In David Lodge’s 1975 novel Changing Places, a send-up of academic pomposities, characters play a parlor game called Humiliation in which players name classical works of literature they have not read. The winner is he who names the work least unread by others in the party, thereby achieving for himself the greatest purported degree of humiliation. Of course, the joke is that only the most highly literate would find the game amusing in the first place. The self-outings are mere tokens; the game is really an opportunity for some backhanded self-puffery.
The game Lodge invented has o’erflowed the borders of fiction and come to be embraced by real-life academics. One scholar I know tells of playing it with a bunch of colleagues on an Edinburgh-bound train from Dundee, Ireland, where they’d all been attending a James Joyce convention. After several noisy rounds, a gentleman sitting a few rows away stood and rotated to address them over the back of his seat. “I have a doctorate in modern literature from Oxford,” he pronounced majestically, “and I’ve never read a word of D. H. Lawrence.” The entire train compartment erupted in hilarious applause and the competition ended there, the posh interloper its uncontested winner.
With its distinctive flavor of braggadocio masquerading as humility, the game proposes an intriguing thesis on the magnetism of shame: Perhaps in an effort to master our dread of it, we flirt with its toothless cousin, much as we might symbolically vanquish a hated tyrant by burning him in effigy.
But although the game might be played exclusively among academics, the dread is hardly limited to the ivory tower. How else to explain the thriving niche economy that preys upon this insecurity? Here’s just a smattering of titles in the current crop of self-help books: The Art of Faking It: Sounding Smart Without Really Knowing Anything; The Concise Guide to Sounding Smart at Parties: An Irreverent Compendium of Must-Know Info from Sputnik to Smallpox and Marie Curie to Mao; How to Impress Anybody: Sound Smarter Than You Are About Everything from Aerodynamics to Zen Buddhism; How to Talk About Books You Haven’t Read; The Intellectual Devotional: Revive Your Mind, Complete Your Education, and Roam Confidently with the Cultured Class; An Incomplete Education: 3,684 Things You Should Have Learned but Probably Didn’t; Everything You Pretend to Know and Are Afraid Someone Will Ask.
And even if none of the above pertains—even if you already know all that stuff—rest assured there’s likely still something to feel insecure about. Students at the Massachusetts Institute of Technology may be able to explain cold fusion and, I don’t know, the proof for Fermat’s Last Theorem, but do they know how to butter their bread? For the past twenty years, MIT has been running an annual tongue-in-cheek charm school that aims to rectify such deficits as uncertainty about whether to hold a wineglass by its stem or bowl, how to cut lettuce, and what to do with your napkin when you go to the bathroom. Graduates are awarded ChDs (doctors of charm).
How about a school that teaches people to say “I don’t know”?
More and more, medical schools are assuming this responsibility. This is notable because it represents a major divergence from the culture of traditional Western medicine. “Doctors use information as part of the therapeutic regimen,” wrote the philosopher Sissela Bok in 1978. “It is given out in amounts, in admixtures, and according to timing believed best for patients. Accuracy, by comparison, matters far less.” She points out that Plato, in his Republic, says that because physicians may use falsehood as a form of healing, they enjoy a right to dissemble that laymen do not. And she suggests that doctors might at times feel, with reason, duty-bound to conceal what they do not know:
Physicians know only too well how uncertain a diagnosis or prognosis can be. They know how hard it is to give meaningful and correct answers regarding health and illness. They also know that disclosing their own uncertainty or fears can reduce those benefits that depend upon faith in recovery.
Hiding uncertainty has been ingrained as part of a physician’s job, although medical students absorb this lesson not so much via straightforward instruction (Now, class, you must at all times maintain an aura of knowing) as through operant conditioning: receiving viscerally aversive stimulus when they acknowledge they don’t know.* An oncologist recalls a fairly standard example of this. She was a third-year student on rounds when the resident told her to look at the computer screen where the patient’s comprehensive metabolic panel—a sea of complicated letters and numbers—was displayed. “What does this value mean?” he asked, pointing at one of the figures.
“I don’t know,” she freely admitted.
“What?” His voice grew lower and more scathing with each successive word. “You. Don’t. Know. That?”
She felt she should quit right then, felt she was an imposter, a fraud. Decades later as she retells the story, her cheeks burn red.
