Your Strength as a Rationalist

(The following happened to me in an IRC chatroom, long enough ago that I was still hanging around in IRC chatrooms.  Time has fuzzed the memory and my report may be imprecise.)

So there I was, in an IRC chatroom, when someone reports that a friend of his needs medical advice.  His friend says that he's been having sudden chest pains, so he called an ambulance, and the ambulance showed up, but the paramedics told him it was nothing, and left, and now the chest pains are getting worse.  What should his friend do?

I was confused by this story.  I remembered reading about homeless people in New York who would call ambulances just to be taken someplace warm, and how the paramedics always had to take them to the emergency room, even on the 27th iteration.  Because if they didn't, the ambulance company could be sued for lots and lots of money.  Likewise, emergency rooms are legally obligated to treat anyone, regardless of ability to pay.  (And the hospital absorbs the costs, which are enormous, so hospitals are closing their emergency rooms...  It makes you wonder what's the point of having economists if we're just going to ignore them.)  So I didn't quite understand how the described events could have happened.  Anyone reporting sudden chest pains should have been hauled off by an ambulance instantly.

And this is where I fell down as a rationalist.  I remembered several occasions where my doctor would completely fail to panic at the report of symptoms that seemed, to me, very alarming.  And the Medical Establishment was always right.  Every single time.  I had chest pains myself, at one point, and the doctor patiently explained to me that I was describing chest muscle pain, not a heart attack.  So I said into the IRC channel, "Well, if the paramedics told your friend it was nothing, it must really be nothing—they'd have hauled him off if there was the tiniest chance of serious trouble."

Thus I managed to explain the story within my existing model, though the fit still felt a little forced...

Later on, the fellow comes back into the IRC chatroom and says his friend made the whole thing up.  Evidently this was not one of his more reliable friends.

I should have realized, perhaps, that an unknown acquaintance of an acquaintance in an IRC channel might be less reliable than a published journal article.  Alas, belief is easier than disbelief; we believe instinctively, but disbelief requires a conscious effort.

So instead, by dint of mighty straining, I forced my model of reality to explain an anomaly that never actually happened.  And I knew how embarrassing this was.  I knew that the usefulness of a model is not what it can explain, but what it can't.  A hypothesis that forbids nothing, permits everything, and thereby fails to constrain anticipation.

Your strength as a rationalist is your ability to be more confused by fiction than by reality.  If you are equally good at explaining any outcome, you have zero knowledge.

We are all weak, from time to time; the sad part is that I could have been stronger.  I had all the information I needed to arrive at the correct answer, I even noticed the problem, and then I ignored it.  My feeling of confusion was a Clue, and I threw my Clue away.

I should have paid more attention to that sensation of still feels a little forced. It's one of the most important feelings a truthseeker can have, a part of your strength as a rationalist.  It is a design flaw in human cognition that this sensation manifests as a quiet strain in the back of your mind, instead of a wailing alarm siren and a glowing neon sign reading "EITHER YOUR MODEL IS FALSE OR THIS STORY IS WRONG."

 

Part of the sequence Mysterious Answers to Mysterious Questions

Next post: "Absence of Evidence Is Evidence of Absence"

Previous post: "The Virtue of Narrowness"

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Anon, see Why Truth?:

When people think of "emotion" and "rationality" as opposed, I suspect that they are really thinking of System 1 and System 2 - fast perceptual judgments versus slow deliberative judgments. Deliberative judgments aren't always true, and perceptual judgments aren't always false; so it is very important to distinguish that dichotomy from "rationality". Both systems can serve the goal of truth, or defeat it, according to how they are used.

A valid point, Psy-Kosh, but I've seen this happen to a friend too. She was walking along the streets one night when a strange blur appeared across her vision, with bright floating objects. Then she was struck by a massive headache. I had her write down what the blur looked like, and she put down strange half-circles missing their left sides.

That point was when I really started to get worried, because it looked like lateral neglect - something that I'd heard a lot about, in my studies of neurology, as a symptom of lateralized brain damage from strokes.

