The Art of Uncertainty

“It is better to be silent and be suspected of being a fool,

than to speak, and remove any doubt.”

I don’t remember where I came across that little gem, but it carries a useful message. How often have you been involved in a discussion with someone who is absolutely certain about something, and you are equally certain that they’re wrong? You try to convince them. You call upon logic; you appeal to evidence; you cite witnesses; you plead for common sense, but nothing seems able to shake that rock solid (mistaken) confidence. Arghhhh!!!!

 There are situations in life where it can be quite dangerous to be certain and wrong at the same time, and then there are situations where it hardly matters anyway. Does it really matter if my friend is convinced that George Washington was the first Prime Minister of Australia? It may be frustrating; it may betray a certain lack of patriotism, but in the big scheme of the universe, it makes very little difference to anyone.

 Then again, a doctor learns very quickly how dangerous being overconfident in your opinion can be. To continue to believe in a diagnosis that is wrong could harm a patient, or in extreme cases, kill them. That is why doctors (the good ones, anyway) work very hard to train themselves in the art of uncertainty.

 A gifted doctor will be able to tell you at any stage of the diagnostic process just how certain s/he is. They may not be able to put a figure on it – “I am 75.492% certain that we are dealing with melanoma here” – but they can usually tell you if they are definitely certain; quite certain with a little room for doubt; leaning towards one diagnosis rather than the other, or quite frankly flummoxed. Knowing one’s degree of certainty influences the therapeutic decisions one takes. Medication may sometimes be given on speculation, such as a case of suspected bacterial meningitis (infection around the brain) where administering antibiotics quickly is crucial and delay could cost lives. In such a situation, one need not wait for test results to improve the degree of certainty. On the other hand, if you’re thinking of administering powerful anti-cancer drugs that are going to cause horrible side effects, you’d better be pretty darn sure you’ve got the diagnosis right!

 Now, there have been those who have tried to tame uncertainty using the whip of mathematics. There are mathematical strategies for putting a number on uncertainty that at least allows you to compare uncertainties, but to use these strategies as if they were completely accurate and infallible would be a mistake. The real world is just far too complicated and involves too many variables for any mathematical model to be more than a mere indication.

 So the art of uncertainty is just that – an art. It is learned through experience: through observation and analysis of one’s mistakes, and the gradual accumulation of this data over many years. It often depends on a degree of informed intuition, rather than being a totally logical process. But I believe it is a very useful tool to have in one’s toolbox of life. Skill in this art will inform all your life decisions and increase your wisdom factor, which usually makes life more comfortable, successful and enjoyable. If nothing else, being skilful in the art of uncertainty will at least limit the number of people whose blood pressure you raise by arguing confidently for that which is false!

 Fr Ant