The truth will set you free… but first, it will piss you off.

Posted on September 25, 2008. Filed under: Everything you wanted to know about doctors, Medical marketing, Personal philosophy, Self-deception |

David J. Balan, on Overcoming Bias, writes about the difficulty of responding honestly when people say, “Give it to me straight.” Generally, it’s such a bad idea that the Cajuns in my neighborhood have a story to illustrate:

Boudreaux was a widower whose most valued possession was his cat, Felix. Boudreaux won a trip to Europe, and he asked his friend Thibodeaux to look after the cat in his absence. “Thib,” he said, “I’ll call you from England to check on Felix.” Three days into the trip, Boudreaux indeed called Thibodeaux and asked, “How’s my cat doin’?” Thibodeaux replied, “Mai, Boudreaux, your cat died.” Boudreaux was beside himself, first with grief, then with anger. “Thib,” he wailed, “You don’t just tell somebody flat out that their cat died. You got no sensitivity. You should ease into it. Like, you should say, ‘Boudreaux, your cat’s on the roof, but I’m pretty sure we can get him down.’ Then when I call the next day, you say, ‘We got your cat down, but he caught pneumonia. The vet’s pretty sure he’ll be OK.’ Then on the next call, you say, ‘The cat took a turn for the worse, but the vet’s giving him some powerful medicine.’ Then the next day, you finally say,’Boudreaux, we did all we could, but your cat passed on.’ That’s the way you handle bad news like this.”

Thibodeaux expressed his remorse for his insensitivity and vowed to be more thoughtful. Two days later, Boudreaux called again. “Thib, how’s my mother?” Thibodeaux replied in his kindest voice, “Boudreaux, your mother’s on the roof.”

I was raised in the Deep South, where manners were as much a part of daily life as bacon. Religious morals also were a staple, and often the two clashed: there can be little doubt that manners and truth frequently are mutually exclusive. Yet, somehow I evolved into an adult who believed that one should not be criticized for telling the truth. As a result, I’ve lived a life of alienating those around me. Why is that? Because the truth is only acceptable among people where underlying love and loyalty is a given: the truth works only with family and very close friends. An exception is mathematicians: “The best part about math is that, if you have the right answer and someone disagrees with you, it really is because they’re stupid.”– J. Wiseman, Agnes Scott College). Pro tip: it is well-known, and the basis of many a comedian’s successful career, that the truth does not work with spouses.

Here’s another exception. My penchant for the truth (another way of saying “my lack of political-correctness”) was an accidental asset in dealing with the 25,000+ men I encountered in my practice of sexual medicine. The scenario almost always consisted of a complete stranger presenting himself for help with one of the most ego-compromising problems that can beset a man: inadequate sexual performance. Within a minute or two, I had to gain his confidence in order to be of any help. It never occurred to me to place myself in a different (or “better”) category, a la “you’ve got a problem and I don’t”; it wasn’t true, and the patients could sense that we were all in this thing together (see the fictionalized version in chapter 5, “Dick Doc”, of my not-yet-nominated-for-the-Pulitzer short novel, Chasing a Light Beam). As a result of brute truth, these men were able to accept both the diagnoses and the treatment recommendations, from a complete stranger, akin to the Marine who meets another “Semper Fi”.

To confirm that the positive effect of truth on this selected group of men was exceptional, consider its impact on my relationships with other men in the industry. From a previous post, it is clear that I think the inflatable penile prosthesis (IPP) is one of the greatest inventions of my generation. Normally, it is the job of the manufacturers to sell the surgeons on the utility of their product, but I found myself in the reverse role, trying to convince CEO’s and Sales Managers of the IPP’s potential. When asked about my impression of industry’s results, the more proof I presented for the under-selling of IPP’s, the more reluctant they became to have anything to do with me, in spite of being their biggest customer. The attitude was, “The stockholders (or my bosses) think we’re doing a great job. Just confirm that.” We were acquaintances, but I did not qualify as one from whom the truth could be tolerated. As Mark Twain observed:

Familiarity breeds contempt. How accurate that is. The reason we hold truth in such respect is because we have so little opportunity to get familiar with it.

It will be interesting to see what becomes of “Generation Y”, a group of young people who, in general, have been raised with the technique of positive reinforcement. Many cannot recall ever having been punished or severely criticized at all, yet they are embarking on a “real world” loaded with “baby boomers” who will not be reluctant to give them their first exposure to the truth about themselves. They will be told, “yes, you do look fat in that dress,” and “you get no extra credit for doing it right.” Perhaps their experiences on blogs will prepare them. Surely no blog participant could have overlooked the change that the Internet creates in personalities: political correctness dissolves in the solvent of anonymity.

One of the barriers to the acceptance of the truth from others is described by Bertrand Russell:

What a man believes upon grossly insufficient evidence is an index into his desires — desires of which he himself is often unconscious. If a man is offered a fact which goes against his instincts, he will scrutinize it closely, and unless the evidence is overwhelming, he will refuse to believe it. If, on the other hand, he is offered something which affords a reason for acting in accordance to his instincts, he will accept it even on the slightest evidence. The origin of myths is explained in this way.

We all have our myths.


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2 Responses to “The truth will set you free… but first, it will piss you off.”

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I’d just like to say that your story made me actually laugh out loud. Not so much because of the punchline, but because of the cajun names.

Btw, I sort of disagree with your depiction of Gen Y:ers. And I am from that generation in Sweden which is even more “progressive” than the US. While there’s little overt criticism or frank evaluations I think the way people act provide plenty of negative feedback.

At worst I think the negative feedback loop is muddled, rather than removed. Which certainly is bad enough, because it can cause a lot more confusion and pain if the recipient have trouble figuring out exactly what is wrong.

In school, for instance, the teacher, may say that everybody does great, but unless she truly believes that her actions will tend to show what she actually thinks. Or if you behave socially unacceptably you will rather be silently ostracised rather than being directly called out on your social defects.

So I think the problem might be more lack of clarity than lack of negative feedback.

Thanks for reading. I’m not a native of the Cajun area, but I’ve lived here for 29+ years. The culture is fascinating, comprised of people who really enjoy simply living (not necessarily living simply, as there’s a LOT of oil and gas money here). The joie de vivre is probably as good as it gets. In particular, there is much less pretentiousness than in other areas I’ve experienced, incorrectly leading to some to perceive the inhabitants as ignorant. They may not all be informed, but they certainly possess their fair share of wisdom. You might enjoy reading one or two of the chapters containing Cajun characters in my short novel, Chasing a Light Beam, linked on the blog.

I’m pleased that you have a positive prediction for Gen Y, as I have a 16 year-old daughter.

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    The director of the Sexual Medicine Center leaves penile implants behind, and launches a quest for knowledge about Artificial Intelligence, extended life, and the issues inside the health-care industry.


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