The funny thing was, nobody in the medical profession seemed to think this was a problem. The medical advice line from her health insurance said it was a "yellow light" for which she should see a doctor in the next day or two. Yellow light?! With a stroke, you have to get the right medication within the first three hours to prevent permanent brain damage! So we went to the emergency room - reluctantly, because California has enormously overloaded emergency rooms - and the nurse who signed us in certainly didn't seem to think those symptoms were very alarming.

The thing is, of course, that non-doctors are legally prohibited from making diagnoses. So neither the nurse on the advice line, or the nurse who signed us into the emergency room, were allowed to say: "It's a migraine headache, you idiots."

You see, I'd heard the phrase "migraine headache", but I'd had no idea of what the symptoms of a "migraine headache" were. My studies in neurology told me about strokes and lateral brain damage, because those are very important to the study of functional neuroanatomy. So I knew about these super dangerous and rare killer events that seemed sort of like the symptoms we were encountering, but I didn't know about the common events that a doctor sees every day.

When you see symptoms, you think of lethal zebras, because those are what you read about in the newspapers. The doctor thinks of much less exciting horses. This is why the Medical Establishment has always been right, in my experience, every single time I'm alarmed and they're not.

But in answer to your question about selection effects, Psy-Kosh, I think I'd have noticed if my friend had actually had a stroke. In fact, it would have been much more likely to have been reported and repeated than the reverse case.

I had a similar experience with my girlfriend, except the symptoms were significantly more alarming. She was, among other things, unable to remember many common nouns. I would point and say 'What is that swinging room separator?" and she would be unable to figure out "door".

I was aware from the start that the symptoms might have been due to a migraine aura, having looked up the symptoms on Wikipedia, but was advised by 811 to take her to the hospital immediately. The symptoms were gone before we arrived. Five hours later (a strong hint that at least the triage people thought it wasn't an emergency), a doctor had diagnosed it as a silent migraine.

"And this is where I fell down as a rationalist. I remembered several occasions where my doctor would completely fail to panic at the report of symptoms that seemed, to me, very alarming. And the Medical Establishment was always right. Every single time. I had chest pains myself, at one point, and the doctor patiently explained to me that I was describing chest muscle pain, not a heart attack. So I said into the IRC channel, "Well, if the paramedics told your friend it was nothing, it must really be nothing - they'd have hauled him off if there was the tiniest chance of serious trouble.""

My own "hold on a second" detector is pinging mildly at that particular bit. Specifically, isn't there a touch of an observer selection effect there? If the docs had been wrong and you ended up dying as a result, you wouldn't have been around to make that deduction, so you're (Well, anyone is) effectively biased to retroactively observe outcomes in which if the doctor did say you're not in a life threatening situation, you're genuinely not?

Or am I way off here?

"I should have paid more attention to that sensation of still feels a little forced."

The force that you would have had to counter was the impetus to be polite. In order to boldly follow your models, you would have had to tell the person on the other end of the chat that you didn't believe his friend. You could have less boldly held your tongue, but that wouldn't have satisfied your drive to understand what was going on. Perhaps a compromise action would have been to point out the unlikelihood, (which you did: "they'd have hauled him off if there was the tiniest chance of serious trouble"), and ask for a report on the eventual outcome.

Given the constraints of politeness, I don't know how you can do better. If you were talking to people who knew you better, and understood your viewpoint on rationality, you might expect to be forgiven for giving your bald assessment of the unlikeliness of the report.

Not necessarily.

You can assume the paramedics did not follow the proper procedure, and that his friend aught to go to the emergency room himself to verify that he is OK. People do make mistakes.

The paramedics are potentially unreliable as well, though given the litigious nature of our society I would fully expect the paramedics to be extremely reliable in taking people to the emergency room, which would still cast doubt on the friend.

Still, if you want to be polite, just say "if you are concerned, you should go to the emergency room anyway" and keep your doubts about the man's veracity to yourself. No doubt the truth would have come out at that point as well.

I saw someone on FB reposting this post today.

Makes an interesting point about not doubting your own models in certain circumstances I guess, but the original post leaves out relevant issues of trust and pragmatism.

Sure people probably gullibly believe untrue stories more often than they should, but biases also often cause us to discount anecdotes that are actually representative of real, lived experiences (such as the subtle experiences of those who suffer from racism and sexism). - http://ntrsctn.com/science-tech/2015/12/tech-guys-allies/

Just because a bug is unusual or difficult to locally replicate/experience doesn't mean you should discount the bug reports.

Also (obviously) faith in even medical experts/institutions should be absolute.

Finally there's nothing wrong with offering someone good advice even if you think they may have lied to you/are trolling... there's still a chance they were not trolling, and arming them with good information might be good for them in the short term or long term.

That article is written as though "are you sure that was sexism" literally means "you had better prove it is sexism with 100% certainty, or I won't believe you".

That is not what it means. It's not a demand for 100% certainty, it's a demand for better evidence. You don't have to be treating the world like a computer in order to think that you should try to rule out innocent explanations before proclaiming someone guilty.

Also, while the author claims that the standard he quotes makes it impossible to prove sexism, his own standard has the opposite problem: according to it it's impossible to prove anyone innocent of sexism. People don't favor uncertainty over assumption because they're computer geeks; people favor uncertainty over assumption because there are such things as false positives, and they have enough of a cost that avoiding them is worthwhile.

From TvTropes:

"According to legend, one night the students of Baron Cuvier (one of the founders of modern paleontology and comparative anatomy) decided to play a trick on their instructor. They fashioned a medley of skins, skulls and other animal parts (including the head and legs of a deer) into a credibly monstrous costume. One brave fellow then donned the chimeric assemblage, crept into the Baron's bedroom when he was asleep and growled "Cuvier, wake up! I am going to eat you!" Cuvier woke up, took one look at the deer parts that formed part of the costume and sniffed "Impossible! You have horns and hooves!" (one would think "what sort of animals have horns and hooves" is common knowledge).

More likely he was saying "Impossible! You have horns and hooves (and are therefore not not a predator.)" The prank is more commonly reported as: "Cuvier, wake up! I am the Devil! I am going to eat you!" His response was "Divided hoof; graminivorous! It cannot be done." Apparently Satan is vegan. Don't comment that some deer have been seen eating meat or entrails, I occasionally grab the last slice of my bud's pizza but that doesn't classify me as a scavenger."

Thank you, Eliezer. Now I know how to dissolve Newcomb type problems. (http://lesswrong.com/lw/nc/newcombs_problem_and_regret_of_rationality/)

I simply recite, "I just do not believe what you have told me about this intergalactic superintelligence Omega".

And of course, since I do not believe, the hypothetical questions asked by Newcomb problem enthusiasts become beneath my notice; my forming a belief about how to act rationally in this contrary-to-fact hypothetical situation cannot pay the rent.

Fair enough (upvoted); but I'm pretty sure Parfit's Hitchhiker is analogous to Newcomb's Problem, and that's an absolutely possible real-world scenario. Eliezer presents it in chapter 7 of his TDT document.

I don't see that you did anything at all irrational. You're talking to a complete stranger on the internet. He doesn't know you, and cannot have any possible interest in deceiving you. He tells you a fairly detailed story and asks for you advice. For him to make the whole thing up just for kicks is an example of highly irrational and fairly unlikely behavior.

Conversely, a person's panicking over chest pains and calling the ambulance is a comparatively frequent occurrence. Your having read somewhere something about ambulance policies does not amount to having concrete, irrefutable knowledge that an ambulance crew cannot make an on-site determination that there's no need to take a person to the hospital. To a person without extensive medical knowledge there is nothing particularly unlikely about the story you were told.

Therefore, the situation is this -- you are told by a complete stranger that has no reason to lie to you a perfectly believable story. You have no concrete reason ("read something somewhere" does not qualify) to doubt either the story or the man's sanity. Thus there is nothing illogical about taking the story at face value. You did the perfectly rational thing.

