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It could be you
DISSECTING ROOM
LIFELINE Alan Meisel Alan Meisel is a law professor and bioethicist. He teaches law and medical students, and does research in health law and bioethics at the University of Pittsburgh, USA, where he is director of the Center for Bioethics and Health Law. Who was your most influential teacher, and why? Dr Jay Katz, a physician who was one of my law professors, because his love of learning and his infectious enthusiasm got me interested in the subjects that have become the core of my career. Which research event has had most effect on your work? The Karen Ann Quinlan case in the USA in 1975–76. What would be your advice to a newly qualified doctor? Try not to lose sight of the fact that you went into medicine to help people. How do you relax? What is that? What is your greatest regret? Not studying Latin. What complementary therapies have you tried? Did they work? Chiropractic. In a manner of speaking; the treatment hurt more than the disease so I decided to live with the disease. What apart from your wife is the passion of your life? Chocolate. What is your greatest fear? Boredom. What is your worst habit? Too much chocolate. Do you believe in capital punishment? No. What do you think is the most exciting field of science at the moment? Genetics. What do you think is the greatest political danger to the medical profession? Corporatisation of the provision of medical care. What part of your work gives you the most pleasure? Creativity— primarily in writing. If you had not entered your current profession, what would you have liked to do? Been a gardener. Have you ever broken one of the ten commandments? Probably all, but not simultaneously.
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It could be you “
ightning kills two women in Hyde park”, ran the headline of the London Evening Standard some time ago. Two women were found dead beneath a tree, the morning after a night of thunderstorms. Initially, police were suspicious. But they soon pieced together the bizarre scenario: “It is thought that the women must have been holding hands . . . The lightning has struck the tree and shot down the trunk. One of the women had her back to the tree trunk and the lightning had gone down her back . . . and come out through her feet.” Everyone who read that article must have been struck by the same thought: what a way to go. In terms of luck, what is the flip-side of getting killed by lightning? Winning the UK National Lottery, perhaps. Both events are extremely unlikely. In fact, the odds of winning the Lottery jackpot are about 14 million to one (6/4935/4834/4733/4632/4531/44). Yet what a contrast in outcomes. One leads to instant cremation; the other to a yacht in the Caribbean. I once read that players of the National Lottery should buy their tickets as close to the draw as possible— since they are roughly 2800 times more likely to die during the week than win the jackpot. If you do make it out of the newsagent’s alive, watch your head as you hurry home to watch the draw on television: you are less likely to scoop the jackpot than get hit by a random meteorite. The truth is, winning the jackpot in the National Lottery is virtually impossible, If you do want to make a killing, you’d be better off in a casino. But the success of the Lottery depends on people believing that winning is easy. To this end, the system is wickedly clever—designed as it is to create the illusion of reasonable likelihood. “Just six numbers,” we think, “it can’t be
L
that difficult.” But just conceptualise those odds. Imagine if every Lottery ticket were the size of, say, a squash court, each printed with 14 million different numbers. All you have to do is pick the correct one. More interesting is the psychology of luck. We often believe that positive events are likelier than negative ones, irrespective of the balance of odds. How many people fill out their Lottery ticket with a sense of hope, and monitor the draw with anticipation? Probably many. How many people set off for work each morning—a journey that is likely to involve car travel or crossing roads—with a fear of impending death? Probably few. Yet it is by far the likelier event. The Lottery, of course, has always been controversial. Some argue it amounts to a tax on the poor to bolster the lifestyles of the rich. Others say it benefits everybody—poor included— since the revenue is channelled into a range of projects. Whatever the politics, the Lottery is rarely attacked on the grounds of sheer difficulty. One exception is a firm of T-shirt manufacturers who advertised in the anarchic UK comic Viz. They were offering T-shirts with a print that parodied the official National Lottery insignia: instead of ‘It could be you’ written beneath blue fingers crossed for luck, the T-shirt bore the quip ‘It won’t be you’ and featured a blue fist with the middle finger extended (“giving the bird”, as Americans call it). Despite the astronomical odds, people will continue to play the National Lottery. Why? The retort they offer conquers the mathematics: ‘Well, somebody’s got to win it.’ Indeed they have. And if you play the National Lottery, or any other lottery, I wish you luck. Just don’t sit under a tree while you’re filling out your ticket. Daniel Davies
THE LANCET • Vol 357 • March 3, 2001
For personal use only. Reproduce with permission from The Lancet Publishing Group.
