As students at Bronx Science, we have essentially become expert test takers. In our academic careers, we have taken hundreds of tests, and with this experience often comes intuition. Have you ever looked at a question and thought, “I don’t know why, but I think the answer is C?” Chances are, the answer probably is C.
Malcolm Gladwell’s Blink, a book about this immediate and unexplained instinct, details the merits of our subconscious rapid cognition. These “gut instincts” come in many different forms and are surprisingly accurate considering how quickly they are made — in the blink of an eye. For example, Gladwell recounts an instance where an art expert felt “intuitive repulsion” when looking at a statue, which was later deemed fake. A tennis coach could inexplicably and preemptively predict exactly when a player would double fault. These experts in their field had so much experience looking at various artwork and watching tennis matches, that their brain subconsciously found a way to identify patterns and detect forgery or double faults.
Gladwell also explains just how accurate these instincts can be. Often, we take in a lot of information, not all of which is useful to the decision making process. “Thin-slicing,” as Gladwell calls it, is a technique where our unconscious brain filters out all the unnecessary information we absorb and only uses a “thin-slice” to make an instinctive decision. He explains that it is advantageous to listen to this instinct, as it is the product of a tremendous amount of experience, a wealth of only necessary information, and numerous small clues for which we are not even consciously aware.
Filtering out this useless information is tremendously important and has the potential to have a real impact on discrimination in our society. Gladwell uses the example of blind orchestra auditions. Someone’s gender should make absolutely no difference when judging their musical ability, yet conductors and judges seemed to be biased as there were only a few women awarded spots in these famous musical ensembles. When they made these auditions blind however, the percentage of women awarded spots increased to 50%. In this case, eliminating visual information automatically “thin-sliced” the information, leaving judges with only their musical ability, or the useful information.
Our subconscious brain does this automatically. With years of practice, repetition and experience in a particular area, our brain quickly filters information by deliberately discarding the useless details, arriving at an answer within a split second. These instincts should not incorporate racial details or someone’s gender because they should be completely irrelevant to our decisions. If we learn to recognize and harness these instincts, we can combat bias and overcome discrimination in society purely through “thin-slicing.”
As students at Bronx Science, we are trained to always ask, “Why?” Many of us do research, weigh our options, and carefully derive an answer from the information that we gather. Sometimes this will yield us the right answer. Other times, however, we do not need to know “why.” After studying the accuracy of these instincts, Gladwell eventually concludes that smaller decisions are better off being made by weighing our options, but when we are faced with big decisions, especially life-or-death scenarios, our instinct is usually correct.
Rapid decision making is specifically crucial in hospitals, where every day brings a new life-or-death scenario. For example, Gladwell mentions an instance where doctors learned to listen to their instincts in recognizing if a patient was having a heart attack. This principle is absolutely necessary, especially in an ICU setting where patients are extremely sick. Dr. Chhavi Katyal, a Pediatric ICU physician of fifteen years and the Medical Director of the Children’s Hospital at Montefiore, says that rapid problem solving accounts for about 50% of her decisions.
Through time, experience, repetition, and fundamental knowledge of human physiology, Dr. Katyal says that she has developed the ability to diagnose patients quickly and often even predict their outcomes. “I know when a patient comes in who is going to survive and who isn’t. And that’s just experience. I don’t have hard data to support it, but I know that the last 100 patients who looked a certain way or had a certain blood pressure had one particular outcome,” she said. With Dr. Katyal’s experience, she developed a pattern for her own version of thin-slicing: focusing on specific symptoms or signs that she deemed crucial in order to make her diagnosis and prediction.
These instincts were especially pertinent to Dr. Katyal and other healthcare workers across the nation during the peak of the COVID-19 pandemic. As hospitals overflowed across New York City, front-line workers had to spring into action, combatting a virus that was not even widely studied or understood yet. In this case, physicians were not able to rely on research or practice guidelines. They were essentially flying blind and had to pinpoint patterns between COVID-19 patients in order to understand how to treat the illness.
Dr. Kaytal worked in an extremely busy ICU last spring, taking care of dozens of patients with Coronavirus. After taking care of these patients, Dr. Kaytal and her colleagues learned to understand the virus, its treatments, and long-term effects. “Initially, we didn’t know that patients would have clotting problems, but during the second [wave of the pandemic], we knew that if you have COVID-19, you’re going to have clotting problems about 80% of the time,” said Dr. Katyal.
Dr. Tanya Bajaj, an emergency medicine physician at North Shore University Hospital, also shared a similar sentiment. After taking care of numerous patients with the virus, she and her colleagues were able to better recognize the symptoms of a person infected with COVID-19. Initially, the only symptoms to look out for were fever and cough. However, Dr. Bajaj stated that patients who present with symptoms such as rashes or severe throat pain are now consistent with previous cases of COVID-19.
Both Dr. Katyal and Dr. Bajaj noticed patterns through their experience and expertise. These are both ideal examples of rapid cognition and thin-slicing because the doctors zeroed in on specific symptoms that COVID-19 patients developed, possibly disregarding other information, in order to diagnose and treat their patients. They used relevant information to derive patterns from their experience and had to make split-second decisions in order to save lives. As Gladwell deduced, their instincts were invaluable in life-or-death settings.
Blink essentially concludes that with experience comes accurate instinct. The reason that the answer was likely C is because we, as students, have a lot of experience taking tests. We are often able to recognize the way that a question is worded or structured and quickly think of the answer, sometimes even without fully reading the question. These quick decisions are based on a tremendous amount of knowledge, but they occur in the blink of an eye. On a broader level, these instincts also have the ability to combat bias, save lives, and even improve our grades. This experience, whether it is with test-taking, medicine, or another field entirely, allows us to have this intuition. Recognizing, understanding, and utilizing these inexplicable feelings is what Blink details.
“I know when a patient comes in who is going to survive and who isn’t. And that’s just experience. I don’t have hard data to support it, but I know that the last 100 patients who looked a certain way or had a certain blood pressure had one particular outcome,” said Dr. Chhavi Katyal, a Pediatric ICU physician of fifteen years and the Medical Director of the Children’s Hospital at Montefiore.