Since there was no irrationality in your initial behavior, the conclusions that you arrive at further in your post are unfounded.

DP

You're talking to a complete stranger on the internet. He doesn't know you, and cannot have any possible interest in deceiving you.

There's plenty of evidence that some people (a smallish minority, I think) will deceive strangers for the fun of it.

Which, as I said later on in the same paragraph, is irrational and unlikely behavior. Therefore, when lacking any factual evidence, the reasonable presumption is that that's not the case.

DP

I think many of us have actually encountered liars on the Internet. I'm not sure what you mean when you say "lacking any factual evidence".

I presume that you have encountered liars in the real world as well. Do you, on that basis, habitually assume that a random stranger engaging in casual conversation with you is a liar?

My point is that pathological liars are a small minority. So if you're dealing with a person that you know absolutely nothing about, and who does not have any conceivable reason to lie to you, there is nothing unreasonable in assuming that he's telling you the truth, unless you have factual evidence (i.e. you have accurate, verifiable knowledge of ambulance policies) that contradicts what he's saying.

DP

I think at this point the questions have become (a) "how many bits of evidence does it take to raise 'someone is lying' to prominence as a hypothesis?" and (b) "how many bits of evidence can I assign to 'someone is lying' after evaluating the probability of this story based on what I know?"

I believe your argument is that a > b (specifically, that a is large and b is small), where the post asserts that a < b. I'm not going to say that's unreasonable, given that all we know is what Eliezer Yudkowsky wrote, but often actual experience has much more detail than any feasible summary - I'm willing to grant him the benefit of the doubt, given that his tiny note of discord got the right answer in this instance.

My argument is what I stated, nothing more. Namely that there is nothing unreasonable about assuming that a perfect stranger that you're having a casual conversation with is not trying to deceive you. I already laid out my reasoning for it. I'm not sure what more I can add.

DP

"Do you, on that basis, habitually assume that a random stranger engaging in casual conversation with you is a liar?"

Yes. Absolutely. Almost /everyone/ lies to complete strangers sometimes. Who among us has never given an enhanced and glamourfied story about who they are to a stranger they struck up a conversation with on a train?

Never? Really? Not even /once/?

Yes. Absolutely. Almost /everyone/ lies to complete strangers sometimes. Who among us has never given an enhanced and glamourfied story about who they are to a stranger they struck up a conversation with on a train?

Never? Really? Not even /once/?

If everyone regularly talked to strangers on trains, and exactly once lied to such a stranger, it would still be pretty safe to assume that any given train-stranger is being honest with you.

Actually, yes, you're entirely right.

In conversations I've had about this with friends - good grief, there's a giant flashing anecdata alert if ever I did see one, but it's the best we've got to go off here - I would suspect that people do it often enough that it's a reasonable thing to consider in a situation like the one being discussed here, though.

Not that I think it's a bad thing that the person in question didn't, mind you. It would be a very easy option not to consider.

("read something somewhere" does not qualify)

Wait, why not?

I read somewhere that if spin about and click my heels 3 times I will be transported to the land of Oz. Does that qualify as a concrete reason to believe that such a land does indeed exist?

DP

I read somewhere that if spin about and click my heels 3 times I will be transported to the land of Oz. Does that qualify as a concrete reason to believe that such a land does indeed exist?

That indeed serves as evidence for that fact, though we have much stronger evidence to the contrary.

N.B. You do not need to sign your comments; your username appears above every one.

That indeed serves as evidence for that fact, though we have much stronger evidence to the contrary.

And not just because clicking the heels three times is more canonically (and more often) said to be way to return to Kansas from Oz. and not to Oz.

I think one would be the closest to truth by replying: "I don't quite believe that your story is true, but if it is, you should... etc" because there is no way for you to surely know whether he was bluffing or not. You have to admit both cases are possible even if one of them is highly improbable.

In it's strongest form, not believing system 1 amounts to not believing perceptions, hence not believing in empiricism. This is possibly the oldest of philosophical mistakes, made by Plato, possibly Siddhartha, and probably others even earlier.

