The Only Sure Thing About Luck Is That It Will Change Apr 2, 2012

by Rick Rader, MD

Walk into the lobby of any mega medical center of excellence.

Looking at the hospital department directory you will find the following signs accompanied by multi-directional arrows: Surgery...Pathology...Imaging...Neurology...Research...Cardiology
.Interventional Diagnostics...all hard core science. Departments that incorporate the best, solid, evidence based practices. Departments that depend on insights, outcomes and results from the gold standard of medicine, the scientific method. No room for a coin toss, the throw of the dice, or shuffling and picking a card. In shor,t no room for chance, no room for luck. Or is there?

In a recent New York Times article by a physician, the vice chairman of clinical affairs of a household word cancer center suggests otherwise: "The hospital I work at has no 13th floor."

Thus, he opens the door for the paradoxical parallel universes of the kingdom of science and the integration of mankind's oldest belief system— superstition. Surgeons who only schedule procedures on even days, physicians who will only use "lucky" computer stations, emergency room directors who know better than to assign certain docs to work during the full moon, research scientists who arranged their lab in sheng fui format and brain surgeons who will not make the initial incision until the staff cranks up Hootie and the Blowfish. Luck? Ritual? Chance?

The reality is that despite years of bowing to the altar of science, training in an environment where data rules, and learning to embrace protocols that receive peer approval, the players are still people, first and foremost. And, being people and only people, they know what works and what doesn't (at least, for them, in any given situation). Thus, no one negates the insistence of the surgeon who will not operate without her floral design surgical cap, or the resident who will always soap up his left hand first (just the way his mentor told him it worked best for him). Luck is a funny thing. A thing you don't abolish, negate or discard if it works for you—or. if you think it works for you.

In medicine the element of "luck" is certainly not restricted to superstitious clinicians. Luck permeates medicine...and disease.

Without using the word, genetic counselors imply that luck abounds when describing the "chances" of a couple conceiving a child with Fields' disease (the rarest disease in the world). Surely there is some "luck" in acquiring a rare disease, just as there must be some element of "luck" in being spared a common one.

If we embrace "luck" or "fortuity" as "the good fortune which occurs beyond one's control, without regard to one's will, intention, or desired result," then "luck" plays a large part in bringing new readers, new exceptional parents, to this time honored publication. Things that occur beyond one's control, to a large degree, is what exceptional parenting is all about.

Outsiders would probably not consider having a child with complex challenges to be the result of "good fortune," that requires an EP veteran. We constantly hear from parents who feel they were lucky to have had what they had and cherish what they have.

Luck, it seems, has three aspects which make it distinct from chance or probability (D.C. Dennett): luck can be good or bad; luck can be accident or chance; and luck applies to an entity.

For my colleagues, those who have gravitated to treating, supporting and advocating for individuals with disabilities and their families, we feel it was luck, our good luck, to have found a niche where we were given both the challenge and grace of being where luck intended us to be.

The science fiction writer Larry Niven has explored the realm of luck; explored and brought it to a new level. Niven wrote several stories set in his Known Space universe that explored the implications of breeding humans for luck. Samuel Arbesman, a science fiction critic observes, "Niven even explores what species would be, when everyone is lucky and almost nothing can go wrong."

And although we try to conduct our lives where almost nothing can go wrong, we find that our response to "things going wrong" are indeed when we find out just how right we can be in the face of "wrong." Luck insists, beyond anything else, that we will not be provided a path where nothing can go wrong. Perhaps we can thank our lucky stars for that.

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