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When a book reaches the bestseller list, it is often just as interesting to speculate on the reasons for its popularity as it is to read the book itself. In the case of the latest blockbuster by Michael Crichton or John Grisham, the author's "brand name" doubtless contributes to its success at the cash register. However, when the author is Malcolm Gladwell (hardly a household name), the reasons for the book's popularity are less straightforward. I suspect the main reason for the success of Blink: the power of thinking without thinking is that it offers exhausted professionals faced with executive responsibilities a version of epistemology that not only excuses, but glorifies, the snap decision.
According to Gladwell, "decisions made very quickly can be every bit as good as decisions made cautiously and deliberately" (p 14); "there can be as much value in the blink of an eye as in months of rational analysis" (p 17). Gladwell supports his thesis by telling stories-often charming, always compelling, and filled with realistic details-of people whose "blink" decisions end up being better than the "scientific" or "rational" decisions made after gathering and considering large amounts of data. He begins Blink by recounting the story of a forged statue, a kouros, which was purchased by the Getty Museum only after extensive scientific analysis showed its authenticity. A number of art experts, he tells us, were immediately able, merely by looking at the statue, to determine it was a fake: "When Federico Zeri and Evelyn Harrison and Thomas Hoving and Georgios Dontas-and all the others-looked at the kouros and felt an 'intuitive repulsion,' they were absolutely right. In the first two seconds of looking-in a single glance-they were able to understand more about the essence of the statue than the team at the Getty was able to understand after fourteen months" (p 8).
Every day, medical practitioners must make such high stakes decisions rapidly and often under conditions of stress. Medical practitioners are also under increasing pressure to integrate evidence from scientific studies into their decision making procedures. Gladwell's advice seems to turn the wisdom of evidence-based practice on its head: "blink" thinking is the very antithesis of the labour intensive effort involved in the thorough literature search, the critical...