oil, but on someone else’s tanker. 8
However, the CEO of BP went to California and said (and I paraphrase), “My lawyers tell me this isn’t our fault, and in my head, I know they’re right. But my heart tells me it’s our oil, and it’s on your beaches, so we’re going to do whatever it takes to make things right.” Absolute genius. The lawyers were happy because he didn’t admit liability, and the community thought the company was wonderful. A headline in the Los Angeles Times says it all: “After Spill, BP Soaked Up Oil and Good Press.” There are many more of these first reactions, but the point is that our instinctive first responses are driven more by primitive parts of our unconscious, which means they might not be appropriate to the circumstances. Understanding Your Audience Let’s move on to what it means to understand your audience. Communication only occurs when I say something, you hear it, repeat it back to me, and I agree that what you said is what I intended. This process is made somewhat complex by a phenomenon I’ve named “The Peril of the Double Filter™.” What we say is filtered—changed—by our values, our belief systems, our emotional condition at the time we say it, our attitude towards our audience—a host of factors, most of them unconscious. But your words are then unconsciously filtered by your audience, and their response to you is filtered by their unconscious, and you, in turn, don’t consciously hear anything until it’s been filtered by your unconscious. That’s four times one message has been filtered. It’s a wonder that we can talk to each other at all. Also, when thinking about the attitudes that audiences bring to an issue, remember that we’ve all been lied to. Since one of the first casualties of a crisis (or even a serious issue) is the loss of credibility, people have no reason to believe a company under attack. They’re probably frightened, angry, even in pain, and they don’t want facts—at least not the company’s facts. When they think they’re at risk, their first concern is for their own welfare, and anything the company says that doesn’t conform to the worst they’ve been told by the 9
opponents will be distorted to reinforce the worst. Daniel Yankelovich, one of the deans of survey research, has said, “Paradoxically, in this Age of Information, the importance of information in shaping public opinion is vastly exaggerated.” It’s not that facts don’t matter or won’t ever work, it’s just that first, you have to win their hearts and then win their minds. The lack of sympathy and empathy demonstrated by the cattlemen, the salmon farmers, the makers of Hormone Replacement Therapy—the list is endless—is simply incomprehensible. The cattlemen tried to minimize the problem and talk about safeguards, while their opponents slammed the lack of real safeguards. Guess who wins in the public’s mind? The salmon farmers so far have been acting like Labradors. And the makers of Hormone Replacement Therapy, quite frankly, just threw in the towel. And then they wonder why they get nailed with so many lawsuits, and why no one believes their facts and science. Risk Management And Communications Which leads to a discussion of some new ways of thinking about Risk Management and Communication. As I’m sure you know, issues and crises are strange creatures. First, issue change is not linear but abrupt, based on reaching certain thresholds. Second, the traditional rules of engagement grow more distorted the hotter the issue gets until they become downright toxic in a crisis. Third, when one is in the middle of firestorm, it’s difficult to realize how the relationship between an organization and its audiences has become so distorted. I want to introduce a new concept I call “Receptivity Theory™” which identifies seven different levels of receptiveness you might find in an audience, ranging from Loyalty or Trust to Hyper-sensitive or Outrage. The value of this model, I hope, is to force us to focus on our audiences needs, rather than our own—to break through our own emotional barriers and focus on theirs’ when dealing with risk issues. 10
Receptivity Theory™* Receptivity State Description/Degree of Openness Desired Response Organizational Behavior 1 Loyal Trust, benefit of doubt, Maintain state Anticipate; do something extra; ambassador/Extremely high treat them special 2 Open Normal relationship/ Moderate to high Loyal Emotional support; quick response, over-deliver, get feedback 3 Guarded Suspicious (not hostile), ignorant, Open Respect; deal with their needs; /moderate feedback 4 Indifferent Unaffected/very low Depends on need Keep open lines of communication; monitor 5 Heightened Concern: Some issue growing/low Guarded or Open Listen! Resolve issue; apology; est. relations 6 Over-Sensitive Fear/anger: feel helpless & lack of Heightened or Respect emotions; listen; est. respect/very low Guarded rapport; find solutions, apology 7 Hyper-Sensitive Outrage: relationships completely broken/ Willingness to Listen! Keep conversation going none engage * Since the writing of this speech, I’ve identified another four distinct receptivity states, and there may still be others to define.