Considering that medical errors apparently kill more people than car accidents each year in the United States, I suspect the establishment is not in fact infallible.

Citation needed? I know I'm coming to this rather late, but a quick check of the 2010 CDC report on deaths in the US gives "Complications of medical and surgical care" as causing 2,490 deaths whereas transport accidents causing 37,961 deaths (35,332 of which were classified a 'motor vehicle deaths'). The only other thing I can see that might be medical errors put under a different heading is "Accidental poisoning and exposure to noxious substances" at 33,041 which combines to still fewer deaths than transport accidents even without removing those poisonings which are not medical errors. (This poisoning category appears to have a lot of recreational drug overdoses judging by the way it sharply increases in the 15-24 age group then drops off after 54 whereas time-spent-in-hospital is presumably increasing with age.)

On the other hand, a 2012 New York Times Op-Ed claims 98,000 deaths from medical errors a year. This number is so much larger than what the CDC reports that I must be misreading something. That would be about 1 in 20 people who die in the US die due to medical error. Original source from 1999). Actually checking that source, 98,000 deaths/year is the upper bound number given (lower bound of 44,000 deaths/year). The report also recommends a 50% reduction in these deaths within 5 years (so by 2004) - and Wikipedia mentions a 2006 study claiming that they successfully preventing 120,000 deaths in an 18 month time period but I can't find this study. A 2001 followup here appears to focus on suggestions for improvements rather than on giving new data to our question. 3 minutes on Google Scholar didn't turn up any recent estimates. This entire sub-field appears to rely very heavily upon that one source - at least in the US.

Also of interest is "Actual Causes of Death in the US" which classifies deaths by 'mistake made' (so to speak) - the top killer being tobacco use, then poor diet/low exercise, alcohol, microbial agents, toxic agents, car accidents, firearms, sexual behaviors, and illicit drug use. Medical errors didn't show high up on this list, despite it being the only source in the Wikipedia article on the original article.

Edit: also some places that cite the 1999 study accuse the CDC of not reporting these deaths as their own category. This appears to have changed given the category I reported above. The fact that there has been substantial uproar about medical error since the 1999 article and a corresponding increase in funding for studying it makes me unsurprised that the CDC would start reporting.

If a doctor makes a mistake treating a patient from a vehicle accident, what heading does it get reported under?

(I ask the question in earnest, to anybody who might know the answer - because depending on what the answer is, it could explain the discrepancy.)

It is a design flaw in human cognition that this sensation manifests as a quiet strain in the back of your mind, instead of a wailing alarm siren and a glowing neon sign reading "EITHER YOUR MODEL IS FALSE OR THIS STORY IS WRONG."

I wouldn't call it a flaw; blaring alarms can be a nuisance. Ideally you could adjust the sensitivity settings . . . hence the popularity of alcohol.

Sounds like good old cognitive dissonance. Your mental model was not matching the information being presented.

That feeling of cognitive dissonance is a piece of information to be considered in arriving at your decision. If something doesn't feel right, usually either te model or the facts are wrong or incomplete.

T

Alas, belief is easier than disbelief; we believe instinctively, but disbelief requires a conscious effort.

Looking through Google Scholar for citations of Gilbert 1990 and Gilbert 1993, I see 2 replications which question the original effect:

(While looking for those, I found some good citations for my fiction-biases section, though.)

I feel really uncomfortable with this idea: "EITHER YOUR MODEL IS FALSE OR THIS STORY IS WRONG."

I think this statement suffers from the same limitations of propositional logic; consequently, it is not applicable to many real life situations.

Most of the times, our model contains rules of this type (at least if we are rationalists): Event A occurs in situation B with probability C, where C is not 0 or 1. Also, life experiences teach us that we should update the probabilities in our model over time. So beside the uncertainty caused by the probability C, there is also uncertainty resulted from our degree of belief in the correctness of the rule itself. The situation becomes more complicated when the problem is cost sensitive.

I got your point (I hope so) and I'm definitely not trying to say "IT IS WORNG" but I think it is true to some degree.