My friend Pam became a psychiatrist after a brief career as a social worker. “In medical school,” she says, “there’s this pressure to know it all. You stand around the patient and the attending asks a question. ‘What is the differential diagnosis for this abdominal pain?’ And you’re just hoping you have the answer, the pearl. That’s what they’re called: knowledge pearls. It’s completely different from the social sciences, where multiple perspectives are valued, where you write essays, where you discuss theory. In medical school there’s one answer. That’s the pearl.”
Another doctor, an obstetrician, tells of a time when, as a new intern, she was asked by the attending physician to assist on a postpartum tubal ligation—a procedure she’d not witnessed before. Eagerly, she did. Two days later, the chief of obstetrics asked her to assist with the same procedure. “You’ve done this?” the chief asked. “You know what you’re doing?”
Yes, said the new intern with a concerted air of confidence.
The chief handed her the scalpel. “Go ahead.”
Scrupulously, meticulously, the new intern cut into the woman’s abdomen exactly as she had seen the first doctor do—and made an incision four times as long as the chief had told his patient her scar would be.
“I should have said, ‘Show me how you want the incision done,’” the obstetrician now says. “I should have said, ‘I’ve seen one of these, but I’ve never done it myself.’ But I was so anxious to show him I knew what I was doing.”
Later, the new intern and the chief went to visit the patient together as she lay in recovery, and the chief delivered a lesson that only reinforced the professional premium on concealing uncertainty. Rather than tell the patient the truth, he delivered a self-serving lie. “Circumstances were tough in your case,” he said smoothly, “but we managed by making the incision a little longer.”
The culture that produced these stories is changing. Part of physicians’ reluctance to reveal uncertainty or acknowledge mistakes stems from the very real fear of malpractice suits. In 1986, Massachusetts became the first state to forbid the use of a doctor’s apology as evidence of wrongdoing. Today, thirty-five states and the District of Columbia have enacted similar “I’m sorry” laws. Studies indicate that these laws, and the concomitant rise in physician honesty, have led to reduced anger in patients as well as lower settlement costs when malpractice suits are brought.
But it’s complicated. Sometimes patients are the ones pressing doctors to don the costume of all-knowing, all-powerful healer.
“One patient made me very nervous,” says another obstetrician, “by putting me up on a Godlike pedestal. She’d say, ‘I know you won’t let anything happen to me or my baby.’ I’d be very careful in how I’d reply. I’d say, ‘I’ll do the best I can.’”
It became a kind of dance, a nervous two-step they’d play out at every visit, with the patient, who’d had numerous pelvic surgeries and a hard time getting pregnant, not-so-subtly exhorting the doctor to promise what he could not possibly know for sure, and the doctor trying to walk a fine line between placation and honesty. “She really seemed to need me to know, for her own psychic well-being. Each time I stopped short of telling her I knew everything would be okay, I felt I was cutting her legs out from under her. Eventually I found myself not quite assenting, but not quite disabusing her, either.” In the end, mother and baby were fine, but the doctor was left with a residue of discomfort.
Still, more and more health-care providers are becoming both sanguine and prolific with their “I don’t knows.”
“Are you kidding?” says Jessi, a midwife. “I tell patients I don’t know all the time. I tell them I’m stumped. I’m just not willing to fake it. That would be so much worse for me. I’d rather have them think I’m stupid.”
“My patients generally appreciated it when I’d say I didn’t know,” affirms a retired internist. “I’d say I’m going to do some research and get back to them. Or I’d step out into the hall and consult with a colleague who might have experience with this issue. I’d think, ‘Who can I bring in who has gray hair?’”
Pam, my psychiatrist friend, talks about how essential it is that she keep her sights on how little she can ever know. As a brand-new social worker, she was once conducting an intake interview when the client interrupted: “Can you just be quiet and listen to me?” Pam was taken aback, but complied, and soon realized the client had been correct; the intake questions didn’t fit what the client needed to say.
Patients often tell Pam, “You have no idea what I’m going through.” Although initially her impulse was to offer solace in the form of empathy, to reassure them that she did know, she has since learned to say, “You’re absolutely right. Please tell me what it’s like. I don’t know, but I can listen.”
“Most people go into this field because we have a need to help people,” she says. “But that’s the hardest thing to get: We’re just the help, we’re not the answer.”
