A Book Review: Talking to Strangers, by Malcolm Gladwell

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January 31, 2020

Unless we live in a small town, we are unlikely to know everyone that we come in contact with. We are often forced to make decisions on how to interact with a stranger without knowing anything about them, and the consequences can be devastating. Malcolm Gladwell struggles to understand the recent police shootings of African Americans, specifically why the encounter between Sandra Bland, a young African American woman and Brian Encinia a white police officer, in a small town in Texas ended up with her in jail for failing to signal a lane change,.and ultimately in her death from suicide. Gladwell wants to understand why their interaction, their strategies for understanding each other’s intentions went so wrong, “figure out where they came from, find out how to fix them.” Malcolm Gladwell is a persuasive story teller and he takes us on a journey using examples from remote times (the Aztecs and the Spaniards), to recent headlines.

He teaches us that we are not as good at assessing people’s character and intentions as we think we are and how this allows spies to go undetected, and pedophiles to go free (think Jerry Sandusky and Larry Nassar). Judges, law enforcement officers and FBI or CIA agents aren’t any better at figuring out when people are telling the truth than the rest of us. This is due to a phenomenon that Gladwell calls “defaulting to truth” This explains why, even when suspicions are raised about a person, if we think we know them or we think positively about them, we give them the benefit of the doubt. 

Another phenomenon that Gladwell illustrates is called “coupling”. This occurs when a certain behavior is linked to a specific situation. As a doctor, I was interested in how committing suicide, for some patients, is coupled with a specific plan as to how to do it, for example jumping off the Golden Gate bridge. It was thought that putting safety nets on the bridge would not decrease the suicide rate because people would just find another way to kill themselves. However, when the bridge was equipped with safety nets, the number of suicides decreased!

The book just spoke to me. I found myself thinking about how I assess people’s intentions and character in the course of my daily life. One common situation in medicine, is how to tell if a patient is really in pain, or are they seeking narcotics because they are addicted. I have a few patients with bad Crohn’s disease who are in chronic pain and are managed with narcotics, by pain management specialists. They hate to go to the emergency room for exacerbation of their pain, first because like most people, they hate to go to the hospital. but, more importantly, they hate to be treated by ER doctors who don’t know them. Often, when they ask for pain medications in the ER, they are treated as though they are addicts, or they are given insufficient medication. The Emergency Room doctors do not have the advantage of knowing these patients and their pain tolerance or intentions.

I had a very difficult time writing this book review and when I discussed it with my son, who had just read the book, he helped me clarify why. Gladwell describes all sorts of stories and studies about difficult and perplexing human interactions and behavior. The book is a quick and entertaining read and each part has it’s own internal logic, but it is not always clear how it all ties together. I am intentionally not telling you how the author gets back to discussion of the Sandra Bland encounter but he provides some background information on the origin of certain policing practices, on the way. I invite you to read the book and see what you think of his conclusions. It made for lively discussions in my family! I felt that I learned a lot in reading the book and recommend it as informative and thought-provoking.