newmiseries.Shehad,Iestimatedforher,a 75 percent
chance I’d make her future better, at least for a little
while, and a 25 percent chance I’d make it worse.
Sowhatthenwastherightthingforhertodo?Andwhy
wasthechoicesoagonizing?Thechoice,Irealized,was
farmorecomplicatedthanariskcalculation.Forhowdo
youweighrelieffromnausea,andthechancesofbeing
able to eat again, against the possibilities of pain, of
infections, of having to live with stooling into a bag?
Thebraingivesustwowaystoevaluateexperienceslike
suffering—thereishowweapprehendsuchexperiences
inthemomentandhowwelookatthemafterward—and
the two ways are deeply contradictory. The Nobel
Prize-winning researcher Daniel Kahnemanilluminated
whathappensinaseriesofexperimentsherecountedin
his seminal book Thinking, Fast and Slow. In one of
them, he and University of Toronto physician Donald
Redelmeier studied 287 patients undergoing
colonos-copyandkidneystoneprocedureswhileawake.
Theresearchersgavethepatientsadevicethatletthem
ratetheirpaineverysixtysecondsonascaleofone(no
pain)to ten(intolerablepain),a systemthatprovideda
quantifiable measure of their moment by-moment
experienceofsuffering.Attheend,thepatientswerealso
askedtoratethetotalamountofpaintheyexperienced
during the procedure. The procedureslasted anywhere
fromfourminutestomorethananhour.Andthepatients
typicallyreportedextended periodsof lowtomoderate
painpunctuatedbymomentsofsignificantpain.Athird
ofthecolonoscopypatients andaquarterofthekidney