• • •
Doctors who are most comfortable saying “I don’t know” tend to describe their relationships with patients as collaborative: They work together to assemble information and decide how to proceed. The doctor has the specialized knowledge; the patient presents the goal or need. In this paradigm, the doctor isn’t entirely unlike a reference librarian helping a patron with a research project.
My friend Stokley happens to be a reference librarian. He works at the Evergreen State College, and saying “I don’t know” is a big part of his job. In fact, it’s what got him the job.
His initial interview was conducted over speakerphone. The head of the search committee asked, “What would you do if a student came to you looking for information on the American sublime?”
“Well, first,” said Stokley, “I’d tell the student I don’t know anything about that.”
From the other end of the line, laughter.
“But that’s a connection,” he went on. “We both don’t know. That’s a kind of intimacy. So, okay, I’d start by asking them questions. What interests you about the sublime? Why does it interest you? What do you already know about it? What do you think about what you know?”
His boss, Sara, remembers the interview well. Other candidates had replied to the same question with stock answers, displaying their knowledge by listing the standard databases they’d consult. “Stokley’s response was the only one that focused on the student,” Sara says. “I remember big smiles around the table. We were, like, ‘We found him. We can hang up now.’”
He started working the evening shift, and soon met and exceeded Sara’s hopes by regularly calling her at home. She laughs, explaining: “I’ve trained so many people and I’ve always said, ‘Call me if you have a question.’ Stokley’s literally the only person ever to do it. The first time he called—I was so happy! What a gift. What a relief. I thought: Here’s a person who knows how to take care of himself, to ask for help. He’s a real grown-up. It instills confidence.”
Isn’t that funny? Isn’t it beautifully antithetical to what we go around fearing? Stokley’s saying “I don’t know,” far from diminishing him in the eyes of others, confirmed his strength, his maturity, his capability. Not only that, it extends the possibilities for his connecting with others—with his boss and colleagues and also with library patrons, those students and faculty members who come bearing the dual gift of their own desires and limitations.
In journalism school, I’d been afraid to admit I didn’t know what a nut graf was because I dreaded exposing myself as inadequate. But the deeper dread was that I’d be cast off, abandoned, that a connection would be revoked. Consider the irony. We swallow the words “I don’t know” for fear of rupture: The admission might sever us from those we love or esteem. But the passive lie—the pretense of knowing—causes shame: an internal rupture, a rupture of self. And the bond we think we’ve managed to sustain with others is not a real bond; it’s based on falsity.
Now consider the alternative. We allow the words “I don’t know” to fly from our mouths, perhaps as a confession of ignorance, perhaps as a voicing of uncertainty. Either way, the result is a relinquishing of control. We declare ourselves open to receiving information, ideas, and perspectives from beyond the borders of self. And in so doing, our connection to others and to the world is not ruptured. On the contrary. In the honest flow of giving and receiving, we are closer than ever.
So much becomes possible when we honor doubt.
What if we were to embrace saying “I don’t know”? What if we were to see it as an instrument for opening up and extending all sorts of possibilities, including, crucially, the possibility for connections among people?
Our civic life is heavily marked—indeed, pocked—by debates in which each side is so certain of its position that any movement is effectively impossible. For that matter, debate—in its original sense of “to consider something, to deliberate”—is impossible. We wind up with so much sound and fury and nothing gained.
Only when we allow the possibility that we may not know for sure, when we slip out from under the terrible yoke of our own notions, when we shift from the fundamentalism that has hardened like clay around our feet and allow doubt to flow freely through our membranes—though this may sting—only in concert with such internal movement can meaningful external movement occur.
Take climate change. For years, scientists and advocates for responsible stewardship have been warning that climate change is a real and serious threat, largely caused by human behavior, and with the possibility of being mitigated or remedied by changes in human behavior. For years, big oil and others have been saying this is baloney. Despite the mounting evidence of global warming presented by scientists and advocates, the deniers seem unbudged. In fact, a 2012 study in the journal Risk Analysis shows a rise in global warming skepticism. (In 2002, only 7 percent of Americans had “naysayer associations,” as opposed to more than 20 percent in 2010.)
One of the authors of that study, Anthony Leiserowitz, director of the Yale Project on Climate Change Communication, is a leading expert on the public’s perception of climate change and the psychology of decision making. In a 2013 interview with Bill Moyers, he spoke to the issue of moving dialogue forward when both sides have entrenched points of view.
