Jeg var på hospitalet i meget lang tid. Og et par år efter jeg kom derfra, tog jeg tilbage, og formanden fra brandskade afdelingen var meget spændt på at se mig -- sagde, "Dan, jeg har en fantastisk ny behandlingsteknik til dig." Jeg var meget spændt. Jeg fulgte med ham til hans kontor. Og han forklarede mig, at når jeg barberer mig har jeg små sorte pletter på venstre side af mit ansigt, hvor håret er, men på den højre side af mit ansigt var jeg slemt forbrændt, så der er ikke noget hår, og dette skaber manglende symmetri. Og hvad var denne fantastiske idé han havde? Han ville tatovere små sorte pletter på den højre side af mit ansigt og få mig til at se meget symmetrisk ud.
So, I was in the hospital for a long time. And a few years after I left, I went back, and the chairman of the burn department was very excited to see me -- said, "Dan, I have a fantastic new treatment for you." I was very excited. I walked with him to his office. And he explained to me that, when I shave, I have little black dots on the left side of my face where the hair is, but on the right side of my face I was badly burned so I have no hair, and this creates lack of symmetry. And what's the brilliant idea he had? He was going to tattoo little black dots on the right side of my face and make me look very symmetric.
Det lød interessant. Han bad mig gå ud og barbere mig. Lad mig fortælle jer, dette var en mærkelig måde at barbere sig på, fordi jeg tænkte på det og det gik op for mig, at sådan som jeg barberede mig der ville være den måde, jeg barberede mig resten af livet -- fordi jeg skulle beholde den samme bredde. Da jeg kom tilbage til hans kontor var jeg ikke rigtigt sikker. Jeg sagde, "Kan jeg se nogle beviser for dette?" Så han viste mig nogle billeder af små kinder med små sorte pletter -- ikke særligt informerende. Jeg sagde, "Hvad sker der når jeg bliver ældre og mit hår bliver hvidt? Hvad vil der så ske?" "Det skal du ikke tænke på" sagde han. Vi har laser; vi kan afblege det" Men jeg var stadig skeptisk, så jeg sagde, "Ved du hvad, jeg gør det ikke."
It sounded interesting. He asked me to go and shave. Let me tell you, this was a strange way to shave, because I thought about it and I realized that the way I was shaving then would be the way I would shave for the rest of my life -- because I had to keep the width the same. When I got back to his office, I wasn't really sure. I said, "Can I see some evidence for this?" So he showed me some pictures of little cheeks with little black dots -- not very informative. I said, "What happens when I grow older and my hair becomes white? What would happen then?" "Oh, don't worry about it," he said. "We have lasers; we can whiten it out." But I was still concerned, so I said, "You know what, I'm not going to do it."
Og så kom en af de største skyldfølelser i mit liv. Okay, det her kommer fra en jødisk fyr, så det siger ikke så lidt. (Latter) Og han sagde, "Dan, hvad er der galt med dig? Kan du godt lide at se asymmetrisk ud? Får du en eller anden pervers nydelse ud af det? Føler kvinder medlidenhed med for og har sex med dig oftere?" Intet af dette skete. Og det var meget overraskende for mig, for jeg havde været igennem mange behandlinger -- der var mange behandlinger, jeg besluttede mig for ikke at tage imod -- og jeg fik aldrig denne skyldfølelse i samme grad. Men jeg bestemte mig for ikke at få behandlingen. Og jeg henvendte mig til hans suppleant og spurgte ham, "Hvad sker her? Hvor stammer denne skyldfølelse fra?" Og han forklarede mig, at de havde gennemført proceduren på to patienter allerede, og de havde brug for en tredje patient til den afhandling de skrev.
And then came one of the biggest guilt trips of my life. This is coming from a Jewish guy, all right, so that means a lot. (Laughter) And he said, "Dan, what's wrong with you? Do you enjoy looking non-symmetric? Do you have some kind of perverted pleasure from this? Do women feel pity for you and have sex with you more frequently?" None of those happened. And this was very surprising to me, because I've gone through many treatments -- there were many treatments I decided not to do -- and I never got this guilt trip to this extent. But I decided not to have this treatment. And I went to his deputy and asked him, "What was going on? Where was this guilt trip coming from?" And he explained that they have done this procedure on two patients already, and they need the third patient for a paper they were writing.
(Latter)
(Laughter)
Nu tænker I sikkert, at denne fyr er en idiot. Det er sådan, han fremstår. Men lad mig give jer et andet perspektiv på den samme historie. For et par år siden var jeg igang med nogle af mine egne eksperimenter i laboratoriet. Og når vi kører eksperimenter håber vi typisk, at en gruppe opfører sig anderledes end andre. Vi havde en gruppe, hvis præstationer jeg forventede, ville være meget høje, en anden gruppe jeg troede, ville have dårlige præstationer. Og da jeg fik resultaterne, var det det vi fik -- jeg var meget glad -- bortset fra en person. Der var en person i gruppen som skulle have haft meget høj præstation, men som rent faktisk præstede meget dårligt. Og han trak hele gennemsnittet ned, hvilket ødelagde den statistiske signifikans i testen.
Now you probably think that this guy's a schmuck. Right, that's what he seems like. But let me give you a different perspective on the same story. A few years ago, I was running some of my own experiments in the lab. And when we run experiments, we usually hope that one group will behave differently than another. So we had one group that I hoped their performance would be very high, another group that I thought their performance would be very low, and when I got the results, that's what we got -- I was very happy -- aside from one person. There was one person in the group that was supposed to have very high performance that was actually performing terribly. And he pulled the whole mean down, destroying my statistical significance of the test.
