I have written about this topic more than ten years ago, but today I was reminded again of the immense difference between knowing what to do about physical problems vs knowing what to do about social or mental problems.

Today, someone I know well was admitted to the emergency room at Lenox Hill (thank God they ended up OK). When I went to visit them I was overwhelmed by the sheer competency of what was happening there. The room was crowded with patients in various stages of distress. Doctors, nurses, administrators, technicians with mobile computers and measuring devices, all roamed the room, knowing exactly where they were going and knowing exactly what to do. The walls had arrays of drawers labeled with every conceivable things one might need, from oxygen breathing tubes to catheters to …. Everyone went about their job knowing what the right thing to do was (‘best practice’ if you have to used that abominable business language term). No single person seemed to be in charge and yet everyone was attending to something important and useful without supervision. It was impressive and I was in awe. (And I recalled my previous personal experiences in two different emergency rooms I won’t name, a few years ago, where you had to have someone who came with you agitate repeatedly in order to get you attended to, where volunteers roamed the ER offering to get you candy from the machine in the lobby.)

And I was struck by the difference between knowing what to do about a physical problem whereas knowing what to do about a social problem. Some social scientists like to portray themselves as having the expertise in their field that scientists or engineers or doctors have in theirs, but it’s just impossible to have that kind of expertise in teaching, politics, social work, mental health, or economics. That’s the way it is, like it or not.