Doesn't any model contain the possibility, however slight, of seeing the unexpected? Sure this didn't fit with your model perfectly — and as I read the story and placed myself in your supposed mental state while trying to understand the situation, I felt a great deal of similar surprise — but jumping to the conclusion that someone was just totally fabricating is something that deserves to be weighed against other explanations for this deviation from your model.

Your model states that pretty much under all circumstances an ambulance is going to pick up a patient. This is true to my knowledge as well, but what happens if the friend didn't report to you that once the ambulance he called it off and refused to be transported. Or perhaps at the same time his chest pains were being judged as not-so-severe the ambulance got another call in that a massive car pileup required their immediate presence.

Your strength as a rationalist must not be the rejection of things unlikely in your model but instead the act of providing appropriate levels of concern. Perhaps the best response is something along the lines of "Sounds like a pretty strange occurrence. Are you sure your friend told you everything?" Now we're starting to judge our level of confidence in the new information being valid.

Which is honestly a pretty difficult model to shake as well. So much of every bit of information you build your world with comes from other people that I think it pretty decent to trust with some amount of abandon.

I see two senses (or perhaps not-actually-qualiatively-different-but-still-useful-to-distinguish cases?) of 'I notice I'm confused':

(1) Noticing factual confusion, as in the example in this post. (2) Noticing confusion when trying to understand a concept or phenomenon, or to apply a concept.

Example of (2): (A) "Hrm, I thought I understood what, "Colorless green ideas sleep furiously" means when I first heard it; the words seemed to form a meaningful whole based on the way they fell together. But when I actually try to concretise what that could possibly mean, I find myself unable to, and notice that characteristic pang of confusion."

Example of (2): (B) "Hrm, I thought I understood how flight works because I could form words into intelligent-sounding sentences about things like 'lift' and 'Newton's third law'. But then when I tried to explain why a plane goes up instead of down, my word soup explained both equally well, and I noticed I was confused." (Compare, from the post: "I knew that the usefulness of a model is not what it can explain, but what it can't. A hypothesis that forbids nothing, permits everything, and thereby fails to constrain anticipation.")

It might be useful to identify a third type:

(3) Noticing argumentative confusion. Example of (3): "Hrm, those fringe ideas seem convincing after reading the arguments for them on this LessWrong website. But I still feel a lingering hesitation to adopt the ideas as strongly as lots of these people seem to have, though I'm not sure why." (Confusion as pointer to epistemic learned helplessness)

As in the parent to this comment, (3) is not necessarily qualitatively distinct (e.g. argumentative confusion could be recast as factual confusion: "Hrm, I'm confused by this hesitation I observe in myself to fully endorse these fringe ideas after seeing such seemingly-decisive arguments. Maybe this means something." (Observations of internal reaction are still observations about which one can be factually confused).

Eliezer's model:

The Medical Establishment is always right.

Information given:

  • Person is feeling chest pain.
  • Paramedics say hospitalization is unnecessary.

Possible scenarios mentioned in the story:

  1. Person is feeling chest pain and is having a heart attack.
  2. Person is feeling chest pain but does not need to be hospitalized.
  3. Person is lying.

Between the model and the information given, only Scenario 1 can be ruled false; Scenarios 2 and 3 are both possible. If Eliezer is going to beat himself up for not knowing better, it should be because Scenario 3 did not occur to him -- not that Scenario 3 is the logical reality.

The way you phrase it hides the crucial part of the story. Rephrasing:

  1. Person is telling the truth a.) They are having a heart attack, but the paramedics judged wrongly, dismissed it, and didn't take him to the hospital. b.) They are not having a heart attack, the paramedics judged rightly, and the paramedics dismissed it and didn't take him to the hospital.
  2. Person is lying.

Eliezer is saying that he should have known scenario 1 is wrong because regardless of whether or not the paramedics think it's legit, they would have taken the person to the hospital anyway. So, 1a and 1b must be wrong, leaving 2.

