Risks and statistics

I ended up in the ED recently after an accident in the kitchen with a meat cleaver. It wasn’t too serious, but I did have to see a consultant surgeon in the end, even though I didn’t end up having any surgery. I wasn’t paying enough attention to where the meat cleaver was about to go, but once I got into the ED I paid close attention to the White Board. Inside the clinic, with the Emergency Clinical Nurse Consultant attending to my hand, I noticed the White Board. You couldn’t miss it. It contained risks and was a litany of all the things that you’re frightened of that exist in the back of your mind that you don’t want to give energy to for fear of bringing those risks closer to your own life.

What are the chances? This is a question you might ask yourself occasionally. What are the chances of having a heart attack? What are the chances of being murdered? What are the chances of being sexually assaulted? What are the chances of being hit by lightning? What are the chances of dying in a motor vehicle accident? What are the chances of dying in an aeroplane accident? What are the chances of being hit by a bus? What are the chances of having a stroke? What are the chances of developing cirrhosis of the liver? What are the chances of getting cancer? What are the chances of losing a limb? What are the chances that I’ll ignore the board, that I won’t see it when I enter the clinic? None at all.

I asked the Nurse about the board: what did it mean? Why was it there? Was this part of an inservice training session? Who had put all the information there? Why was it still there? He told me that it was there as a reference. As people often ask, “What are the chances…?” Someone had decided to write down and explicitly state exactly what those chances were. I think that he believed that it was a useful reference, a good source of facts to be delivered to people in a setting where they may have just received the news that they too were now the part of one of these categories.

I was morbidly fascinated by the White Board. I wish I’d taken a photograph of it to ponder it afterwards. I wasn’t comforted in the slightest by the statistical information that it carried. I was more horrified by the small window of comfort that I perceived that I had in not being part of the statistics. It was really only small.

As my hand was bandaged up and I was allowed to leave to go home until I could see the surgeon the day after I continued to think about the numbers that I’d seen. Life is frail and we hang on by a thread. I imagined pulling all those statistics out of a reference, getting my White Board marker and writing them all up. Like most things written on a White Board, would the staff accustomed to seeing this data day in and day out eventually become immune to its message, immune to its meanings and the reality of its potentials? Writing up this information, coming face to face with such data serves both to inform and remind people of the tenuousness of life and at the same time, much like the living of life itself, serves to create a fog whereby we live in forgetfulness every day denying the fact of our own mortality.

Everything we do contains within it a calculated risk, even if we’re not aware of this risk. We take risks in love, in partnering, in having children. We put ourselves out there and take a risk in applying for jobs, in being brave, in developing friendships. We take risks in simply putting up our hands. One of the greatest risks we take is that of self-disclosure although this is mediated in new ways with social media. We reason rightly that if we don’t extend ourselves, don’t risk something of ourselves the payoffs will not be as great as if we had risked more. And we’re probably right. At different points in our life we have to take greater risks, hurl ourselves into unknown paths with the promise of the potential of a desired future outcome.

But risk is also used to calculate the data on the White Board, and inclusion within those categories may not be the desired outcome we seek in life.

Even this behaviour, this calculation of the risk of a thing has a cultural component and has a sociality inherent within it. This behaviour is constructed, lived and expressed within our own cultural context and so there exists a cultural inflection in what we are able to and choose to risk. The calculation of a risk and the interpretation of this information and the way in which we determine its meaning in our lives resides within culture. I learn about risk, about danger, about safety and about my sense of invulnerability through the life and the relationships that I hold with the people around me.

So my response to the data on the White Board in the ED includes my learned response to the very information that the White Board presents to me. I understand that it’s telling me the risk of death and disability inherent within everyday life within my own society. And I understand naturally without anyone needing to tell me what I can do to mediate those risks. All this goes without saying because we are all acculturated to health messaging, to preventative health programs, to messages about harm minimisation in our everyday lives. This too is a part of my culture.

I didn’t get out of the ED so easily. It seems that my injury was not so clear cut; the surgeon really wanted to put me under a general anaesthetic and have a closer look at my hand. Why? Because statistically, the kind of injury that I had incurred meant that I had an increased risk of disability, of developing arthritis, of losing a part of the functional ability of my hand. Was I certain that I wanted to risk all this, just go home with a few sutures and a script for some antibiotics?

When we’re offered choices like this, they are not real choices. I had to try to imagine the reality that the surgeon was painting for me. Was it possible? Would it affect me? What were the chances really? In the end I took my chances, opted for the sutures and the antibiotics and hoped for the best. However I look at my hand every now and again and wonder, what are the chances….?