The Trust Game

When is tech savvy a requirement for professional competence, and when does it just not matter?

• By Geoffrey H. Fletcher
• 06/01/10

‘Who Do You Trust?” was a game show from the late 1950’s, hosted for much of its run by Johnny Carson. Three couples competed each week. Johnny would name a question category and the male in the couple (always the male) would decide whether he would answer the question or if he would trust his wife to answer it better. Aside from the blatant cultural sexism of the time (and the ungrammatical title of the show), it was an amusing program, especially with Carson as emcee.

I recently found myself confronted with a 21st century version of “Who[m]Do You Trust”—one where technology plays a starring role. I’ve been having numbness in my hand and tingling down my arm. After an initial consultation and MRI, I was advised to see two neurosurgeons. The first—I’ll call him Dr. Kildare—listened to my symptoms and immediately pronounced, “You don’t want or need surgery; it doesn’t work for this problem.” Then he looked at the MRI on a fancy dual-screen monitor. He expertly navigated through the program, and I saw my neck and spine from more angles than I thought possible. If it weren’t my neck, it would have been very cool. He told me to do nothing, including simple tasks like weeding. He also said I should not do physical therapy and that the offending bulging disk might recede. He ran no tests on me; he did not touch me. He relied on images from the MRI and my description of the symptoms.

The second doctor—I’ll call him Ben Casey—had a different approach. He listened to me describe my symptoms and then tested my every reflex; had me walk a straight line for balance; pulled on my arms and hands to check for strength loss; poked my hands, arms, and feet with pins; and checked the range of motion in my arms, hands, and neck. Only after 20 minutes of such activity did he turn on the computer and insert the CD with my MRI. I wanted to blow the dust off the keyboard, but held back. The 11-inch monitor was at least 10 years old.

Dr. Casey had a difficult time operating the mouse and did not know how to navigate the program to show simultaneous side and internal views, nor could he zoom in on a particular vertebra. He claimed the resolution on the MRI was not good, but it was the same MRI I could see very clearly on Dr. Kildare’s monitor. Dr. Casey said I should go to a physical therapist and use steroids for a week, and if that didn’t relieve the symptoms, he would inject steroids directly into the disk. If that didn’t change things, he would operate. “I can fix this.”

So, whom should I trust? The technology-dependent Dr. Kildare or the technologically inept Dr. Casey? There’s a metaphor in here somewhere for technology in higher education that I’m still trying to figure out. But first, I have to decide where to make my next doctor’s appointment.