Or, if I were going to add to your model, I would add "The Medical Establishment always takes in the ambulance if they call for a medical reason." Then, when the information given is "Paramedics say hospitalization is unnecessary," that would have been a direct conflict between model and information, where Eliezer had to choose between rejecting the model and rejecting the information.

Your strength as a rationalist is your ability to be more confused by fiction than by reality.

Yet, when a person of even moderate cleverness wishes to deceive you, this "strength" can be turned against you. Context is everything.

As Donald DeMarco asks in "Are Your Lights On?", WHO is it that is bringing me this problem?

How do you face this situation as a rationalist?

There are four answers on a multiple answer question, A B C and D. Using prior study knowledge, you immediately dismiss B and D. Problem! A and C sound equally plausible, your first urge is A, for some reason, but after some examination, B seems more plausible to your mind.

Results notwithstanding, how would you think of this as a rationalist. Is it even relevant?

I believe the evidence is that the initial urge of A is more credible than the rationalization of B. That is, when students change answers on multiple choice tests, they are more likely to turn a right answer to a wrong answer than a wrong answer to a right answer. (I don't know if that generalizes to a true-false setting.)

I'm not sure that listening to ones intuitions is enough to cause accurate model changes. Perhaps it is not rational to hold a single model in your head, as your information is incomplete. Instead one can consciously examine the situation from multiple perspectives, in this way the nicer (simpler, more consistent, whatever your metric is) model response can be applied. Alternatively you could legitimately assume that all the models you hold have merit and produce a response that balances their outcomes e.g. if your model of the medical profession is wrong and they die from your advice it is much worse than the unnecessary calling of the ambulance (letting the medical profession address the balance of resources). This would lead a rational person to simultaneously believe many contradictory perspectives and act as if they were all potentially true. Does anyone know of any theory in this area? the modelling of models (and efficiently resolving multiple models) would be very useful in AI.

An alternative explanation? You put your energy into solving a practical problem with a large downside (minimizing the loss function in nerdese). Yes, to be perfectly rational you should have said: "the guy is probably lying, but if he is not then...".

Okie, and yeah, I imagine you would have noticed.

Also, of course, docs that habitually misdiagnose would presumably be sued or worse to oblivion by friends and family of the deceased. I was just unsure about the actual strength of that one thing I mentioned.

Is EY saying that if something doesn't feel right, it isn't? I've been working on this rationalist koan for weeks and can't figure out something more believable! I feel like a doofus!

No. Two possibilities, not just one:

"EITHER YOUR MODEL IS FALSE OR THIS STORY IS WRONG."

It is a design flaw in human cognition...

Since I think evolution makes us quite fit to our current environment I don't think cognitive biases are design flaws, in the above example you imply that even if you had the information available to guess the truth, your guess was another one and it was false, therefore you experienced a flaw in your cognition.

My hypotheses is that reaching the truth or communicating it in the IRC may have not been the end objective of your cognitive process, in this case just to dismiss the issue as something that was not important anyway "so move on and stop wasting resources in this discussion" was maybe the "biological" objective and as such it should be correct, not a flaw.

If the above is true then all cognitive bias, simplistic heuristics, fallacies, and dark arts are good since we have conducted our lives for 200,000 years according to these and we are alive and kicking.

Rationality and our search to be LessWrong, which I support, may be tools we are developing to evolve in our competitive ability within our species, but not a "correction" of something that is wrong in our design.

See, this is why it's a bad idea to use the language of design when talking about evolution. Evolution doesn't have a design. It optimizes locally according to a complex landscape of physical and sexual incentives, and in the EEA that usually would have favored fast and frugal heuristics. Often it still does; if you're driving a car or running away from a bear, you don't want to drop what you're doing and work out the globally optimal path before taking action. That's all well and good.

But things have changed in the last 12,000 years; we spend more time doing long-range planning and optimization work, for example, and less time running away from tigers and hitting each other on the head with clubs. Evolution works slowly, and we haven't reached a local maximum for our environment yet, nor are we likely to in the near future as we continue to reshape it; we're left with a set of cognitive tools, therefore, that are often poorly adapted to our goals. It's these that we seek to compensate for, when and where doing so is appropriate.