Bill Moyers: Assume that I’m a skeptic. Not only a skeptic, but a Tea Party Republican who goes to church every Sunday where my beloved pastor tells me that, reassures me that God created the earth six thousand years ago and that if God wants to end the earth, God will on God’s terms, that this is out of our control. If you were sitting across from a good, disciplined believer like that, what argument would you make to me?
Anthony Leiserowitz: Well, the first thing I would do is I would listen, I would really listen. Because I’d want to know really what are the depths of, not just their concerns about this issue, but what are their aspirations? What do they want for their children? What do they want for their grandchildren? What kind of community do they want to live in? What are the values that really animate and motivate them?
He continues at some length, not presenting facts or studies or data, but rather detailing the kind of conversation he would hope to engage in, a conversation about ethos and desire and common ground. But did you notice the very first thing he said? Moyers asked what he’d argue and Leiserowitz said he’d listen. He’d come from a place of not knowing, as a way of connecting with the other.
Can you imagine if politicians were to adopt this style of debate? Just picture it: the presidential candidates at their podiums, or senators and members of Congress on the legislative floor. There they are, assembled to debate issues and policies, bills and provisions, and instead of trammeling and tromping over one another with their words, they turn to one another and listen, really listen.
We see another example of how deep listening can loosen up entrenched beliefs in the realm of gay marriage. Here, it’s often a specific human connection that sparks a willingness to think fluidly. The connection might be as direct as having a son or daughter who is gay. In March 2013, after the Republican senator Rob Portman reversed his position on gay marriage, he spoke of how his son’s coming out had been instrumental in shifting him from his previous convictions. “It allowed me to think of this issue from a new perspective,” he told reporters, “and that’s of a dad who loves his son a lot and wants him to have the same opportunities that his brother and sister would have.” Portman’s loving wishes for his own son allowed him to reconsider what he thought he knew.
But the connection that moves us can also be more subtle, less direct. One year earlier, when President Obama announced his support for gay marriage, he spoke of his “evolution” on the issue being influenced by various personal relationships. First he named relationships with friends, family, neighbors, and members of his own staff who were in “incredibly committed” same-sex relationships. But later in the interview he spoke of another connection that contributed to his shift:
You know, Malia and Sasha, they’ve got friends whose parents are same-sex couples. And I—you know, there have been times where Michelle and I have been sittin’ around the dinner table. And we’ve been talkin’ and—about their friends and their parents. And Malia and Sasha would—it wouldn’t dawn on them that somehow their friends’ parents would be treated differently. It doesn’t make sense to them. And—and frankly—that’s the kind of thing that prompts—a change of perspective.
The change of perspective Obama talks about here wasn’t motivated by wanting something—in this case, marriage equality—that would directly benefit his children. Instead, it was enabled simply by listening to the views of people he loves and values and respects.
Nor do you have to be related to someone in order to be changed by your connection; the transformation might even arise from a contentious relationship. In 2010, David Blankenhorn, the founder and president of the Institute for American Values, was a star witness in California’s Proposition 8 trial, testifying against gay marriage. But in the summer of 2012, in a move that shocked his allies and even his own board members, he announced he was dropping his opposition in favor of an egalitarian pro-marriage agenda. In a 2012 radio interview, asked to address what led to his change of heart, Blankenhorn first speaks in broad, abstract terms: a process of thinking, conversation, intellectual argument, etc. But then he begins to talk about Jonathan Rauch, the journalist and activist in favor of gay marriage. Initially, their relationship was antagonistic, to say the least. (“I said many ugly things about him,” Blankenhorn recalls.)
But over time, debate led to rapport, rapport to empathy, and empathy to doubt. Blankenhorn tells the interviewer:
I don’t want to get schmaltzy about it, but the truth is . . .
But the truth is that I probably wouldn’t have changed my mind without knowing Jonathan personally. You know, and I used to think, well, oh, gee, what a lame thing, you know, your friendships are influencing your thinking.
