[Originally posted to my personal blog, reposted here with edits.]
Introduction
You could call it heroic responsibility, maybe,” Harry Potter said. “Not like the usual sort. It means that whatever happens, no matter what, it’s always your fault. Even if you tell Professor McGonagall, she’s not responsible for what happens, you are. Following the school rules isn’t an excuse, someone else being in charge isn’t an excuse, even trying your best isn’t an excuse. There just aren’t any excuses, you’ve got to get the job done no matter what.” Harry’s face tightened. “That’s why I say you’re not thinking responsibly, Hermione. Thinking that your job is done when you tell Professor McGonagall—that isn’t heroine thinking. Like Hannah being beat up is okay then, because it isn’t your fault anymore. Being a heroine means your job isn’t finished until you’ve done whatever it takes to protect the other girls, permanently.” In Harry’s voice was a touch of the steel he had acquired since the day Fawkes had been on his shoulder. “You can’t think as if just following the rules means you’ve done your duty. –HPMOR, chapter 75.
Something Impossible
Bold attempts aren't enough, roads can't be paved with intentions...You probably don’t even got what it takes,But you better try anyway, for everyone's sakeAnd you won’t find the answer until you escape from theLabyrinth of your conventions.Its time to just shut up, and do the impossible.Can’t walk away...Gotta break off those shackles, and shake off those chainsGotta make something impossible happen today...
The Well-Functioning Gear
I feel like maybe the hospital is an emergent system that has the property of patient-healing, but I’d be surprised if any one part of it does.Suppose I see an unusual result on my patient. I don’t know what it means, so I mention it to a specialist. The specialist, who doesn’t know anything about the patient beyond what I’ve told him, says to order a technetium scan. He has no idea what a technetium scan is or how it is performed, except that it’s the proper thing to do in this situation. A nurse is called to bring the patient to the scanner, but has no idea why. The scanning technician, who has only a vague idea why the scan is being done, does the scan and spits out a number, which ends up with me. I bring it to the specialist, who gives me a diagnosis and tells me to ask another specialist what the right medicine for that is. I ask the other specialist – who has only the sketchiest idea of the events leading up to the diagnosis – about the correct medicine, and she gives me a name and tells me to ask the pharmacist how to dose it. The pharmacist – who has only the vague outline of an idea who the patient is, what test he got, or what the diagnosis is – doses the medication. Then a nurse, who has no idea about any of this, gives the medication to the patient. Somehow, the system works and the patient improves.Part of being an intern is adjusting to all of this, losing some of your delusions of heroism, getting used to the fact that you’re not going to be Dr. House, that you are at best going to be a very well-functioning gear in a vast machine that does often tedious but always valuable work. –Scott Alexander
Recursive Heroic Responsibility
Heroic responsibility for average humans under average conditions
I can predict at least one thing that people will say in the comments, because I've heard it hundreds of times–that Swimmer963 is a clear example of someone who should leave nursing, take the meta-level responsibility, and do something higher impact for the usual. Because she's smart. Because she's rational. Whatever.
Fine. This post isn't about me. Whether I like it or not, the concept of heroic responsibility is now a part of my value system, and I probably am going to leave nursing.
But what about the other nurses on my unit, the ones who are competent and motivated and curious and really care? Would familiarity with the concept of heroic responsibility help or hinder them in their work? Honestly, I predict that they would feel alienated, that they would assume I held a low opinion of them (which I don't, and I really don't want them to think that I do), and that they would flinch away and go back to the things that they were doing anyway, the role where they were comfortable–or that, if they did accept it, it would cause them to burn out. So as a consequentialist, I'm not going to tell them.
And yeah, that bothers me. Because I'm not a special snowflake. Because I want to live in a world where rationality helps everyone. Because I feel like the reason they would react that was isn't because of anything about them as people, or because heroic responsibility is a bad thing, but because I'm not able to communicate to them what I mean. Maybe stupid reasons. Still bothers me.
That's a bit of self contradictory statement, isn't it? (People can be unassertive but internally very overconfident, by the way).
So you have that patient, and you have your idea on the procedures that should have been done, and there's doctor's, and you in retrospect think you were under-confident that your treatment plan was superior? What if magically you were in the position where you'd actually have to take charge? Where ordering a wrong procedure hurts the patient? It's my understanding that there's a very strong initial bias to order unnecessary procedures, that takes years of experience to overcome.
I suspect it's one of things that look very different from the inside and from the outside... None of those arrogant newbies would have seen themselves in my description (up until they wisen up). Also, your prototype here is the heroic responsibility for saving the human race, taken upon by someone who neither completed formal education in relevant subjects, nor (which would actually be better to see) produced actual working software products of relevance, nor other things of such nature evaluated to be correct in a way that's somewhat immune to rationalization. And a straightforwardly responsible thing to do is to try to do more of rationalization-immune things to practice, because the idea is that screwing up here has very bad consequences.
Other issue is that you are essentially thinking meat, and if the activation of the neurons used for responsibility is outside a specific range, things don't work right, performance is impaired, responsibility too is impaired, etc, whether the activation is too low or too high.
edit: to summarize with an analogy, say, driving a car without having passed a driving test is irresponsible, right? No matter how much you feel that you can drive the bus better than the person who's legally driving it, the responsible thing to do is to pass a driving test first. Now, the heroes, they don't need no stinking tests. They jump into the airplane cockpit and they land it just fine, without once asking if there's a certified pilot on board. In most fiction, heroes are incredibly irresponsible, and the way they take responsibility for things is very irresponsible, but it all works out fine because it's fiction.
No, that is an entirely coherent claim for a person to make and not even a particularly implausible one.