The Russian Connection, Part 1 - The Pandemic Meets Ivan Pavlov: "Wait a Doggone Minute!"

       Probably good advice, as you'll soon see. This, slowing down, buying time, waiting a minute to minimize our errant conclusions, especially when it comes to dramatically experienced situations. Which are probably occurring at a higher rate and more intensely the past several months in our collective lives. Given the last few and current national election cycle in our country and the now daily allegations of the 'Russian Connections' (won't be surprised to see people endorsing Putin as a write-in candidate, despite failing a few eligibility criteria, and was surprised, on the other hand, the supreme court nominee didn't get asked how she would vote on this), the time is ripe to acknowledge two notable Russians--one internationally renowned and the other who became a hometown hero here in Detroit about twenty years ago.

Man's Best Friend: The Russian connection under consideration today is that of Ivan Pavlov, a Russian physiologist familiar to any undergraduate psychology student. For the 'unwashed', a CliffsNotes version: in 1889 Dr. Pavlov demonstrated how a naturally occurring, instinctual response like salivation in dogs when smelling food, can be elicited by a neutral stimuli or trigger (such as a bell, in this case), when paired often enough (i.e., "Classical Conditioning"). Eventually, just ringing the bell without presenting the food could produce salivation (what a tease!) which, if it went on long enough, would then eventuate in a decrease in salivation unless once again accompanied by food.                                                              

Pick on Someone You Own Size: About 30 years later and closer to home, Dr. John Watts and one of his graduate students, at the well respected Johns Hopkins University, demonstrated that a youngster ("Albert B.", only nine months old, hardly old enough to give consent) could be taught to fear a previously benign object (such as a white rat). That is, they instilled a phobic response by pairing it with an obnoxious noise, which eventually also led Little Albert to fear other furry objects ("stimulus generalization"). While his subsequent fate and whether he was appropriately counter-conditioned remains somewhat a mystery, such experiments could not be conducted today due to current ethical guidelines (let alone HIPPA!).                                                                                                                                                         

A Laughing Matter - Silly Superstitions: A product of classical conditioning and 'illusory correlations' (the impression that because two things occur in proximity there is a cause and effect relationship), come many of our mainline superstitions and caveats to avoid ("step on a crack...don't let a black cat...don't open an umbrella indoors...), as well as those silly rituals strongly associated with sports to break a curse or maintain luck (e.g., rally hats, playoff beards, not changing stinky socks until a win/loss, pregame rituals). Or, on a more practical level, as our mothers used to caution, "You'll be judged according to who you associate  with, so choose your friends wisely" (guilt by association?).                                                      

No Laughing Matter: Some other less benign habits and rituals have connected (aka associated) with dramatically experienced events and/or times in our collective history. During the 14th century, for example, the Black Death plague gave rise to 'flagellants', which were a group of people who repeatedly whipped themselves and each other with scourges, believing their self-mutilation was a form of atonement to God. While the pope's disapproval a few years later contributed to its disappearance, can you think of contemporary people and forms of flagellation which, at first glance might simply appear as silly, but could lead to serious harm? Such as consuming various substances that may be effective for other conditions or designated for nonhuman applications, but taken to prevent/stop COVD could be hazardous, if not lethal. On a social level, we may also be at risk of 'over-associating' COVID with all Chinese people, even those residing in Wuhan, leading to personally damaging stereotypes, insults, and unjustifiable fears (not the first time in our history, eh?). Of course, a sizeable group  of people have also been declaring the pandemic as a "hoax", in part because it is so closely aligned in time with the election here in the U.S. ("when the election's over, you'll see a big change in COVID cases and policies", a common prediction from these believers of such an association). Finally, treating PTSD instrumentally involves increasing one's awareness (as well as counter-conditioning) of the dramatically/traumatically linked events and experiences that have probably led to dysfunctional coping strategies.

        To come full circle, there are two types of diagnostic errors one is at risk of in any professional setting (including the ER/ICU) and/or domain of life. Simply put, these include either over-diagnosing (Type 1/"False Positive") and under-diagnosing (Type 2/"False Negative"), which are in turn a product of several types of human/cognitive errors. A few include a rush to judgement (which has been cited by many health professionals early in the pandemic, due to the numbers and speed they were required to make critical decisions),  overgeneralizing from previous experience (aka associations), and  oversimplification (trying to take a complex situation and reduce it to a more simplified formula). Hopefully, you can see how these factors, which have been more at play in our lives lately, can contribute to erroneous assumptions and related decisions--some silly and laughable, whereas others quite serious. So, if you have the opportunity to "wait a doggone' minute" and think, both are highly advised.