What is a black swan?

As a doctor and a man of scientific temper, I have realized that we believe that the science of medicine is evidence based and provides consistent clinical outcomes, but this often eludes us. For routine ailments we get predictable outcomes and as this happens more we tend to become complacent, till we get surprises and shocks. The universe has laws and modern allopathic medicine too has rules evidence and algorithms. But, medical treatment is an art too and human beings are not mere physical creatures, they also have mind and the intellect to deal with. Besides this there is the individual and universal consciousness which are beyond the realms of the body mind and intellect. This means a pure mathematical logical model cannot and will not work. Intuition, faith belief can play a role in clinical outcomes. These can make a mockery of "evidence based medicine". However, this blog is not about medicine but is about statistics and probability. 

While doing the course on hospital administration, I noticed a relatively unexplained phenomenon relating to the subject of statistics and research methodology. This was that nearly all the doctors and dental students hated and showed a huge indifference to Statistics. The economists and the non medical persons revelled and loved the subject. This may be explained by the fact that we do not see consistency in clinical outcomes and yet seek an explanation for such inconsistencies. Does life and it's events remain predictive or do we have  non probabilistic moments changing the course of life? There is a book which is in my reading list, Black Swan which talks of the impact of the highly improbable.

Most human beings want order and consistency in life and are creatures of habit ad conformity. While the need of the day is to become creative and innovate to make a difference if we want progress. Oscar Wilde famously said that "Consistency is the last refuge of the unimaginative." My guess is that he felt that for that to happen, we need to be shaken up from our inertia to force us the rediscover new dimensions in ourselves. These are black swan events. 

Since this blog is experiential and many of my gentle readers know me, I will allude to two personal moments which took my life into a different direction. In 1990, I became a father and bucking the expected normal child, we were blessed with our daughter Delna who was diagnosed to have Trisomy 21, a birth defect which meant she had what was called Down's Syndrome. The purpose and focus of life transformed from excelling and becoming a successful Orthopedic surgeon to ensuring her future and after years of effort has led to the creation of Ahura Support a non profit which provides comprehensive residential care to the differently abled (mentally and physically challenged young adults). https://www.facebook.com/ahsupgr. The decision to become a Hospital administrator in 2014 was created by a day on which two patients on the same day with Ankle injuries went away to my competitors where I offered non operative care for one and operative care for the other and they were treated in the opposite way based on unscientific reasons. The frustration of seeing unindicated surgeries being performed and top professionals showing incorrect data led me to search for other avenues in healthcare. I became a Hospital Administrator and achieved success in the roles given to me. 

There are many black swan events in he lives of great men and Ramchandra Guha in his biography of Gandhi says that has a young Mohandas Karamchand Gandhi after returning from England with a degree n law succeeded in Rajkot and Mumbai , he would have remained an obscure lawyer. Besides, at the same time his uncle had fallen from grace in the eyes of the ruler of Porbandar. The Dewaship of Porbandar  which was held by his father which would have gone to him also did not come his way. So he got a job in South Africa where a series of evets led him to create the weapon Satyagraha and non-violent passive resistance was honed and developed. The rest they say is history. 

All of us may have had black swan events in our lives which can be turned into opportunities to create something different and expand their canvas in life. My only fear is the ability to recognise the black swan event and to follow our instinct and turn the immediate adversity or setback into opportunity must be honed and cultivated by constant self reflection and the ability to move on. So black swans are required in this world, not too often because the change is painful and hard work but in the end we land up creating something beautiful. 

One crucial thing to recognize is to not make any event not to our advantage black swan events as in such a case the import rarity and the change it brings about in our life direction will not be real but only cosmetic. I would love to find out from you the black swan events in your life and how they have led to positive change. It will be a good learning experience. 

Vispi Jokhi