But, I—you know, you build up a kind of barriers of belief in theory, and it keeps the other people out, and so you talk about them. You have theories about them. You can explain their lives to them, but you never really talk to them and see it from their point of view. So for me as this guy from the South, older guy, you know, hadn’t known many gay people, so it was a meaningful thing. And after [my] being very aggressive and abusive, you know, he responded with kindness and, like, uh, well, you know, maybe we could talk a little bit.
Maybe we could talk a little bit. The same thing Anthony Leiserowitz proposes. The same thing that happened between Rob Portman and his son. The same thing that happened around the Obama family dinner table. The same thing we are all capable of choosing, on a daily basis, with those people in our lives whom we do not fully fathom. Real civil discourse necessarily leaves room for doubt. This doesn’t make us wishy-washy! We can still hold fervent beliefs. The difference is, we don’t let those beliefs calcify into unconsidered doctrine. As Blankenhorn has written:
Doubt and civility go together naturally, like ham and eggs, coffee and cream . . . Doubt is my friend. I don’t mean that I’ve stopped having beliefs, or stopped being passionate about those beliefs; it’s just that I’m more and more certain, when it comes to the free life of the mind, of the importance of uncertainty.
Human connection helps usher in doubt. Doubt may in turn increase the quality and reach of human connection. Put another way: In the presence of love we may soften our certainties, and in the softening of our certainties we may be led into fuller love.
By the same logic, fundamentalism of any kind is the refusal to allow doubt. The opposite of fundamentalism is the willingness to say “I don’t know.”
• • •
But how frightening those words remain. Even if we can be persuaded that they do not commit us to loneliness or exile from human company, instead paving the way for more intimate, authentic connection, still they persist in reminding us of our essential vulnerability. We are small, limited creatures in an illimitable, unknowable world, appallingly wobbly beneath our feet.
Developmental psychologists say fear of the unknown presents in infants as young as five months. Evolutionary psychologists say such fear may be a positive adaptive behavior, one that helped early hominids avoid danger. But fear of the unknown is not quite identical to fear of not knowing. With the former, the peril is external. With the latter, it’s rooted in the precincts of the self. The recognition that we are in some profound sense alone and without answers fills us with existential dread. Yet looked at another way, the realization may brim with hopeful possibility. The British psychoanalyst D. W. Winnicott called doubts about the self a “child’s most sacred attribute.” Whether we tilt more in the direction of dread or hope boils down to how we manage our feelings about living with mystery.
Primitive cultures responded to the unbearable scariness of mystery with a method at once simple and ingenious: What they didn’t know, they made up. Why does it get dark at night? Because so many birds fill the sky, their wings block out the sun (so said the Mamaiurans of Brazil). Why has the moon been growing smaller? Because the gods have been imbibing some of its elixir (so said Hindu mythology). Why are all the people of my village getting sick? Because the god Tlaloc threw one of his wrathful lightning bolts our way (so said the Aztecs). And what, oh what, is that amazing ribbon of colored light arcing across the sky, making me weep and laugh and quiver with awe? That’s Bifröst, said the ancient Norse: a shimmering bridge to Asgard, home of the gods.
In modern times we are no less anxious about the unknown, but we are more likely to seek comfort through science or ideology. Or, failing that, superstition. As a child, I went through an intense period of fearing the unknown. It affected me most upsettingly at bedtime, and for the better part of a year I could not go to sleep without the soothing relief of rituals that presented themselves to me without my consciously devising them: I became prisoner to a certain way of wrapping my head in the bedsheet, of rubbing my feet together, of silent counting and of matching my inhalations and exhalations to the rhythm of the numbers as I spoke them in my head.
I was helped to outgrow this phase by my mother, who one day invited me to sit at the kitchen table with pencil and paper and write down my fears. Of course, in order to do that, I had to give them language, and this minor intervention—the act of plucking them from the roiling stew of the unnameable and setting them down as words on lined paper, in my own familiar handwriting—tamed them somewhat.
The other, mightier, part of my recovery also came to me through my mother, but it took the exact opposite approach: Instead of an attempt to master my fears by coming to know them, it involved making friends with the unknown. My mother was not religious in any conventional sense, but she had a kind of faith in, and reverence for, that which must always remain mysterious. The way she opened herself up to this mystery without ever expecting to decrypt it conferred on me a sense of limitless potential and peace.