What I’m showing is a very simplified version of a fairly complex model, but it will provide a basis from which to proceed. My assumption is that States 2 through 5 are the most common, and the easiest for organizations to manage. Loyalty is a rare and wondrous event, requiring extraordinary sustained effort. The Issue/Crisis world where risk management and communication become major factors lives most often in States 6 and 7, and that’s where most companies find themselves rudderless. There is an underlying model that transforms Receptivity Theory from two- dimensions to multi-dimensions—a necessary complication because it is never the case that issues exist solely between an organization an one of its audiences. Let’s consider the rare but highly desired “Loyalty” state. Loyalty State Media Company Public Allies Gov’t Foes Limits of Known World
This graph shows the relationships among an organization and its various audiences. The length of the line shows the relatively closeness of the various players, and the thickness of the line shows the strength of the relationship. Note that in a loyal relationship, the line between the company and public is short and thick. To fully understand the dynamic relationships among the various audiences, we need research to quantify each of the variables. I don’t have those tools, but I’m working on it. However, it doesn’t take a statistician to see that a how a company is perceived and how receptive its audiences are is a function of both the length and thickness of the lines, compared to those of the other players in the game. Let’s redraw this for what we’re calling the “Open” receptivity state: 13
Open State Open State M edia Media Company Company Public Public Allies Allies Gov’t Gov’t Foes Foes Limits of Known World Notice the company and public are further apart and that all the lines are of the Limit s of Known same thickness. The one point I want to emphasize with this chart is that the greater the distance and thinner the line between company and public, the greater relative influence of other audiences in terms of affecting the receptivity state of your target group. Let’s jump down to the “Over-Sensitive” receptivity state. 14
Over Sensitive State L1v= ? Company Company Media Company Public Allies Gov’t Foes Limits of Known World Here, the degree of openness—the level of receptivity—is very low. Part of the purpose of this chart is to emphasize that there are times—too often—when one doesn’t know if one is fighting a tough issue or a crisis. It’s critical because you manage them differently. But one thing that’s clear is that the distance is growing and that the lines are getting thinner—not just between company and public, but among virtually all the company’s audiences. 15
We noted before that the nature of the company’s relationship with their audiences has changed. Behaviors and messages that were perfectly appropriate during normal times probably no longer work—in fact, they’re becoming counter- productive. One critical factor executives have the most difficulty with is that their credibility is also a function of line length and thickness. In a state of over-sensitivity, their credibility is reaching zero. The dilemma is both fascinating and frightening: Just when a company needs a receptive audience, when it needs to be able to respond effectively to challenges and attacks, its ability to do so is severely damaged. Dave Snowden of Harvard has found that there are different brain functions for being taught (i.e., taking in information) and learning (i.e., engaging in a two-way process.) As Winston Churchill once said, “I am always ready to learn, but I do not always like being taught.“ During an issue or a crisis, people will not tolerate being taught. They have opinions and facts that to them are every bit as relevant as yours. You can educate me about something when I lack information that I need, you have it, and I think you’re a trusted source. But during an issue or crisis, where there are multiple sources of conflicting information available, the organization is not only no longer a trusted source, it’s becoming an unknown quantity. Who you going to believe, Shell or Greenpeace? So the challenge is to capture people’s attention in a way that makes them less hostile and guarded and more receptive. The answer lies again with the unconscious and brain chemistry. If a company responds exactly as expected—defensively, dismissively, or not at all—the unconscious simply uses that to reinforce the negative opinions it’s formed. Actually, there was a great example in the paper today. Here’s the headline: “No Foolproof Way is Seen to Contain Altered Genes.” I’d call that vivid. While the story reported on what seemed to be a balanced report by the National Research Council, the lead paragraph read: “A new report commissioned by the government suggests that it will be difficult to completely prevent genetically engineered plants and animals from having unintended environmental and public health effects.” 16
Here’s the response from the Biotechnology Industry Association: technology providers have a variety of methods available to ensure confinement of organisms modified through biotechnology when risk warrants it. Reassuring, isn’t it? We now know that learning takes place—or the conscious mind gets engaged— only when something unexpected happens and dopamine levels in the brain rise or fall. The unconscious, recognizing a unusual situation, calls on the conscious to intervene. I want to use Monsanto to as a best case and worst case. First, when it was still a chemical company, how Monsanto responded to the Bhopal disaster. Within a matter of weeks, the CEO implemented a number of high-profile, high-risk, activities. He immediately and publicly sent out a high-level team to inspect every plant, world-wide. They found a lot of good things…and they found some things that caused us to wince. For example, we found that in downtown St. Louis, we were storing as many as 5 tank cars of elemental chlorine. That was reduced to one-half a tank car in a protected location. He also made every finding public, which was unexpected, to say the least, and the company was praised by government, community leaders, and environmentalists. Against the advice of his plant management, he opened up the plant gates, made Material Safety Data sheets public, ordered every plant manager to keep an open door policy, and instituted Community Environmental Panels that had extraordinary access to plant information. And finally, frustrated by the lack of progress made in reducing air emissions, he announced that Monsanto would reduce air emissions by 90% in five years, and then move to zero. Environmentalists began calling it the Monsanto pledge and called on other companies to do the same. Unexpected behavior and communication that captured the attention of critical audiences and positively redefined the company. Perhaps the most confusing condition is being in a crisis. 17
