Patching Cracks

 

November 2, 2022



James Garfield, who was the 20th president of the United States, is only remembered for one thing. He was shot by an assassin in July of 1881. In an interesting twist, he did not die until two and a half months later. The length of time between his being shot and actually dying is due largely to the efforts of Doctor Willard Bliss. Dr. Bliss was a disgraced physician, who became something of an expert in ballistic trauma as a result of his service as a surgeon during the Civil War. He was called in by a member of Garfield’s cabinet after the president was shot. Bliss took over the treatment of Garfield, even chasing off the president’s personal physician. Bliss is noteworthy because his course of treatment essentially killed his patient. For nearly 10 weeks, Bliss insisted that removing the bullet was the most important objective, which prompted repeated probing of the wound with unsterilized instruments. The injury wasn’t allowed to heal, and the president ultimately died of infection from a wound that was never allowed to close. The strangest twist came about afterward when investigators realized that the doctor had no official standing. He simply walked in and took charge.

The story is interesting because it illustrates an important principle. When we are anxious, afraid, in pain, or otherwise distressed, we tend to make really poor decisions. The various officials surrounding the president were in an unprecedented crisis. There were no procedures. No one knew quite what to do. In the panic of the moment, they handed the mess over to a guy that sounded like he knew what he was talking about. Much of the reason for this type of response has to do with how our brains are wired to help us survive peril. In a moment of fear and danger, we don’t have time to think or consider. Decision making is shifted from the part of our brain that considers and reasons to the “more primal” part that produces emotional response and where the “fight or flight” mechanism resides. This is a useful adaption when we are about to be eaten by a pack of wolves on the prairie, but less so when the danger is less imminent. The problem is that our most primitive survival instincts aren’t good at differentiating between wolves and a panic attack. A related adage I heard often when I worked in clinical settings applies here: “Anger makes you dumb.” Really, any powerful, overriding emotion has the same effect. This is why arguments between spouses tend to devolve into messes rather quickly. Anger and hurt don’t make us think through our words. We simply speak or act, which tends to hurt or anger our partner. This devolves into a cycle or speaking without thinking. Though marriage is the obvious example, there are plenty of others we see daily.

The one I see most often is in the realm of politics, where fear and anger are the currency of power. Get people mad or scared enough that they stop thinking, and they’ll vote for anyone, regardless of whether they have any business handling the problem or not. The phenomena applies to other types of trauma and fear as well.

The real trick to handling this reality of our brain’s response to emotion is slowing down and thinking. This may involve taking a few deep breaths or walking away for a moment. The biggest thing is to stop and detach enough that the thinking parts of your brain have an opportunity to take the steering wheel. One policy I have tried to apply is to not make decisions in the heat of the moment. Slow down and consider carefully. In organizations, this is best accomplished by setting policies that are carefully considered before things are an issue. You don’t set a fire escape plan during a fire. You do it beforehand. I know couples who have made it a rule to stop any argument for a “time out” period as soon as voices are raised. Whatever it is, the more *thinking* you do before making a choice, the better the odds that the decision will be a right one.

 
 

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