Stephen J Gould and a Classic

Hester Hill Schnipper, LICSW, OSW-C

MARCH 13, 2018

  It is snowing in Boston. Actually it is more like blizzarding and, for the first time this year, I am snowed in. The driveway has not been plowed, and it does not  yet make a lot of sense to shovel as it is pouring down. I do know the wisdom of keeping up with the storm, so won't wait until all "up to two feet" of snow is on the ground before getting to work. At the moment, however, it is warm and cozy inside, and I am doing the equivalent of closet cleaning as it applies to this column. Meaning, I am thinking about what hasn't been mentioned in years and is well worth another look.

  The most important piece would be Stephen Jay Gould's classic essay: The Median Isn't the Message. Dr. Gould was an evolutionary biologist who was diagnosed with peritoneal mesothelioma, a lethal for of cancer with a median mortality of eight months. Being a scientist, he immediately pondered those dire statistics and reminded himself that median means that half of the people will die before then and half afterwards. In any curve, there are people at the two ends--both the unlucky and the very fortunate one. He thought about those people who were at the lucky end and wondered what their shared luck was about. It is impossible to really understand, but he was determined to get himself into that group. And he did. Basically, he was cured (although, knowing oncologists as we do, I doubt that anyone ever used that word) and lived for many, many years--eventually to die of a totally different cancer.

  Even those of us who are much less sophisticated about science and statistics know that all statistics apply to a group of people, not to an individual. As I say to my patients over and over and over again, you are an N of one, and there is no reason not to consider yourself poised to be in the lucky end.

  If you have never read this essay, put it at the top of reading list. In fact, it would be wise to read it right now.

From Cancer Guide:

Stephen Jay Gould was an influential evolutionary biologist who taught at Harvard University. He was the author of at least ten popular books on evolution, and science, including, among others, The Flamingo's Smile, The Mismeasure of Man, Wonderful Life, and Full House.

As far as I'm concerned, Gould's The Median Isn't the Message is the wisest, most humane thing ever written about cancer and statistics. It is the antidote both to those who say that, "the statistics don't matter," and to those who have the unfortunate habit of pronouncing death sentences on patients who face a difficult prognosis. Anyone who researches the medical literature will confront the statistics for their disease. Anyone who reads this will be armed with reason and with hope. The Median Isn't the Message is reproduced here by permission of the author.

The Median Isn't the Message by Stephen Jay Gould
My life has recently intersected, in a most personal way, two of Mark Twain's famous quips. One I shall defer to the end of this essay. The other (sometimes attributed to Disraeli), identifies three species of mendacity, each worse than the one before - lies, damned lies, and statistics.

Consider the standard example of stretching the truth with numbers - a case quite relevant to my story. Statistics recognizes different measures of an "average," or central tendency. The mean is our usual concept of an overall average - add up the items and divide them by the number of sharers (100 candy bars collected for five kids next Halloween will yield 20 for each in a just world). The median, a different measure of central tendency, is the half-way point. If I line up five kids by height, the median child is shorter than two and taller than the other two (who might have trouble getting their mean share of the candy). A politician in power might say with pride, "The mean income of our citizens is $15,000 per year." The leader of the opposition might retort, "But half our citizens make less than $10,000 per year." Both are right, but neither cites a statistic with impassive objectivity. The first invokes a mean, the second a median. (Means are higher than medians in such cases because one millionaire may outweigh hundreds of poor people in setting a mean; but he can balance only one mendicant in calculating a median).

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