When you’re facing a life or death situation, what do the odds mean – to you personally? As Brian Zikmund-Fisher from the University of Michigan School of Public Health pointed out to Robert Siegel on NPR yesterday, “We’re never 95 percent alive. We either live or die. We experience outcomes”. Brian’s story is a compelling one. it’s also an important illustration of how feelings and personal decisions come into play when thinking about risk.
Risk and reason
Brian’s interview was the first in an series airing on NPR this week on Risk and Reason. In it he gets to the heart of the tension between the probability of harm within groups of people – which are used to make informed public health decisions – and the probability of you as an individual experiencing this harm.
Brian again:
“On a population level, I can have 100 people in a room, and some will have something happen to them and some will not. And that’s the hard part because if you happen to be the unlucky one who has that rare event happen to you, you still have the bad thing happen to you in its full awfulness.”
Risk gets personal
He speaks from experience – in 1998 he was diagnosed with myelodesplastic syndrome – a condition which increases significantly susceptibility to bleeding and infection. Brian faced a tough decision – without treatment, he had an estimated 10 years to live. He could have a bone marrow transplant, which had a success rate of 70%. However, this also came with a 25% – 30% chance of dying within a year.
For anyone who’s been in a similar position, the math suddenly becomes very personal indeed. What made Brian different though is that he was studying behavioral decision theory at the time. He was able to weigh up the the personal and family impacts and benefits from 10 years of being alive but ill, compared to a 70% chance to get to know his then-unborn daughter as a healthy father. Risk got personal.
You only get one life
Brian took the gamble – and is now a leading expert on risk communication and decision analysis in the University of Michigan School of Public Health. (He’s also a member of the UM Risk Science Center). He understands the math of risk – and how public health and medical professionals need to see the bigger risk picture. But he also gets how personal it is when you are the one whom the risk falls on. As he concludes in the NPR interview:
“I only have one hand in this poker game. I only get one life,” he says. “I can play the odds. I can try to give myself the best opportunities. But risk is a part of our everyday life, and rare things do happen, and we have to accept that.”
Listen to the complete NPR series on Risk and Reason here.
Brian leads the Risk Science Center Focus Initiative on Risk Communication. He is a leading expert on decision analysis, and teaches risk communication. He is also a contributor to the Youtube Channel Risk Bites: