As a new mother, working in the emergency department made me want to go home and childproof every nook and cranny of our house. On a daily basis at work I would care for children, most often toddlers, injured at home in various ways.
I remember vividly caring for the 2-year-old girl who burnt her entire hand and arm with hot coffee after reaching up to grab mommy’s mug from the counter top. She screamed in pain and her mother felt so incredibly guilty for the honest mistake. After seeing that, I made sure to always keep hot liquids away from the edges of the countertop and never hold my children while drinking something hot.
Another time there was a 2-year-old boy who fell down the stairs breaking his collar bone. The parents hadn’t installed a baby gate at the top of the stairs which could have prevented his fracture. They felt awful. We had a gate at the top of our stairs, but it was a reminder to always close the gate when my toddlers were upstairs.
I can’t count the number of times I have seen small children with cuts to their foreheads or near their eyebrows after bumping into the sharp corners of a coffee table. Needless to say, we got rid of our wooden coffee table soon after my first child was born and replaced it with an ottoman. But putting foam bumpers on the table would have done the trick as well.
I worried all those things would happen to my kiddos. So I baby proofed like crazy and worried way too much. But then it turned out none of those things happened to my kids and a lot of the anxiety was unnecessary.
As I reflected on it I realized I was going to worse case scenario more than necessary because of the selection bias of my work. Because I saw these injuries so often I thought it happened to all kids and most definitely would happen to mine. But this was a thought error.
How Selection Bias and Confirmation Bias Might Be Impacting You
As doctors I realized we have to be careful about taking what we see happening to our patients and in our daily work and generalizing it as something that happens to everyone and also will happen to us or our loved ones.
How might this be playing out for you?
Do you see lots of patients with hypertension and diabetes and that have family history?
Do you see many people complaining about low energy and all the aches and pains of aging and asking for hip and knee replacements?
Do you see loads of patients struggling to lose weight sustainably?
Do you see perimenopausal women complaining about hot flashes and rapid weight gain often?
Well of course you do. Because as a healthcare professional, they are coming to you looking for answers and a solution. This is selection bias. They are self-selected group or patients. (This is exactly why my brain offered me the thought: Every toddler ends up in the ER from an injury.)
Remember though that there are plenty of people out there who don’t have any of those problems too.
They have family history but never develop hypertension or diabetes or high cholesterol.
They maintain their weight throughout their lives. They transition through menopause just fine.
They age gracefully and without health problems and don't require medications.
It’s just that we don’t see them very often because they don’t really need our help. So what I learned is: don’t make your patients reality your own.
You have more power than you know especially when it comes to lifestyle illnesses. It’s all a choice!
Everyday you have a choice about how you fuel your body, what you eat and drink and whether you walk or take the stairs or exercise even for just 5 minutes. You also get to choose who you spend time with and even what messages from others or social media you let in.
Our brains want to confirm what we think. And when we think everyone is overweight or obese, we find evidence of it.
That's confirmation bias. Our brain loves to be right and loves to find evidence for what it believes because it's just like a google search. Whatever you put in search, it finds evidence for.
But when instead we tell ourselves: there are many women my age and above who are in phenomenal shape, we find evidence for that instead all over the place. I know I do when I go looking for it - when I go to the store, when I'm at social gatherings and at the gym. I can even find examples of it in my own family tree in my aunt, cousin and grandma.
They aren’t lucky with good genes. They chose to believe it’s possible for them and focused on creating it for themselves with each and every choice they make each day.
Our genes are just 10% of the picture, the other 90% is our lifestyle which can turn those genes on or off.
As one of my favorite quotes reads:
“The genetic gun is loaded, but we are the ones who pull the trigger.”
In order to not pull the trigger, we must first understand our own power and how our beliefs shape our reality. Because as author Marisa Peer says, "First you create your beliefs and then your beliefs create you."
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