My mother held with no catechism, no rote set of questions and answers. She did not look to accrue knowledge pearls or put uncertainties to rest. She liked puzzles—crossword, jigsaw, tangram—and paper craft, and she liked making things with leaf and vine, thread and charcoal and yarn. Silver blades and matte board. Paint and cloth and wax. It seemed to me she’d spend forever rearranging things, feeling her way toward large patterns, toward harmonies of meaning and shape, but always with a looseness, an attentiveness to alteration. I remember watching her work at the kitchen table, wondering at her stern concentration, which at the time seemed almost a scowl, but which I now understand was a look of bottomless receptivity. A harking.
About death, that most intractable of mysteries, she was unrepining, curious, patient. The winter my oldest child was ten, he became frightened of death. He’d been sledding on a hill near home when his toboggan skimmed out of control, going much too fast for me to intercept him before he reached the road. There were no cars. He shot over the empty street and up the driveway opposite, smashing into a garage door which had been left open a foot. His toboggan continued into the garage; he was stopped at the point of contact between the garage door and his shin. There were tears, and the gash on his leg was already swelling, but no serious damage had been done.
That night in bed, he said he couldn’t stop replaying the crash in his mind. He’d overheard a remark one of the grown-ups had made, something to the effect that if the garage door had been open another foot, “he might have been beheaded.” That frightening phrase was now lodged in his imagination, compounding his fear of the concrete—a decapitating blow—with fear of the unthinkable—death.
Several days later we visited my parents. The specter of death had been hovering over him for days, rattling his mood, interfering with his sleep, and now he spoke of it to my mother. She asked, “Did I ever tell you my theory about the contract?”
He shook his head.
“The way I think of it,” she said, “is when we’re born, we get this wonderful prize, we get to be a person in the world. We get to partake of life. There’s only one condition: At some point we have to die. That’s the contract.”
The way she saw it, she continued, problems arise when people forget that dying is part of the contract all along. Problems arise when we fall into the trap of thinking death is unnatural. If we accept it as the single condition for receiving the vast, tremendous experience of being alive, if we keep this contract in mind, it can lift the dread. “I think it’s a great deal,” she said, with a kind of marveling happiness. This was about a year after she’d learned she was dying of cancer.
To regard the ultimate unknown as something not evil, not alarming or wrong, but just that: unknown. This was a gift she had to give.
Sometimes we bite our tongues rather than admit, “I don’t know.” This act arises from shame, and perpetuates shame, and is a shame. Other times we say “I don’t know” in an effort to absolve ourselves of responsibility and vulnerability. This act borders on blasphemy. For when we use these words to ratify responsibility and embrace vulnerability, saying and thinking and feeling them become a form of grace.
Of course, it is possible to revel in the experience of not knowing without speaking a single word.
It’s funny that my son’s dread of dying arose from an experience with snow, for my mother loved snow with an ardor that bordered on the devout. She once copied down a line from a Billy Collins poem—This is the true religion, the religion of snow—and thumbtacked it to a corkboard. Snow, for her, was the universe’s magnum opus, the icing on the cake, though in truth she thrilled to all weather, the very fact of it—its uncontrollable nature, its magisterial indifference, its inexhaustible mysteriousness. She passed along that devotion, that reverence for something we may never hope to master or comprehend, to us, her family. The most memorable lesson she ever gave me about falling willingly, in gratitude, toward the unknown was delivered without fanfare, without words, amid snow.
I was nine. School had been canceled because of a blizzard the night before. In the afternoon, my mother and I visited the library one town over. When we’d had our fill of books, my mother made a proposal: How about, instead of calling my father for a ride home, we walk? Four and a half miles north along the Hudson; it seemed to me not just far but far-fetched—and irresistible.
The snow had resumed falling, very lightly. Specks of glitter. There was the cold spangling our lungs, our breath hanging tinsel-like in front of our mouths, the faint dusky drum skin of the sky blackening over our heads. We hardly spoke. We walked and walked. Home was far off, and night deepened, and the land was foreign and huge. The lights in the houses along the road came on one by one, amber lozenges cut out of the darkness. Beyond the houses the river ran sluggish with ice. Streetlights shone and trees formed a vaulted ceiling above, with the white plumage of the pines splendid as arms, and the bony branches of the hardwoods like stained glass windows framing the beyond, and every twig encased in ice, glittering, celebrated, every single one: oh the world, the world, exquisitely insoluble.