Neil Tambe

I'm a Detroiter who happens to enjoy writing, national parks, orange juice, the performing arts, and fanciful socks. More than anything though, I aspire to be a good husband, father, and citizen.

The questions we should and shouldn’t be asking when the path forward is unclear

The questions I should be asking when the path forward is unclear:

  • What matters in this situation? (Or its variants, like - what result are we trying to create, or for what purpose are we here)?
  • Why does it really, really matter? 

The mistake I usually make is jumping to these two questions, first:

  • What’s the problem?
  • What’s the solution? 

The consequences of this mistake became very clear to me as I ready Dr. Atul Gawande’s Being MortalIn its pages Gawande shares many stories about the decisions families make when a loved one is choosing treatment options at the end of their life.

If we jump to problems and solutions, for example, we choose based on what the default mindset is (fight the disease until our last breath, damn it). The problem is, the patient might not want the pain, suffering, and loss of mental faculty that comes with aggressive treatments. 

I find this a difficult thought experiment, but bear with me. Imagine you are terminally ill with a tumor in your abdomen somewhere. You can’t eat and constantly feel nausea and intense bouts of pain. It’s hard to walk around. You have uncertain amount of time left, maybe a few months or a year. 

The first default scenario is you try aggressive treatment and it doesn’t work. You’ve just gone through hell and you have terrible quality of life for your remaining days. That’s bad.  

What’s maybe worse is if the aggressive treatment actually does work. You’ve gone through hell, extended your time only to have worse quality of life than before. This scenario is great if extending time on Earth at all costs is your preference. That’s just not usually the case. For a lot of people, maybe most, more suffering for more time is actually a worse outcome than less time.

The questions of what matters and why, helps ensure that whatever course of action we take, we’re trying to pursue the outcome that really matters. This prevents everyone from spending time wondering if we’re going the right direction and distracting from actually getting there.

Perhaps more importantly, asking what matters and why prevents the nightmare scenario of achieving precisely the wrong goal.

The questions of problem and solution are important to ask, just not first.