Så jeg kiggede omhyggeligt på denne fyr. Han var omkring 20 år ældre end alle andre i stikprøven. Og jeg huskede, at den gamle og fordrukne fyr kom ind til laboratoriet en dag for at tjene nogle hurtige penge og det var denne fyr. "Fantastisk!" tænkte jeg. "Lad os smide ham ud. Hvem var dum nok til at inkludere en fuld mand i stikprøven?"
So I looked carefully at this guy. He was 20-some years older than anybody else in the sample. And I remembered that the old and drunken guy came one day to the lab wanting to make some easy cash and this was the guy. "Fantastic!" I thought. "Let's throw him out. Who would ever include a drunken guy in a sample?"
Men et par dage senere tænkte vi over det sammen med mine studerende, og vi sagde, "Hvad ville være sket, hvis denne fulde fyr ikke var i denne tilstand? Hvad ville være sket, hvis han var i en anden gruppe? Ville vi have smidt ham ud så?" Vi ville sikkert slet ikke have set på dataene, og hvis vi så på dataene ville vi sikker have sagt, "Fantastisk! Sikke en smart fyr som præsterer dårligt", fordi han ville have trukket gennemsnittet for gruppen længere ned, hvilket ville have givet os endnu stærkere statistiske resultater, end vi kunne. Så vi bestemte os for ikke at smide fyren ud og for at gentage eksperimentet.
But a couple of days later, we thought about it with my students, and we said, "What would have happened if this drunken guy was not in that condition? What would have happened if he was in the other group? Would we have thrown him out then?" We probably wouldn't have looked at the data at all, and if we did look at the data, we'd probably have said, "Fantastic! What a smart guy who is performing this low," because he would have pulled the mean of the group lower, giving us even stronger statistical results than we could. So we decided not to throw the guy out and to rerun the experiment.
Men I ved, disse historier og en masse andre eksperimenter som vi har lavet om interessekonflikter bringer egentlig to pointer frem for mig. Den første er, at vi i livet kommet til at møde mange mennesker som, på en eller anden måde, prøver at tatovere vores ansigter. De har bare de incitamenter, som får dem til at blive blændet fra virkeligheden, og giver os råd, som i sig selv er forudindtagede. Og jeg er sikker på, at det er noget, vi alle genkender, og vi ser det ske. Måske genkender vi det ikke hver gang, men vi er klar over, at det sker.
But you know, these stories, and lots of other experiments that we've done on conflicts of interest, basically kind of bring two points to the foreground for me. The first one is that in life we encounter many people who, in some way or another, try to tattoo our faces. They just have the incentives that get them to be blinded to reality and give us advice that is inherently biased. And I'm sure that it's something that we all recognize, and we see that it happens. Maybe we don't recognize it every time, but we understand that it happens.
Det sværeste er, selvfølgelig, at genkende at vi nogle gange selv er blændede af vores egne incitamenter. Og det er en meget, meget sværere lektion at tage med i regnestykket. For vi ser ikke, hvordan interessekonflikter virker på os. Da jeg lavede disse eksperimenter hjalp jeg, i mit hoved, videnskaben. Jeg fjenede data for at få det sande mønster i dataen til at skinne igennem. Jeg gjorde ikke noget forkert. I mine tanker var jeg faktisk en ridder, som prøvede at hjælpe videnskaben med at komme fremad. Men det var ikke tilfældet. Jeg blandede mig faktisk i processen med en masse gode intentioner. Og jeg tror den sande udfordring, er at finde ud af hvor i vores liv interessekonflikter har deres virkning på os, og at prøve ikke at stole på vores egen intuition for at overkomme det, men at prøve at gøre ting som forhindrer os i at falde for disse dårlige vaner, fordi vi kan skabe mange uønskede omstændigheder.
The most difficult thing, of course, is to recognize that sometimes we too are blinded by our own incentives. And that's a much, much more difficult lesson to take into account. Because we don't see how conflicts of interest work on us. When I was doing these experiments, in my mind, I was helping science. I was eliminating the data to get the true pattern of the data to shine through. I wasn't doing something bad. In my mind, I was actually a knight trying to help science move along. But this was not the case. I was actually interfering with the process with lots of good intentions. And I think the real challenge is to figure out where are the cases in our lives where conflicts of interest work on us, and try not to trust our own intuition to overcome it, but to try to do things that prevent us from falling prey to these behaviors, because we can create lots of undesirable circumstances.
Jeg vil gerne efterlade jer med en positiv tanke. Jeg mener, det her er alt sammen meget deprimerende, OK -- mennesker har interessekonflikter, vi ser det ikke, og så videre. Det positive perspektiv er, mener jeg, at af alt dette, hvis vi opdager, når vi gør noget forkert, hvis vi forstår de dybe mekanismer der gør at vi fejler og hvor vi fejler, er der faktisk håb for at vi kan rette op på tingene. Og det, tror jeg, er håbet. Mange tak.
I do want to leave you with one positive thought. I mean, this is all very depressing, right -- people have conflicts of interest, we don't see it, and so on. The positive perspective, I think, of all of this is that, if we do understand when we go wrong, if we understand the deep mechanisms of why we fail and where we fail, we can actually hope to fix things. And that, I think, is the hope. Thank you very much.
(Klapsalver)
(Applause)