Jul 30 2010
Dad always thought laughter was the best medicine, which I guess is why several of us died of tuberculosis.
We have a saying in medicine that you can’t kill a jerk. Not that we try to kill anyone, but that particularly unpleasant individuals, rife with psychopathology, survive whatever illness comes their way. The corollary is that particularly nice people are prone to having horrible diseases with unpleasant outcomes. We all know intellectually that it is not true, but there is an ongoing feeling in health care providers that somehow patient personality determines the consequences of their diseases. As an aside, I am often left with the explanation for patients that the reason for their odd infection comes down to bad luck. Everyone responds something to the effect that “Typical. I get all the bad luck.” I have never had a patient say, “That’s odd, I am usually so lucky.”
On the question of nurture versus nature, raising two children has convinced me of the relative lack of importance of nurture in the personalities of my children. While abusive/pathologic environments will certainly lead to pathologic personalities, for the average child raised in middle class America I can’t help but think that, to quote Popeye, “I yam what I yam and that’s all what I yam.” I expect to be schooled in the comments on that subject. Yes, I read the Blank Slate and have some understanding of the literature. And yet. My kids, my friends kids. I watch them grow in what is (and isn’t) a similar environment and end up with diverse personalities that often appear present before they can speak. I am well aware of the multiple logical fallacies that lead to that conclusion. Parenthood and medical practice (where people seem to do the same damn stupid things over and over) have lead me to the conclusion that free will is mostly a myth and we are mostly programmed to behave the way we do. Discuss. It is not the main point of the post, but my bias.