Hyper-Sensitive State L 1v= A + x Compan M edia Hyper-Sensitive State Public Company Media Allies Gov’t Foes Public Allies Gov’t Foes Limit s of Known Limits of Known World 18
Open S L oyalty State M edia M edia Company A crisis is the worst of all worlds. Note first that the lines linking the media, Company government, foes Public shorter and thicker than before. Perhaps most important, what Public are all does it mean that the company now lies outside the “Limits of the Known world? One definition of a crisis is an event or occurrence that significantly and dramatically violates the trust between an organization and its audiences. A crisis is Allies a violent, disruptive Allies event that causes people to question everything they thought they knew about a company. Think back to when someone you thought you knew did something that violated Gov’t Gov’t your trust. How might you have described that? Foes Foes “I feel like I don’t know that person anymore.” Or…”he’s just not the same.” Will you ever look at Martha Stewart in the same way? Or Dick Grasso at the New York Stock Exchange? Or Arthur Andersen or the mutual fund industry? Or a hamburger? If, in an issue state, communication becomes strained, in a crisis, all the traditional rules need to be tossed out the window. They just won’t work. I’ve identified 17 rules that managers use to climb the corporate ladder in normal times, but turn toxic Limit s of Knowns of Known Limit in a crisis—but that’s the subject for another speech. If you go back to the Receptivity model, the desired response during a crisis is quite simple: Find some members of some audience who will engage and stay engaged. Peter Drucker once said, “The most important thing in communication is to hear what isn't being said.” Behind every so-called fact is an intense, unbreachable emotion. The longer you can keep them talking—or yelling—the more you’ll begin to diffuse their anger. You need to be responsive on demand, empathetic and sympathetic, and keep your anger under control. To them, you don’t have the right to be angry regardless of what they say. Now, this doesn’t mean giving away the store, but my goal isn’t to do a training seminar on crisis management, but rather examine ways of reaching hostile audiences. 19
When dealing with a hostile, scared, or outraged audience, you will not be able to communicate with them until you first eliminate whatever barriers they’ve erected. Thinking in terms of this new science, one first must do something unexpected to change dopamine levels and force the issue into the conscious realm. During the breast implant crisis, through our research, we came up with a concept I termed, “The Disarming Prelude.” The phrase we developed, which I’ve since used successfully many times is this: “I represent the Dow Chemical Company, and I’m not going to ask you to simply believe what I say.” (That’s an unexpected remark for a corporate executive.) “Frankly, I don’t blame you. We do have a financial interest in this matter.” (Who is this guy?) “Therefore, all I’m asking you to do is listen to our position, listen to our opposition, and then make up your own minds.” Research showed that that quote alone was powerful enough to get a significant number of people to change their minds about the issue. Why does it work? It’s unexpected, it demonstrates respect for the audience’s intelligence, and it acknowledges that people are going to decide for themselves anyway. I used a slightly different take on the Disarming Prelude when a major teaching hospital had a young woman who came in for a C-section, died three days later of flesh- eating bacteria. The following is a heavily edited beginning of the statement the chief medical officer read at the news conference: “At moments like this, it’s frankly very hard for me to express what I’m feeling. Even when someone dies, and we can face their family and friends and say we did everything humanly possible, there’s a part of us that questions and second guesses. “That’s why this death is so difficult, because we can’t face [patient’s] family and say we did everything humanly possible. Today, I would like to tell you and the public what I’ve already told [patient’s] family: We let you down. And we are deeply, deeply sorry. And we are going to do whatever is necessary to make sure that these problems never happen again in this institution. 20
“Could we have prevented [patient’s] death? We believe the answer is no. But we’re not asking anyone to accept that. What we believe doesn’t matter right now. The fact is she died, the fact is we made mistakes, and, at some level, it doesn’t help for us to debate publicly whether our mistakes led to her death. Our responsibility is to help her family in their time of grief, and to the people of Rochester–to restore their confidence in our hospital.” How can you attack an organization that issues a statement such as that? They showed their humanity, they refused to engage in a debate about the cause of death but simply apologized for making mistakes, they acknowledged that they let people down and that it was their responsibility to restore the community’s confidence. And, by the way, that was crafted in close consultation with the hospital’s corporation counsel. How to conclude? Could I have thrown many more different concepts and models at you this afternoon? I think the best way to conclude is to return to the beginning. As a science junking speaking to real scientists, I have to say that science has let us down. We can laugh about 22 epidemiological studies on breast implants, but tell that to a woman with a life-threatening disease. People used to treat science and scientists with awe—it was the promise of a wondrous new world. Norman Augustine, the former Chairman of Lockheed Martin, Allies commented that when people today think about science, they bring up images of Gov’t Foes Media Hiroshima, Chernobyl, 3-Mile Island, genetically-engineered tomatoes that eat Detroit, and a host of other potential horrors. Our faith in science has been replaced with uncertainty and fear. Saccharine is bad. Saccharine is good. Hormone replacement therapy cures all ills. HRT cures hot flashes and may cause breast cancer. Global warming is real. Global warming is an environmental plot. Just as physicists stand humbled by how much they’ve learned about how much they don’t understand, so too should experts in risk assessment, management, and communication be humbled by how weak are our tools, how little we know about how people think, feel, and respond, and by how much we have yet to learn. 21
Albert Einstein once said, “We know nothing at all. All our knowledge is but the knowledge of schoolchildren. The real nature of things we shall never know.” Perhaps not, but we can do better. Through your science, you have made the world safer, you’re helping people live longer and healthier lives, but, in the process, much like in the medical sciences, you created a myth of infallibility that’s been shattered. I hope I’ve offered some help in putting the pieces back together. Thank you. 22
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