Class 6

Case #1

The baby whose heart was not pounding 80 times per minute

A nurse in a neonatal intensive care is providing primary care for a baby, and is uncomfortable about another baby, which seems to be having subtle color changes. Sometimes the baby will fade a bit; sometimes it will come back to healthy pink.
She remarks the fact to the primary nurse, who agrees.
Suddenly the baby turns blue. The monitor shows that his blood pressure has bottomed out completely; his heart rate drops, then goes back to 80 beats/minute.

She just knows it’s a pneumopericardium (Air has filled the sac that surrounds the heart and the pressure prevents it from moving blood to the body).
In that case, the baby will die within minutes if the air is not released. She has seen it happen before to a previous baby patient.

The primary nurse does not agree with the diagnosis. The heart monitor keeps displaying 80 beats per minute, so she thinks it’s a collapse of the baby’s lung.
The discussion starts. The nurse says that “it’s the heart”, while the team points to the heart monitor.
She pushes them away from the baby and screams for quiet, listening to his heartbeat—which is just not there.
She begins doing compressions on the baby’s chest, then the doctor comes.

She gives the neonatologist a syringe and tells him “it’s a pneumopericardium. Stick the heart.”
Across the room, the x-ray technician says “she’s right! The baby’s pericardium is filled with air.”

The doctor releases the air, and the baby’s life is saved. Now…

What about that heart monitor?
Afterwards, the team discusses why the heart monitor still displayed activity. As it turns out, the monitor responds to electrical activity, and the heart’s electrical activity was fine, even though its mechanical activity was suppressed by the air pressure.

The mystery #1 How did the nurse know immediately that it was a heart problem? What theory could explain it? Be the mind!

By the way…
I think it was this nurse 
But perhaps it was another one.

Case # 2: Fireground decision making
Experts - 23 years (N = 26) Critical Incidents Context Rich Natural Task Dynamic - 5 changes/incident Time Pressure - 78% of cases < 1 minute Real Consequences

In the summer of 1985, Klein’s team is studying firefighters’ decision-making processes, when an alarm call comes at 3.21pm.
Three minutes later, the truck is approaching a common house on a residential neighborhood.
Lieutenant M sees a man on the ground. The first decision facing him is to diagnose the problem.

As he runs towards the man, he makes his diagnosis. He sees from the amount of blood surrounding the man that he has an open artery, and from the dishcloths around the arm which artery is open.
Next comes the decision on how to treat the man; so he applies firm pressure, and starts to look for other injuries (neck?) which would prevent him from moving the man. But there’s no time for such thing; the man is dying within minutes.

Lieutenant M assigns his strongest man to help moving the man to the truck. Even tough he’s not an experienced member of the crew, Lieutenant M finds him a good suit for the job.
On the way to the hospital, the crew put inflatable pants on the man’s legs, stabilizing blood pressure. Had they put them before driving, they’d have wasted valuable time.
They arrive at the hospital 10 minutes after the alarm.

The mystery #2 How did the commander know immediately how to act? What theory could explain it? Be the mind!

Naturalistic decision making
Time pressure
High stakes
Experienced decision makers
Inadequate information
Goals are unclear
Poorly defined procedures (as opposed to lab studies)
Dynamic conditions

Klein’s starting point: Soelberg (1967)
Soelberg teached his students at MIT Sloan School of Management how to perform the rational choice strategy, in which the decision maker:
Identifies a set of options;
Identifies the way of evaluating these options;
Weights each evaluation dimension;
Does the rating;
Picks the option with the highest score.

Soelberg taught his students how to apply the rational choice strategy
And in his PhD thesis he studied the decision strategies his students used to select their jobs as they graduated.
But he was wrong; his students did not systematically compare options. Soelberg found that they were using their gut feelings, and he could predict with 87% accuracy their ultimate choice, three weeks before they did their decision .

Soelberg’s thesis
Students had a gut choice, then…
…then they would find another option to compare, then…
… then they would construct a justification for their gut decision.
So Klein also hypothesized that fireground commanders would be comparing, instead of lots of options, just two.

KLEIN: “Can you tell us about difficult decisions you’ve faced?” “I don’t make decisions.” “I don’t remember when I’ve ever made a decision.”
Klein’s 2-choice hypothesis started to collapse; fireground commanders did not seem to be comparing options at all.
It seemed “unhappy news” for the researchers. The subjects insisted that commanders never made decisions.

Commanders agreed that there were options.
But it was just obvious what to do in any situation.
There are OPTIONS, but no DECISIONS?
what’s going on here?

