'Expecting the Unexpected'

CAERS SUBSTACK ARTICLE #78

‘Expecting the Unexpected’

CAERS Substack Article #78

It is not at all uncommon for the universe to surprise us. Who would have thought that something as potentially lethal as ionizing nuclear radiation would be at the heart of two very significant, and positive, medical advancements: x-rays that allow us to peer inside the human body, and radiation therapy that can help manage cancer?

It is a good example of the benefit of keeping an open mind about things that scare us. As children we seem naturally curious about almost everything, perhaps because we know so little. As adults we often lose that curiosity, perhaps because we think we know it all. Maybe we adopt such an attitude because, unlike in childhood when we believed that our parents could always protect us, we know as adults that the buck stops with us so we assume a kind of false bravado. It’s likely a spinoff of eons-old denial.

As a physician I was acutely aware that bad things can happen quite unexpectedly to good people. That’s a tough pill to swallow; we want to deceive ourselves that the universe is fair by our standards and that playing by our rules always pays off. When it comes to medical science, we convince ourselves that we understand the human body and its myriad diseases really well when in fact we have only scratched the surface. We want to believe that if we eat the right food, do the right exercise, engage in the right activities or pray the right way that we will be safer and happier than the rest of our peers who don’t (and thus don’t deserve the same good fortune as us). As the old joke goes, you don’t have to outrun the bear chasing you, you just have to run faster than the slowest one in your group.

Equally, human behaviour is difficult to predict; forecasting how anyone will act in all circumstances is a tall order, even when it comes to our own conduct. Sometimes we amaze ourselves with truly inspiring acts of courage or insight; and sometimes we are disappointed with the not-so-good stuff we do. Although lack of innate ability or unfortunate external circumstances may determine future results, not infrequently our desire, or lack thereof, plays a critical role in our success or failure. Sometimes we just don’t want something badly enough. For example, it is often accurate, and always much easier, to blame capitalism, corporate greed or corruption for our financial misfortune. However, there are also times when our own lack of self-discipline or poor prioritization contribute significantly too; our situation may not be as unexpected as we would like to think.

But we are capable of learning and growing; evolution is not just something that happens in nature on a grand scale. Can you see evidence of your own personal evolution? Do you ever cringe when you think back to who you were just ten years ago? Would you have been startled back then with who you have become now? Was it expected or unexpected? Similarly, we are prone to judging those who have gone before us, especially those who lived in very different eras than our own. Are we as critical of our earlier selves as we are of them?

Managing the ‘unexpected’ requires an openness to change. Fear can hold us back if we let it, but if we are sufficiently devoted to self-improvement, it can be managed and even overcome, especially with the help of others. This is the basis for democracy: a belief that none of us is smarter than all of us put together. As Harry S. Truman once said: ‘You can accomplish anything provided it doesn’t matter who gets the credit’. We don’t need to depend on politicians alone to fix all of our problems; we can work together to manage the unexpected and thrive.

To do so requires that we hold one another accountable, and the more power someone has the more accountable they must be. For example, politicians can at times do good things, but even in the best of democracies they can always do great harm. It is wise to remember that for some, power is the ultimate aphrodisiac, even more so than money, and that can be dangerous. To prevent the unexpected, recognizing this reality by providing the appropriate checks and balances is absolutely necessary.

Developing a universally agreed upon code of conduct can be helpful; leaving the rules up for everyone to decide on their own may not work out nearly so well. One may be optimistic that people are fundamentally good, but we are all vulnerable to manipulation, including by our own feelings. Childlike naïveté may result in us being caught off-guard by things we consider to be unexpected, but given human nature they are more expected than we might like to admit.

It’s common in various life ventures to think that the next piece of the jigsaw puzzle we find is the last piece, but that is seldom the case. Our dismay when we find that there are still more pieces to deal with should not be as unexpected as is frequently assumed. Humility at realizing the immense complexity of all human endeavours should encourage us to be more open- minded so as to be caught unprepared less often.

Have you been surprised by events during the pandemic? In retrospect, were some less unexpected now that you have had time to think about it? Are there any lessons to learn that might make the next ‘unexpected’ event more predictable? Would holding leaders more accountable be helpful?

There will always be unexpected events. But the more willing we are to understand human nature, particularly denial and avoidance, the more likely that some of those events will be recognized as ‘expected’. When that is the case, we will find ourselves much better prepared and much less easily manipulated.

J. Barry Engelhardt MD (retired) MHSc (bioethics)

CAERS Health Intake Facilitator