The Process

A quote from The Art of Clear Thinking by fighter pilot Hasard Lee translates into the clinical decision making process in functional medicine, for which nonlinear thinking has to be applied to the massive complexity of the systems biology presented by a living patient—versus rushing to the simplest diagnosis that will explain the symptoms and stopping there, blinded by the anchoring bias that eclipses the rest of the picture. It includes the subtle cues noted in conversation to lab values that diverge slightly from the norm, with persevering curiosity for pursuing whatever is unexplained.

"The decisions we make form the connections we have with the world around us. It's only by first assessing the problem that we can gain enough understanding to reliably make the right decision.

When flying fighters we’ll use a cross check to build our assessment. All of our senses contribute to the model. What are the instruments displaying? What's going on outside the aircraft? What sort of vibrations can be felt? How are the G forces changing? What radio calls or alarms can you hear? Is there a smell of smoke or fumes?

Buried within all the data is the information that's needed to solve the problem at hand. Instead of trying to multitask, something humans are notoriously bad at, we’ll spend anywhere from a fraction of a second to several seconds understanding each piece of information before moving on to the next one. The key is to not let yourself focus on just one data source at the expense of the rest, something we call getting sucked into the soda straw. When that happens, the pilot will quickly lose sight of the big picture and be unable to see how their actions fit the larger system they're operating within.

The ability to make sense of a chaotic environment while simplifying and structuring information is not just applicable to flying. It's a fundamental skill that's required to navigate our increasingly complex world. We’re saturated with hundreds of times more information than previous generations. What’s required is a way to quickly sift through the noise to understand key parts of a system so that we can then create an outsize impact given our time and resources. This requires judgment, and judgment requires nonlinear thinking."

“When nothing seems to help, I go and look at a stonecutter hammering away at his rock perhaps a hundred times without as much as a crack showing in it. Yet at the hundred and first blow it will split in two, and I know it was not that blow that did it, but all that had gone before.” 

19th century social reformer Jacob Riis