LIFELINE Alan Meisel Alan Meisel is a law professor and bioethicist. He teaches law and medical students, and does research in health law and bioethics at the University of Pittsburgh, USA, where he is director of the Center for Bioethics and Health Law. Who was your most influential teacher, and why? Dr Jay Katz, a physician who was one of my law professors, because his love of learning and his infectious enthusiasm got me interested in the subjects that have become the core of my career. Which research event has had most effect on your work? The Karen Ann Quinlan case in the USA in 1975–76. What would be your advice to a newly qualified doctor? Try not to lose sight of the fact that you went into medicine to help people. How do you relax? What is that? What is your greatest regret? Not studying Latin. What complementary therapies have you tried? Did they work? Chiropractic. In a manner of speaking; the treatment hurt more than the disease so I decided to live with the disease. What apart from your wife is the passion of your life? Chocolate. What is your greatest fear? Boredom. What is your worst habit? Too much chocolate. Do you believe in capital punishment? No. What do you think is the most exciting field of science at the moment? Genetics. What do you think is the greatest political danger to the medical profession? Corporatisation of the provision of medical care. What part of your work gives you the most pleasure? Creativity— primarily in writing. If you had not entered your current profession, what would you have liked to do? Been a gardener. Have you ever broken one of the ten commandments? Probably all, but not simultaneously.
730
It could be you “
ightning kills two women in Hyde park”, ran the headline of the London Evening Standard some time ago. Two women were found dead beneath a tree, the morning after a night of thunderstorms. Initially, police were suspicious. But they soon pieced together the bizarre scenario: “It is thought that the women must have been holding hands . . . The lightning has struck the tree and shot down the trunk. One of the women had her back to the tree trunk and the lightning had gone down her back . . . and come out through her feet.” Everyone who read that article must have been struck by the same thought: what a way to go. In terms of luck, what is the flip-side of getting killed by lightning? Winning the UK National Lottery, perhaps. Both events are extremely unlikely. In fact, the odds of winning the Lottery jackpot are about 14 million to one (6/4935/4834/4733/4632/4531/44). Yet what a contrast in outcomes. One leads to instant cremation; the other to a yacht in the Caribbean. I once read that players of the National Lottery should buy their tickets as close to the draw as possible— since they are roughly 2800 times more likely to die during the week than win the jackpot. If you do make it out of the newsagent’s alive, watch your head as you hurry home to watch the draw on television: you are less likely to scoop the jackpot than get hit by a random meteorite. The truth is, winning the jackpot in the National Lottery is virtually impossible, If you do want to make a killing, you’d be better off in a casino. But the success of the Lottery depends on people believing that winning is easy. To this end, the system is wickedly clever—designed as it is to create the illusion of reasonable likelihood. “Just six numbers,” we think, “it can’t be
L
that difficult.” But just conceptualise those odds. Imagine if every Lottery ticket were the size of, say, a squash court, each printed with 14 million different numbers. All you have to do is pick the correct one. More interesting is the psychology of luck. We often believe that positive events are likelier than negative ones, irrespective of the balance of odds. How many people fill out their Lottery ticket with a sense of hope, and monitor the draw with anticipation? Probably many. How many people set off for work each morning—a journey that is likely to involve car travel or crossing roads—with a fear of impending death? Probably few. Yet it is by far the likelier event. The Lottery, of course, has always been controversial. Some argue it amounts to a tax on the poor to bolster the lifestyles of the rich. Others say it benefits everybody—poor included— since the revenue is channelled into a range of projects. Whatever the politics, the Lottery is rarely attacked on the grounds of sheer difficulty. One exception is a firm of T-shirt manufacturers who advertised in the anarchic UK comic Viz. They were offering T-shirts with a print that parodied the official National Lottery insignia: instead of ‘It could be you’ written beneath blue fingers crossed for luck, the T-shirt bore the quip ‘It won’t be you’ and featured a blue fist with the middle finger extended (“giving the bird”, as Americans call it). Despite the astronomical odds, people will continue to play the National Lottery. Why? The retort they offer conquers the mathematics: ‘Well, somebody’s got to win it.’ Indeed they have. And if you play the National Lottery, or any other lottery, I wish you luck. Just don’t sit under a tree while you’re filling out your ticket. Daniel Davies
THE LANCET • Vol 357 • March 3, 2001
For personal use only. Reproduce with permission from The Lancet Publishing Group.