Magical Thinking

Magical Thinking


Leonard Zwelling

         I first came upon this term in 2005 when I read Joan Didion’s book The Year of Magical Thinking, a memoir about the death of her husband, John Gregory Dunne. To simplify, magical thinking is the belief that thoughts can influence the physical world. If I wish for something hard enough, it will occur.

We may be in a time of extreme magical thinking.

         Let’s start with the coronavirus. The overwhelming scientific evidence is that this is a highly contagious respiratory virus, new to mankind, and emanating from Wuhan, China, but probably entering the United States from several ports including Europe. Furthermore, the threat of this virus to kill is mostly to the elderly, especially people in nursing homes, but that it can be very harmful to some young people although the reason some die and others shake it off is not at all clear at this time. Furthermore, it appears that the asymptomatic carrier state is common, especially among the young. Whether or not there are long-term effects of the asymptomatic carrier state will not be known for years. Social distancing, hand washing, and the use of face masks seem to decrease the person-to-person transmission of the virus.

         Despite the fact that over 120,000 Americans have died from the virus (putatively—I am not sure how accurate these statistics are given that autopsies have been done on few of these victims), surely many more have been sickened although the actual penetrance of the virus into the population is unknown as testing has been limited, results of DNA and antibody testing mixed together, and there is a clear asymptomatic case burden that has gone largely undetected. What is certainly true is that this is an infectious agent spreading through the population and the risk for contracting the disease is largely unabated since February. Despite the ongoing threat, many Americans have chosen to congregate in large, closely packed groups, often without any PPE, because they believe the pandemic risk is over. It’s not. Just because the crowd you are in is protesting racism instead of praying in church does not alter the risk. To believe that the righteousness of the cause alters the risk of the contagion is magical thinking. It is easy for a demonstrator to mouth the words that his or her cause is worth risking his or her life for, but have they truly contemplated that risk? Doubtful. They magically believe they are invulnerable. This is compounded by the President and Vice President modeling the exact opposite behavior of what their health experts call for. They will not wear masks and are trying to convince the country that they have done a good job when America leads the world in Covid-19 deaths.

         And the same is true of the protests.

         Just because you put a group of thousands together with their fists in the air does not make that an impetus for change. What exactly is wanted? “Justice” is too vague a term. Thinking that a police department can be dismantled without some form of civil order replacing it is also magical thinking. I understand Camden, NJ redid its police force. Great. Let’s see the plan for New York City or Houston, not just the gathering in groups or the ridiculous sight of whole blocks being closed in Seattle without the mayor or governor doing a thing to open them up as 9-1-1 response times rise. Good will does not restore traffic. Believing that it might is magical thinking. Not caring about the flow of life in the city is selfish.

         Finally, the concept that managing an academic medical center like a Fortune 500 corporation will lead to success in the mission to eradicate disease is also magical thinking. The essence of progress in medicine is traditional academic pursuits of patient-based research, lab-based investigation, and population-based science. Shut those down and you minimize the likelihood of progress. Good will doesn’t cure cancer.

         Finally, let’s be honest about magical thinking. It is the basis if hexes, taboos, and voodoo. It is a belief that somehow a behavior, or ritual will lead to a desired event in the real world. Not likely. I know that this will offend some who honestly believe in the power of prayer to affect events in the real world, but that is not my understanding of the power of prayer. My understanding of prayer is that it puts the individual in touch with his spiritual nature implying parts of humans that cannot be understood by science, but also science should not try to understand. There is much about our natures we don’t know and cannot measure. That does not make them unreal. But it does mean that the spiritual should remain that and not be conflated with cause and effect as measured by science. Prayer is not physics. Physics isn’t prayer.

         Magical thinking is unclear thinking and it tends to give the person using it the belief in powers that he or she really doesn’t have. The virus will not magically disappear. Magical thinking is superstition. It has no place in medicine or politics. Both of these fields need to be grounded in reality.

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