Doctors' errors, novelists' sins

Readers defend Ian McEwan's "Atonement" and argue that computers should never replace doctors.

By Letters to the Editor
Published April 15, 2002 7:00PM (EDT)

Read "Robo-docs"

I have to say, I think turning diagnosis over to computers is a terrible idea. Even if a computer may have a higher "success rate" than a doctor, there can still be cases that would be obvious even to a resident that a computer might be incorrect about. It would only take one case where a computer sent a patient in for brain surgery to treat what turned out to be a head cold before the entire country got behind even inexperienced doctors as an alternative to computers.

Far better to provide computer-based diagnostic tools that are capable of being used by doctors themselves to "red flag" cases for follow-ups or possible further tests. Ideally, such computer tools would be capable of providing additional information to a doctor about why they flagged a particular case, so the doctor could have more information with which to form an opinion. Why not create tools that help doctors do their jobs better, instead of trying to replace them?

-- Andrew Norris

Ivan Oransky's call for computers to be the main instruments of medical decision making is positively breathtaking in its simple-mindedness and naiveté. While it is true that needless medical errors are a problem of catastrophic proportions, the sort of reliance on the computer that Oransky proposes is no solution at all. To reason from the premise that "doctors make needless errors" to the conclusion that using the computer will remove human error may say something about the reasoning abilities of doctors, but it does not build the case that Oransky thinks he is making.

On Oransky's premises, we might as well delegate to computers the authority to grant or deny mortgage applications, grant or deny admissions to college, render verdicts in trials and decide whether or not to declare war. Oransky seems to have derived his strange misunderstandings about the capabilities of computers from science fiction. What he seems to hope they can do is something that does not exist in real life.

As to removing humans from the equation, where does Oransky think computers get their information to begin with? Computer data, as everyone but Oransky knows, may be flawed, and in a way that the computer cannot detect. For that matter, who programs them to process the data, of whatever quality it may be? A computer with flawed data or flawed programs is capable of making errors every bit as terrible as those Oransky is concerned about right now. Anyone who doubts that should see some of the nonsensical comments that are returned when running Microsoft Word's grammar and spell check feature.

As a technical writer who has spent most of a 16-year career in and around data-processing environments, I can assure Oransky that the problems to be found in both programming and data entry are an absolute bar to the computer becoming the magic solution that he hopes for. Computers are a valuable resource, yes. They are not a substitute for attentive and knowledgeable professionals.

-- Michael Huggins

Read "Mirror, Mirror"

Helen Macleod's screed about Ian McEwan's metafictional enterprise in "Atonement" issues a blanket indictment of all fiction concerned with the tenets of fiction making, a proclamation that leaves her bookshelves bereft of all Nabokov, most of Roth, a good portion of Melville, Hawthorne, Joyce and the collected works of a raft of other 19th- and 20th-century all-stars.

Keep fighting the good fight, Ms. Macleod.

-- Nathan Hensley

Helen Macleod almost nails the point in her piece, but she backs down with the statement, "After a few decades of doing nothing but writing fiction, it must be hard to carry on fudging the fact that really what you know about best is the life of a fiction writer." Hard to fudge the facts? But isn't that what fiction writers do? Thank God Shakespeare (whoever he is this week) managed to lift his precious hand and write about something other than being a writer.

To witness the state of fiction in full wilt, take a look at 99 percent of the major literary journals. Most of the selections read like parodies of four to five overinfluencing authors of the past 50 years. Everyone lives in shush-shush misery, and you can check off the by-the-numbers, five-senses, overworkshopped writing, if you have the stomach for it.

But it's not just the writing about writing that sickens the heart. It is the endless eroticizing of food, the parade of precious coming-of-age narrators, the divorcing academics. The problem is not that this is elitist self-indulgence. The problem is that it is uninteresting elitist self-indulgence.

Writers once documented their time and place, or imagined other times and places. Our most frequently published (not best) writers today neither document nor imagine. What they do is called wallowing, and it takes place in a barren, overdrilled hole in the ground.

-- Paul A. Toth

Just because she wrote a novel, Helen Macleod perhaps thinks she has become an authority on what novelists should write about. Has she forgotten the saying that there are no bad topics, only bad writers? If, to her, McEwan's delivery is inadequate and leaves much to be desired, maybe, there are many out there who could learn something about writing from his book and feel entertained at the same time.

-- Gras Reyes

I believe that your columnist, in her stubborn indulgence of what are obviously her own preconceptions, has grossly misrepresented Mr. McEwan's novel. In attempting to accurately depict a writer writing a novel in an unbiased fashion as a writer writing a novel, authors will rarely avoid the scrutiny of critics and others who might be wondering, "Is this supposed to be introspective or just plain sanctimonious?" It is simply my contention that it is the author's privilege and duty to be both, and perhaps ambiguous intentions are merely just that ... ambiguous. Finally, I'd like to opine that the analogical comparisons to Mr. McEwan's novel at the end of the column are both absurd and caustic.

-- Justin Hoops

"Being professionally imaginative is hard, no doubt. But turning the craft of fiction writing to the exploration of the art of writing fiction is one of the least worthwhile things a novelist can do."

This is one of the most profoundly incorrect statements I have read in awhile. A writer writes to explore his feelings. And when a writer writes about something he has done for decades of his life, he is capable of reaching down to the depths of his feelings and truly understanding them through his own experience. Creating fictional characters deprives the author of a certain depth of clarity because the context of the fictional character is removed from the author. But when an author creates a story based on his own life and experiences, we are provided a deeper examination of life itself, one we can learn valuable lessons from. Saying that it is the "least worthwhile thing a novelist can do" is to project one's own inadequacies onto the author and ignore the lessons about life and feelings that can be learned. The author is not writing for Ms. Macleod, he is writing for himself. We are lucky that some people are willing to put their emotional lives on public display so that we may see in them a source of strength and inspiration.

-- Michael Lacy

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