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Your Strength as a Rationalist

69 Eliezer_Yudkowsky 11 August 2007 12:21AM

(The following happened to me in an IRC chatroom, long enough ago that I was still hanging around in IRC chatrooms.  Time has fuzzed the memory and my report may be imprecise.)

So there I was, in an IRC chatroom, when someone reports that a friend of his needs medical advice.  His friend says that he's been having sudden chest pains, so he called an ambulance, and the ambulance showed up, but the paramedics told him it was nothing, and left, and now the chest pains are getting worse.  What should his friend do?

I was confused by this story.  I remembered reading about homeless people in New York who would call ambulances just to be taken someplace warm, and how the paramedics always had to take them to the emergency room, even on the 27th iteration.  Because if they didn't, the ambulance company could be sued for lots and lots of money.  Likewise, emergency rooms are legally obligated to treat anyone, regardless of ability to pay.  (And the hospital absorbs the costs, which are enormous, so hospitals are closing their emergency rooms...  It makes you wonder what's the point of having economists if we're just going to ignore them.)  So I didn't quite understand how the described events could have happened.  Anyone reporting sudden chest pains should have been hauled off by an ambulance instantly.

And this is where I fell down as a rationalist.  I remembered several occasions where my doctor would completely fail to panic at the report of symptoms that seemed, to me, very alarming.  And the Medical Establishment was always right.  Every single time.  I had chest pains myself, at one point, and the doctor patiently explained to me that I was describing chest muscle pain, not a heart attack.  So I said into the IRC channel, "Well, if the paramedics told your friend it was nothing, it must really be nothing—they'd have hauled him off if there was the tiniest chance of serious trouble."

Thus I managed to explain the story within my existing model, though the fit still felt a little forced...

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