This is Fish, yes she is a dog called Fish. To give her full name, she is Fishalinka. What do you see?
Perhaps you wonder if she is blind in one eye because it’s blue and the other is brown?
Let me explain, this little girl is completely and profoundly deaf from birth. She isn’t blind, she has a slight merle, recessive, trait. She has brilliant vision, but absolutely no hearing. She came in to me when she was nearly 8 months old, from DogsTrust. She was bred to be a working dog on a farm. She’s a kelpie, collie, whippity thing cross. At least so I surmise. She was sold at 6 weeks old for farm work, but she was given back when the new owners realized she was deaf and ended up in a rescue. In a way Fish was lucky and clever, the breeder didn’t realize she was deaf. If they’d known she might not have made it to 6 weeks. She is very pretty, wide smile, sweet nature.
Life in kennels for a deaf dog must have been tough, especially for such a young pup. Dogstrust is great, but kennels is no place for an OCD, working dog that’s deaf. The biggest problem was that nobody wanted a deaf pup, until I came along and saw her picture on Facebook. You have to admit she looked quite cute.
When I first took her on she had really bad behavioral problems, she shadow chased constantly, was very fearful, anxious, bit other dogs on the nose to greet them, had no recall, no idea what living in a home meant. Plus she had no friends, she had no pack and nobody to show her what to do. It’s been a tough job to train her but uber rewarding.
If you’ve read this far you are probably wondering why I’m writing about a dog when these blogs are meant to be about health, and pain support and creativity and science. Let me explain that I mention Fish, because she was the victim of both conscious and unconscious bias. I’m quite sure that many people stopped and looked at her in the kennels, but then most would have walked on. Consciously aware that the last pet they wanted was a deaf one. They would have been completely biased towards having a hearing dog and just dismissed her. Then there would have been others who might have stopped and considered her, but they too moved over and left. I’m aware that a couple of people did seriously consider taking Fish on. But something just didn’t work out. Maybe they were unconsciously biased and at the first sign something wasn’t working they caved & handed her back.
Unconscious bias is something we all have. Even if we believe we are not biased we are. It’s not logical or rational to be unconsciously biased, not something we stop and consider day to day. But it’s something we do. If you’re not sure then take a moment to watch this youtube presentation. It’s only 2.5 minutes.
Wow, are you back now ?
That short youtube was about choices for the Royal Society, but we all make choices.
- As a patient you make choices, most of those choices are made based on an unconscious bias, not science. The difference between science and unconscious bias is that science is logical and unconscious bias is illogical.
- Many many clinicians and therapists practice from a place of unconscious bias. If a professional has a deep belief that surgery or phamacology or exercise is the best form of management, then will likely ignore publications that show marginally better outcomes for their preferred intervention. They may read articles with authors and publication editors who are biased. An example would be an article saying massage is effective, published in a massage magazine edited by manual therapists.
So unconscious bias is a problem in healthcare. Its a problem in therapy because most therapists are biased to believe their form of therapy is the most effective. With the rise in social media and information just a quick search on the internet away, its tough for people with health problems to know where to find science.
My tips for this are straightforward.
- Its your health problem so get interested in it and start to read round the science. Pubmed has over 26 million citations to start with. But remember the quality of the research is more than the abstract. The quality of the research is more than just one publication on a topic. But if you get interested its a start
- The best way to make decisions about your healthcare is to ask questions, be a bit skeptical. Begin by asking your professionals to direct you to great places to find good resources. But dont be fobbed off. On NHS Choices, most of the statements don’t have any science references and much information is simply misleading. I avoid saying ‘wrong’ but citing sciatica and disc problems is old fashioned biomechanical thinking, it’s not mentioning the brain
- Accept that everyone has unconscious bias. This includes your favorite Doctor who you trust implicitly, the Doctor who advises injections or surgery, the therapist who advises dry needling or the massage practitioner who advocates myofascial work. Science shows that many kinds of treatment have very little evidence if any evidence to support any demonstrable effects on tissues. Plus it’s likely that tissues are healed after 12 weeks, most ongoing pain is produced by the brain
- Accept that you have unconscious bias you will have preferences and irrational beliefs and bias surrounding different treatments. You may well believe wholeheartedly in a treatment with very little science to show how it works. It may be the treatment is a placebo, but if it works for you, and doesn’t cause pain. And as long as you stay aware that the theory of the treatment hasn’t been shown by science to be true, if it helps then it’s your choice.
- FINALLY: Whatever your choice of treatment be a little skeptical about the explanation given by the clinician and therapists. Ask for some science publication and check out what the publication is and which professional organization read it. Just because a clinician is well qualified with lots of letters after their name and lots of evidence of attending courses, it doesn’t mean they are keeping up to date with science
If you have any questions please email them to me and remember; We ALL have unconscious bias