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Chief Medical Editor Message

We Notice
What Stands Out

January 2007

Have you ever been in a room with a noisy air conditioner and not noticed its sound until it turned off?  

Have you ever seen a patient with lots and lots of benign nevi and noticed a melanoma right away because of how different it was from the other spots?  

Have you ever looked at a dermatopathology specimen and seen the blue nests of basal cell carcinoma just jump out at you from the red dermal sea?  

Our minds are built to detect what stands out, what is different from the rest. It might not be surprising that the ability to detect something amiss was a useful function, one that evolution would strongly conserve in the organization of our mental faculties.

How Our Perceptions are Shaped

Our tendency to notice the unusual affects our perceptions of the everyday world.

Our minds probably pay little attention to the routine payment of bills by insurance companies. But when they choose not to pay for something, it certainly grabs our attention.

When we go home at night we hardly think of the dozens of patients who had great, albeit regular, experiences in our offices. What makes or breaks our days will be one or two patients, ones about whom we can’t stop thinking because something exceptionally good, or exceptionally bad, happened with them.

Building A Warped Sense of Reality

Our perceptions of the world are based largely on the uncommon and will tend to ignore the routine and the mundane. Our minds lend too much weight to the outlier, giving us a warped view of reality.

We might come to think insurers are evil, though for the most part, they pay the cost of medical care.

One troubled patient might make us think it was a terrible day, even though we touched dozens of lives in a positive way and helped dozens of patients with appropriate treatments.

The Outliers and the Ordinary Matter

In this time of war, it may be worth noting that what is news is news because it grabs our attention. The routine and the ordinary won’t sell commercials.

While 100,000 of our troops are doing well, we are going to hear the body count of those who are killed or injured.
While perhaps hundreds of millions of Muslims around the world pray five times each day for peace, the two or three who commit suicide bombings are the only ones we are likely to hear about on any given day.

It would not stretch credulity to believe that Arabs who see only foreign invaders from largely Christian countries might not realize there are hundreds of millions of Christians praying for peace, too.

We do need to pay attention to the outliers. They have a lot to tell us. But we also need to be mindful of the common and ordinary that would otherwise be lost in the noise.



Steven R. Feldman, M.D., Ph.D.
Chief Medical Editor

Have you ever been in a room with a noisy air conditioner and not noticed its sound until it turned off?  

Have you ever seen a patient with lots and lots of benign nevi and noticed a melanoma right away because of how different it was from the other spots?  

Have you ever looked at a dermatopathology specimen and seen the blue nests of basal cell carcinoma just jump out at you from the red dermal sea?  

Our minds are built to detect what stands out, what is different from the rest. It might not be surprising that the ability to detect something amiss was a useful function, one that evolution would strongly conserve in the organization of our mental faculties.

How Our Perceptions are Shaped

Our tendency to notice the unusual affects our perceptions of the everyday world.

Our minds probably pay little attention to the routine payment of bills by insurance companies. But when they choose not to pay for something, it certainly grabs our attention.

When we go home at night we hardly think of the dozens of patients who had great, albeit regular, experiences in our offices. What makes or breaks our days will be one or two patients, ones about whom we can’t stop thinking because something exceptionally good, or exceptionally bad, happened with them.

Building A Warped Sense of Reality

Our perceptions of the world are based largely on the uncommon and will tend to ignore the routine and the mundane. Our minds lend too much weight to the outlier, giving us a warped view of reality.

We might come to think insurers are evil, though for the most part, they pay the cost of medical care.

One troubled patient might make us think it was a terrible day, even though we touched dozens of lives in a positive way and helped dozens of patients with appropriate treatments.

The Outliers and the Ordinary Matter

In this time of war, it may be worth noting that what is news is news because it grabs our attention. The routine and the ordinary won’t sell commercials.

While 100,000 of our troops are doing well, we are going to hear the body count of those who are killed or injured.
While perhaps hundreds of millions of Muslims around the world pray five times each day for peace, the two or three who commit suicide bombings are the only ones we are likely to hear about on any given day.

It would not stretch credulity to believe that Arabs who see only foreign invaders from largely Christian countries might not realize there are hundreds of millions of Christians praying for peace, too.

We do need to pay attention to the outliers. They have a lot to tell us. But we also need to be mindful of the common and ordinary that would otherwise be lost in the noise.



Steven R. Feldman, M.D., Ph.D.
Chief Medical Editor

Have you ever been in a room with a noisy air conditioner and not noticed its sound until it turned off?  

Have you ever seen a patient with lots and lots of benign nevi and noticed a melanoma right away because of how different it was from the other spots?  

Have you ever looked at a dermatopathology specimen and seen the blue nests of basal cell carcinoma just jump out at you from the red dermal sea?  

Our minds are built to detect what stands out, what is different from the rest. It might not be surprising that the ability to detect something amiss was a useful function, one that evolution would strongly conserve in the organization of our mental faculties.

How Our Perceptions are Shaped

Our tendency to notice the unusual affects our perceptions of the everyday world.

Our minds probably pay little attention to the routine payment of bills by insurance companies. But when they choose not to pay for something, it certainly grabs our attention.

When we go home at night we hardly think of the dozens of patients who had great, albeit regular, experiences in our offices. What makes or breaks our days will be one or two patients, ones about whom we can’t stop thinking because something exceptionally good, or exceptionally bad, happened with them.

Building A Warped Sense of Reality

Our perceptions of the world are based largely on the uncommon and will tend to ignore the routine and the mundane. Our minds lend too much weight to the outlier, giving us a warped view of reality.

We might come to think insurers are evil, though for the most part, they pay the cost of medical care.

One troubled patient might make us think it was a terrible day, even though we touched dozens of lives in a positive way and helped dozens of patients with appropriate treatments.

The Outliers and the Ordinary Matter

In this time of war, it may be worth noting that what is news is news because it grabs our attention. The routine and the ordinary won’t sell commercials.

While 100,000 of our troops are doing well, we are going to hear the body count of those who are killed or injured.
While perhaps hundreds of millions of Muslims around the world pray five times each day for peace, the two or three who commit suicide bombings are the only ones we are likely to hear about on any given day.

It would not stretch credulity to believe that Arabs who see only foreign invaders from largely Christian countries might not realize there are hundreds of millions of Christians praying for peace, too.

We do need to pay attention to the outliers. They have a lot to tell us. But we also need to be mindful of the common and ordinary that would otherwise be lost in the noise.



Steven R. Feldman, M.D., Ph.D.
Chief Medical Editor