Evaluation in the Blink of an Eye – Thin-Slicing Unlocks the Complexities of Intuition

Blink: The Power of Thinking Without Thinking. by Malcolm Gladwell, 2005, Little Brown and Company, 277pp., $25.95.

Eddie Kahn was the most intuitive person I have ever known. He had an uncanny ability to instantly evaluate neurological patients, and no one at the University of Michigan Neurosurgery Department ever remembers him being wrong. On one occasion, I presented a 13-year-old patient to him in clinic. He walked in the room, glanced briefly at the patient and announced that she had a craniopharyngioma. The patient had had no imaging studies or endocrine laboratory tests but, of course, Dr. Kahn was right. The neurosurgical residents were in awe of Dr. Kahn and always wondered how he could do it. Now a book written for the general public may explain his uncanny evaluative power.

Blink, written by Malcolm Gladwell, staff writer at The New Yorker and best-selling author of The Tipping Point, is about the content and the origin of those instantaneous impressions and conclusions that spontaneously arise whenever we meet a new person, confront a complex situation or have to make a decision under conditions of stress. This is not a fanciful explanation. Our unconscious is a powerful force, but our snap judgments can be educated and controlled. The power of knowing in the first few seconds is not a magical gift given only to a few, but rather an ability that we ourselves can cultivate.

A major reason that people can judge others so rapidly is that faces can be read so accurately. Facial expression has been carefully analyzed and categorized through the Facial Action Coding System, or FACS. Researchers have used this system to study everything from schizophrenia to heart disease. It has even been put to use by computer animators in the movies.

One of the key techniques in rapid cognition is known as “thin-slicing.” This refers to the ability of our unconscious to find patterns in situations and behavior based on very narrow samples of experiences. In the same way that a small biopsy can give an accurate diagnosis of a complex tumor, psychologists can learn to predict the outcome of a marriage based on a few minutes spent observing a couple.

Gladwell credits neurologist Antonio Demasio with localizing the ventromedial prefrontal cortex as the key site in decision making. Patients with damage to this area may be intelligent, rational and functional, but they lack judgment.

Rapid cognition does have the potential for leading us astray. We make connections much more quickly between pairs of ideas that already are related in our minds than we do between pairs of ideas that are unfamiliar to us. That explains why tall people generally get more respect, and earn more money, than short people. That also explains why it is much easier for attractive political candidates to get elected.

Truly successful decision making relies on a balance between deliberate and instinctive thinking. On the other hand, in good decision making, frugality matters. Complex problems must be reduced to their simplest elements: Even the most complicated of relationships and problems have an identifiable underlying pattern. A successful decision maker needs to edit.

An interesting two-hour read, Blink is a good choice for a book to grab at the airport the next time you take a flight.

Gary Vander Ark, MD, is director of the Neurosurgery Residency Program at the University of Colorado. He is the 2001 recipient of the AANS Humanitarian Award.

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