Maybe if we change definitions?
“A decision is a choice point where reasonable options exist, and the commander might have selected another option.”
As opposed to a “selection between previously compared alternatives”

As it turned out, the commanders were not refusing to compare options; they did not have to.
When facing a complex situation, commanders would immediately respond in appropriate fashion without conscious thought.
They were primed to act .

Recognition-primed decision making
Decision-makers would look at several options, but never compare them.
HOW?

Recognition-primed decision making
Decision-makers would look at several options, but never compare them.
HOW?
Commanders thought about one option at a time, evaluated it, then turned to the next possible rescue technique (named as a singular evaluation approach) .

But there was a second puzzle:
If they did not compare one course of option with another, how did they evaluate the options?
How did they know, without comparing, that a course of action was any good?

But there was a second puzzle:
If they did not compare one course of option with another, how did they evaluate the options?
How did they know, without comparing, that a course of action was any good?
They used a simulation heuristic , running the action through in their minds .

They used a simulation heuristic , running the action through in their minds .
If they spotted a potential problem, they would move on to the next option, then the next, until something that would seem to work in that particular situation.

“ Before we did this study, we thought that
Novices  impulsively jumped at the first options
Experts  carefully deliberated about the course of action
Now, it seems that experts have one course of action, and novices have to think it through.”

There are times for deliberating about options  usually when experience is inadequate & logical thinking is a substitute for recognizing a typical situation.
This explains Capablanca’s remark about chess: “You figure it out what to do. I see only one move. The best one.”

“Decision-makers recognize the situation as typical and familiar, and proceed to take action. They [immediately] understand
What types of goals make sense,
Which cues are important,
What to expect next,
Immediate access to a typical course of action .

Recognition-Primed Decision Model no yes Perceived as typical [Prototype or analog] Expectancies Relevant Cues Plausible Goals Recognition has four byproducts Action 1...n Modify yes,but Evaluate Course of Action Will it Work? Implement Course of Action Evaluate Action (n) [Mental Simulation] Experience the Situation in a Changing Context

Key Features of RPD Model 1. First option is usually workable Not random generation and selective retention 2. Serial generation/evaluation of options Not comparative evaluation 3. Satisficing Not optimizing 4. Evaluation through mental simulation Not MAUA or Decision Analysis 5. Focus on elaborating and improving options Not choosing between options 6. Focus on situation awareness Not CoAs 7. DM primed to act Not waiting to complete the analysis

Decision-makers do not start with goals or expectancies and figure out the nature of the situation.
Instead, they find themselves immersed into a situation, and rapidly gather information in order to make a diagnosis.

George Soros, according to his son, makes critical decisions in the stock market because "his back starts killing him." His intuition, in other words, has a physical manifestation. Flavia Cymbalista has written about this in more detail: According to Soros, his theory informs his decisions, and his body gives him the signals. The making of a self-reinforcing trend brings water to his mouth. The need for a portfolio shift makes his back hurt. His body "knows" he needs to take action, or to take careful note of a situation before his intellect can grasp it É Realizing that logic alone cannot be the basis for successful speculation led me to study bodily knowing in my post-doctoral research. There's a whole side to our embodied, experiential knowledge that computers don't have and that the "rational economic man" in models most economists construct doesn't have either. Our bodies "know" the situations we meet in life and how they can unfold. I found that physical experience has much more organized information about the world than the usual understanding of the body assumes.

Apparently, Soros is not alone in this. Here is Bob Woodward, in "Maestro" (p. 120) talking about Alan Greenspan, the legendary chairman of the U.S. Federal Reserve: "I've been in the economic forecasting business since 1948, and I've been on Wall Street since 1948, and I am telling you I have a pain in the pit of my stomach." He noted that in the past he had listened to his instincts and that they had been right. The pain in the stomach was a physical awareness Greenspan had experienced many times. He felt he had a deeper understanding of the issueÑa whole body of knowledge in his head and a whole value systemÑthan he was capable of stating at that moment. If he was about to say something that wasn't right, he would feel it before he was intellectually aware of the problem. It was this physical feeling, this sense in the stomach, that he believed kept him from making dangerous or absurd statements that might appear on the front page of the newspapers. At times, he found his body sensed danger before his head. As he walked down the street there would be an approaching car, and his body knew to stay out of its way before his head."

Only under time pressure ?
Klein says that naturalistic decision making should be studied under high time pressure (and argues for a ‘rational procedure’ given few constrains on time).
But in many cases people do have time, but the intuitive judgments of recognition-primed decision should still apply.
Case: the Getty Kouros

The Getty Kourus

The Getty Kourus
In 1983, The Getty Museum was offered a kourus dating from the 6 th century BC by art dealer Gianfranco Becchina. The price bordered on 10 Million dollars, but the statue looked almost perfectly preserved.
The Getty began a full investigation.

