Archive Monthly Archives: October 2014

Hashimoment: Do You Think Like A Fox or a Hedgehog?

Red Fox

Think Like A Fox

Hedgehog

Not Like A Hedgehog


I recently read a book called the Signal and the Noise by Nate Silver.

It’s an in depth look at how to use data and other information to make better predictions.

What does that have to do with Hashimoto’s?

Well, Hashimoto’s is very complex and there is an extraordinary amount of noise, that is information and advice that may or may not be helpful.

And as someone who is trying to solve problems and help others with this complex problem, I thought that learning how to better interpret the data and the information might give all of us some clues about how to get better results.

Ultimately, solving this problem requires that you be a detective and to be a good detective you have to look at the available information and be able to make predictions about whether or not what you are going to do will work.

Because if you are wrong, there are consequences.

And sometimes those consequences can result in you feeling a whole lot worse.

And pushing this thing in the wrong direction.

Our recent look at people’s experience with iodine is a perfect example of this (see our last post).

In the book there is a reference to a professor of psychology and political science named Philip Tetlock.

He identifies 2 distinct types of writers and thinkers: Foxes and Hedgehogs.

Hedgehogs are type A personalities who believe in Big Ideas – in governing principles about the world that behave as though they were physical laws and they are the foundation of everything.

Like Karl Marx and class struggle or Sigmund Freud and the subconscious. Or many MDs and Synthroid.

Foxes, on the other hand are scrappy creatures who believe in lots of little ideas and in taking a multitude of approaches toward a problem.

They tend to be more tolerant of nuance, uncertainty, complexity, and dissenting opinion.

If hedgehogs are looking for that one big meal, while foxes are gatherers.

Well, it turns out that foxes are a lot better at making accurate predictions.

And better predictions usually means better results.

So, to get better results with your Hashimoto’s, think like a fox.

How Foxes think:

They are multidisciplinary: They incorporate ideas from different places regardless of their origin on the ideological spectrum.

(Both doctors and alternative care practitioners are right about some things and wrong about others. Evaluate the message regardless of the messenger.)

They are adaptable: They find a new approach – or pursue multiple approaches at the same time – if they aren’t sure the original one is working.

(If lab tests show your TSH and antibodies going up as a result of a treatment, this is not necessarily a good thing. No matter how it is rationalized or justified.)

They are self-critical: They are sometimes willing (if rarely happy) to acknowledge their mistakes and accept responsibility for them. (Can your doctor admit when he or she is wrong or stumped?)

They are tolerant of complexity: They see the universe as complicated, perhaps to the point of seeing many problems being unpredictable.

(Hashimoto’s is the very definition of complexity.)

They are cautious: They express their predictions in terms of what will probably happen and qualify their opinions.

(There are no absolutely certain outcomes.)

They are empirical: They rely on observation and real data rather than theory.

(They use what exists, not what they want it to be or what will sell more of the products they created or endorse.)

Foxes are better forecasters and, therefore, get better results.

How Hedgehogs think:

They focus on one or 2 things that are the answer or the solution. They may view the opinions of “outsiders” skeptically.

(Synthroid is the only answer.)

They are stalwart: they stick to the same “all-in” approach – new data is used to refine their original model. To confirm their bias.

(See? You didn’t do well on Armour, Synthroid is the only answer.)

They are stubborn: Mistakes or bad decisions are blamed on bad luck or weird circumstances – a good theory had a bad day.

(Removing the thyroid removes the disease. And Synthroid is the only answer, you just need to increase the dosage.)

They are order seeking: They expect that the world will be found to follow a relatively simple set of rules.

(It’s just a thyroid problem. Synthroid is the only answer.)

They are confident: They rarely hedge their predictions and are reluctant to change them.

(You read too much on the internet. Synthroid is the only answer.)

They are ideological: The expect that solutions to many problems are manifestations of some grander theory or struggle.

(Sythroid is the only answer. It was the #1 prescribed drug in the US in 2013. I rest my case.)

Hedgehogs are weaker forecasters and, therefore, don’t get great results.

Here are 3 broad principles to be more fox-like:

1. Think probabilistically. In other words, think about a range of possible outcomes. Don’t make broad assumptions.

For example, take the theory that everyone needs more T3. Reality is more nuanced: Some people need more T3, others don’t and some people get worse with the addition of T3.

The same is obviously true of iodine and a number of other things. You may fall anywhere on that continuum. Find out what is true for you.

2. When the facts change, change your mind.

There’s nothing worse than stubbornly holding onto a belief that has been proven to be untrue.

This is why I’m opposed to protocols. They force you into a pre-existing solution.

There are so many variables, so many moving parts.

Let the facts on the ground dictate your approach.

3. Look for consensus.

Time and experience generally has a way of revealing the truth.

Sometimes there are big innovations, but these events are pretty rare.

Lastly, beware of magic bullet solutions.

With Hashimoto’s, after working with and talking to hundreds of people with this disease, I can tell you that there is nothing that works for everyone.

NOTHING.

You just need to learn to be like a fox and accept that.