Ten male students crowded around a clean-shaven instructor who asked a series of questions. The students had meticulously prepared and would maintain close proximity to well-rehearsed answers. Hopefully the questions are simple, they thought. One by one, they answered, at times stumbling through their responses. This was expected. The students were learning and the incorrect answers allowed room for humility. Such a scene could easily describe an American teaching hospital, or, a Republican presidential debate.
The parallels between medicine and politics are abundant. For starters, the phrase “I don’t know” is on the minds of medical students and presidential candidates everywhere — despite rarely being uttered on the wards or in debates. Further, the stereotypes of some politicians and doctors overlap in that both believe themselves to be infallible. And, in medicine as well as in politics, mistakes are so taboo that being wrong is not only unacceptable, it becomes seemingly impossible.
Given these similarities, one would think Dr. Ben Carson was well suited for the job. A president is a public servant, as is a doctor, and the excitement around his candidacy grew from this fact. Medical school offers a modest beginning that nurtures skills like self-awareness, which is found within good physicians. Of course, that doesn’t mean that those traits endure.
As Carson progressed through the debates, deep inside him was a clandestine skill honed in medical school that provides, admittedly, an odd utility: the ability to be wrong. Put differently, he was a medical student. He had the potential to be honest.
In theory, a doctor would make a great president. Skills in listening, advocacy for patients and decision-making, all bridge medicine and public service. But, from vaccine hedges to Fox News Sunday stumbles, Carson revealed his struggle to exercise the political calisthenics required for such a race. Maybe, Carson was wrong too much. Or, perhaps he didn’t instill the confidence needed to woe voters. In the end, the caucus goers who proclaimed they sought a beltway outsider with honesty found a more abrasive alternative.
It’s hard to imagine another role other than America’s President where such perfection is expected, but the physician’s role might be a close second. This pedestal comes with a price: candidates become mechanical in their answers and hostile to questioning. When “I don’t know” isn’t an acceptable response, thoughtless alternatives result. We get policy proposals that offer perplexingly massive border walls, nationwide bans on religious minorities and what might as well be concealed carry permits bestowed to kindergarteners. When brash answers are expected, thoughtfulness becomes as useful as money was to Jeb Bush’s campaign.
In politics, the theme of perceived weakness is well known. It certainly goes beyond simply not knowing the answers to questions. FDR made numerous attempts to hide his paralysis that was secondary to polio. Bill Clinton ran circles around a mid-1990s psuedo-apology for not acting during Rwanda’s genocide. Not surprisingly, our human nature — and our presidential nature — isn’t good at embracing fault or weakness.
In his book Being Mortal, Dr. Atul Gawande describes a similar insecurity faced by physicians and patients in their conversations about the end of life. The difficulty of these conversations uncovers, in part, physicians’ struggle to express their limitations to affect the finality of death. The book cites one study by sociologist Nicholas Christakis that showed how physicians consistently overestimated a terminally ill patient’s survival. On average, the overestimate was by 530 percent. Death, like many nuanced topics, like heavy political questions for Carson and the other former candidates, induces a blind sprint toward comfortable and preferably short answers.
In the transition from medicine to politics, Carson quickly discovered that his conservative synapses had moved to Syria, not the brain matter more easily navigable by a neurosurgeon. Microbiology was replaced by ISIS, and despite their dual viral natures, the former didn’t help when answering national security questions on CNN. To be President is to be a generalist, but the expectation is to be an uber-specialist — on everything.
Except no one can know everything. The “fast and now” of American culture has crept into our presidential candidate’s policies. Immediate answers that require no research is a poor plan for both medical care and policy. What should be robust solutions to convoluted problems are instead diluted to terse sound bites leaving listeners wondering, Was there even a policy in that statement?
It’s true that in presidential debates and medical school examinations, you don’t earn points for incorrect responses. To develop trust, however, whether with constituents or patients, there is value in recognizing your limitations and the answers you might not have. With that in mind, to the next President, whoever that may be: embrace your wrong answers, much like a modest medical student.