The documents
A letter accompanying it, supposedly written by German scholar Ernst Langlotz in 1952, placed the statue in a Swiss collection over the XXth century.

The Geology
Univ. California Geologist Stanley Margolis analyzed it using:
Stereomicroscope;
Electron microscope;
Electron microprobe;
Mass spectometry;
X-ray diffraction; and
X-ray fluorescence.
The results indicated a statue made of dolomite marble from the island of Thasos. The statue was covered with a thin layer of calcite—and dolomite can only turn into calcite over the course of hundreds or thousands of years after exposure. Margolis told the Getty that the statue was old, not some contemporary fake.

Triumph of the Getty
After 14 months of investigation, the kouros was acquired in 1986, for a reported $7 to $9 million.
New York Times: front-page news
The art journal The Burlington Magazine ran a enthusiastic piece: “[…] the kouros expresses the confident vitality that is characteristic of the best of his brothers. […] God or man, he embodies all the radiant energy of the adolescence of modern art.”
Scientific American ran a piece called “Authenticating Ancient Marble Sculpture”

BUT…
The statue brought funny reactions from the Greek art experts.
Frederico Zeri, from the Getty’s board of trustees, thought it just looked wrong; and kept starring at its fingernails.
Evelyn Harrison, a renowned expert on Greek sculpture, when first seeing the statue, told the Getty people “I’m sorry to hear you bought this”.

The first word Thomas Hoving (a director of the Metropolitan Museum of Art) thought instantly after seeing it was: “fresh”. “Have you paid for this? If so, try to get your money back.”
Georgios Dontas, after seeing the statue, felt cold, and said “I felt though there was a glass between me and the work”.
Experts argued that the kouros was a fake on “aesthetic grounds”, “traditional stylistic and aesthetic grounds”, “a forgery based upon bits and pieces of ancient kouroi”.

“ One of the most embarrassing legacies of the Getty’s freewheeling past is the statue of a kouros, a naked youth, supposedly from the sixth century BC.
Th[e origin document, a] letter is a forgery; it bears a postal code that came into use only in the 1970s. In 1990, an art historian compared the Getty’s kouros to a torso allegedly made in Rome in 1985 by an Italian forger. The Getty acquired the torso, made its own comparison, and could not decide if the kouros was genuine or not.
To this day, the enigma continues.”

www. getty .edu/art/ getty guide/artObjectDetails?artobj=12908 Around US$ 8.000.000,00

Art experts felt in two seconds “ a wave of intuitive repulsion ” that told them the kouros was a fake.
What happens during these 2 seconds? Recognition-primed decision.

Klein’s burden of proof argument
“ You could argue that perhaps the decision makers were comparing options but not consciously. We have no way of knowing whether this might be true. Still, you have to be careful about making that argument because when you do, the burden of proof shifts from me to you. I cannot prove that something is not happening. I can tell you I do not believe decision makers are comparing options since they do not report it, there usually was not much time for it, and I can explain their actions in other ways. If you want to claim they are subconsciously comparing options, then the burden of proof is on you to provide evidence.”

What if…
They’re not comparing options…
… but there still is unconscious competition to prime the appropriate response?

Bell curve on the number of primed actions
>1  cheating student; mother & kid on bicycle;
<1  baby playing with triangles, squares & circles
1

Bell curve on the number of primed potential actions
>1  speech errors; fleeting hesitations
<1  unsatisfactory feeling concerning situation; raising of anxiety; feeling that something must be done but no idea of what
1

Recognition-Primed Decision Model: BOX AND ARROW PSYCHOLOGY? no yes Perceived as typical [Prototype or analog] Expectancies Relevant Cues Plausible Goals Recognition has four byproducts Action 1...n Modify yes,but Evaluate Course of Action Will it Work? Implement Course of Action Evaluate Action (n) [Mental Simulation] Experience the Situation in a Changing Context

Limitations
No falsifiable predictions
Boxes and Arrows approach
However, explains Libet’s results nicely.

Next week…
What is recognition?
(Hofstadter’s findings)
How do we discard options?
(Libet’s findings)

The legal reasoning against world domination by women!

Since world domination started when they took our babies, this is where we should place our efforts!

Next week…
What is recognition?
(Hofstadter’s findings)
How do we discard options?
(Libet’s findings)

Class 6

by Alexandre Linhares on Oct 16, 2006

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Class 6 — Presentation Transcript

http://www.intuition-sciences.com	11
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