Perception, reality, and all that other stuff

If you are the kind of person that likes to study human behavior, like me, and you have never been through an airport on a busy day, I highly suggest that you do so. You will get to see all sorts of interesting people and the things that they do to get through security and on to their gates and their flights on time. You will see frustration, anger, hate, and suffering in many of their faces. Of course, you will also see the other end of that spectrum and see people who are totally at peace with the organized chaos going on around them.

Since the attacks on September 11, 2001, airport security has gone through some interesting changes. I remember being a kid and being allowed to go all the way to the gate to say goodbye or welcome loved ones to and from their flight. I also remember when you only had to go through a metal detector and put your bags though an x-ray machine. There no pat-downs and no high-tech machines to detect “bulges” on you. And there certainly wasn’t as much exasperation on the faces of people traveling.

As I stood in line to be inspected, I got to crunching some numbers in my head. There are thousands of flights within the United States each day, with hundreds of thousands (or millions) of people up in the air at any given time. Now, I ask you, are there thousands of terrorists out there ready to board a plane, take it over or bring it down, and kill a whole bunch of us? I can bet you that there aren’t. The overwhelming majority, almost all of us, will make it safe to our destination. If we don’t, it’s far more likely that it was the result of a missed connection, a mechanical failure, or some other mundane thing and not terrorism. However, because of the events back in 2001, and the ongoing wars in the Middle East, we all allow the Transportation Safety Administration to go through our belongings and even our bodies.

But trying telling those impacted by the attacks on the World Trade Center, the Pentagon, and Pennsylvania that the odds are against a terror attack, even if we go back to pre-2001 security levels. Better yet, try being a lawmaker or some other person of authority that this is the case. Wouldn’t quite work out too well for you.

One of my mentors at the health department was talking to me about emergency preparedness the other day. He said that we humans have this idea in our heads that things like airplane accidents and terrorist attacks are so awful that it doesn’t matter how often they occur. It only matters that they do occur, and one occurrence of these is enough to make everyone crazy, so to speak. Smaller, more limited and yet deadly incidents like car crashes, food poisonings, and everyday crime are, well, more everyday, more common. Yet we don’t allot as many resources to fight them as we are doing to prevent a terrorist attack on a plane or a building.

Then again, he said, it takes one attack to change the minds of people on a mass scale. They demand action, politicians listen, and tons of useful resources are wasted. But this is a utilitarian view, of course. For those who are affected, it’s a huge deal. (Notice how I’m emphasizing that?)

One of the challenges I am sure to face in my next phase as an epidemiologist is to balance reality with expectations or points of view. As I’m sitting on this plane, we are hitting some rough turbulence over Nebraska. The flight attendants are not up doing their thing yet, and the pilots have indicated that we remain in our seats. The overwhelming odds are that the plane will get through the turbulence and that we’ll land in Baltimore with no problems, but try telling that to the acrophobic people among us. (I can and have gotten anxious on bumpy flights.) The perception is our reality, and there is very little rationale for this. We’re human after all.

So I look forward to the next years, or even decades, of telling people that they need to play the odds and make better decisions based on those odds (and the science and evidence that came up with those odds) more than by their instincts. I really do.