While our goals are informed by biology, though, their biological influences are no "truer", no more "correct", than any other. We certainly shouldn't treat them as gospel; if they turn out to be in tension with the environment, as in many cases they have, evolution will be quite happy to select against them.

Since I think evolution makes us quite fit to our current environment I don't think cognitive biases are design flaws

They're design flaws insofar as that there are far better possibilities. Just because something doesn't fail entirely, doesn't mean its design is any good.

If the above is true then all cognitive bias, simplistic heuristics, fallacies, and dark arts are good since we have conducted our lives for 200,000 years according to these and we are alive and kicking.

This is the same as above. This might also be relevant.

Rationality and our search to be LessWrong, which I support, may be tools we are developing to evolve in our competitive ability within our species, but not a "correction" of something that is wrong in our design.

Many of us do not (consciously) want to gain competitive advantages compared to other people but rather raise the sanity waterline.

If the above is true then all cognitive bias, simplistic heuristics, fallacies, and dark arts are good

Good for survival, but not for truth seeking. Epistemic and instrumental rationality are difference things.

And even in terms of survival, human neurology isn't that great. It was good enough to get our species to survive until now, but it's nowhere close to optimal.

Of course, it's also possible to overdo it. If you hear something odd or confusing, and it conflicts with belief that you are emotionally attached to, the natural reaction is to ignore the evidence that doesn't fit your worldview, thus missing an opportunity to correct a mistaken belief.

On the other hand, if you hear something odd or confusing, and it conflicts with belief or assumption that you aren't emotionally attached to, then you shouldn't forget about the prior evidence in light of new evidence. The state of confusion should act as a trigger mechanism telling you to tally up all the evidence, and decide which piece doesn't fit.

This looks like an instance of the Dunning-Kruger effect to me. Despite your own previous failures in diagnosis, you still felt competent to give medical advice to a stranger in a potentially life-threatening situation.

In this case, the "right answer" is not an analysis of the reliability of your friend's account, it is "get a second opinion, stat". This is especially true seeing as how you believed the description you gave above.

If a paramedic tells me "it's nothing", I complain to his or her superiors, because that is not a diagnosis. Furthermore, I don't see in your description a claim that the paramedics said there's no need to worry even if the pain becomes worse later on, so it seems sensible for you to presume they didn't. So, even if the first assessment is presumed correct, it is not admissible to think that it extends to different evidence.

And if that doesn't convince you, compute the expectation value of probably being right in a chat vs. the small chance of being sued for wrongful death times everything you own and will ever earn.

Was a mistake really made in this instance? Is it not correct to conclude 'there was no problem'? Yes, the author did not realise the story was fictional; but what of what he concluded implied the story was not fictional?

Furthermore, is it good to berate oneself because one does not immediately realise something? In this case, the author did not immediately realise the story was fictional. But evidently the author was already working toward that conclusion by throwing doubt on parts of the story. And the evidence the author had was obviously inconclusive; the story could have been fictional (and the lie could have been invented at several stages), or the complainant could perhaps have simply misinterpreted chest pains as something else, or perhaps the doctors could have in fact made a mistake etc. Given all that, it seems rather after-the-fact to conclude the "Rational" conclusion one should have reached was that the story was a fiction. Surely the "Rational" conclusion would be to suspend judgement pending further investigation; or perhaps judge, but judge lightly. In any case, the self-flagellation at the end of the article seemed unnecessary. Humans are not capable of permanently being "Rational" thinkers; to get to the "Rational" conclusions, it is often best to proceed in baby-steps we can take rather than "Rational" leaps prescribed by whatever vision of "Rationality" is imagined by the author.

This sort of brings to my mind Pirsig's discussions about problem solving in ZATAOMM. You get that feeling of confusion when you are looking at a new problem, but that feeling is actually a really natural, important part of the process. I think the strangest thing to me is that this feeling tends to occur in a kind of painful way -- there is some stress associated with the confusion. But as you say, and as Pirsig says, that stress is really a positive indication of the maturation of an understanding.