The cheapest diagnosis… in the world

The people who turned out to be right were usually called deluded first. The doubter was almost always an institution.

With thanks to Jezza…

There is a phrase the powerful reach for when they cannot be bothered to do the work. Delusions of grandeur. Say it out loud and watch what it does. It closes the file. It does the entire job of a rebuttal without the tedium of having to be one, and it lets the man saying it feel like a clinician rather than what he usually is, which is somebody protecting his furniture.

It is the cheapest diagnosis in the world. You can issue it without getting up.

In 1935 a twenty-four-year-old named Subrahmanyan Chandrasekhar stood up at the Royal Astronomical Society in London and explained, with the maths to back it, that a sufficiently large star would not retire quietly into old age. It would collapse. Keep collapsing. Become the thing we now call a black hole. Sitting in the room was Arthur Eddington, the most powerful astrophysicist alive, the man who had measured starlight bending around the sun and turned Einstein into a household name. Eddington rose after him and ridiculed the lot. Not with a counter-calculation. With contempt. The room, being a room, laughed along.

Chandrasekhar was right. He simply had to wait until 1983 to collect the Nobel Prize for it, by which time Eddington had been dead for thirty-nine years and the universe had carried on manufacturing black holes throughout, never once consulting the minutes of the meeting.

Everybody enjoys the vindication. I am more interested in the part nobody puts on the commemorative stamp.

Eddington never refuted the maths. He couldn’t. So he did the next best thing available to a great man, which is to stand at the front of the room being conspicuously great at the problem until it lost its nerve. That is the manoeuvre delusions of grandeur exists to make respectable. It is what you say when you have the standing to dismiss a man and not the arithmetic to disprove him.

I have spent enough years reading the histories of people who were called mad and turned out to be merely early to notice that the doubter is almost never a lone sceptic muttering in a corner. The doubter is a body. A faculty, a society, an institution with a charter, a letterhead, and a profound preference for not being startled.

Ignaz Semmelweis worked out, in 1847, that doctors were ferrying death from the autopsy table to the maternity ward on their own unwashed hands. He made them scrub with chlorinated lime and watched the death rate fall through the floor. For this the Viennese medical establishment treated him as an irritant, eased him out, and left him to finish in an asylum, where he died at forty-seven of an infection of the precise sort he had spent his career trying to prevent. The profession that buried him now teaches hand-washing to first-years as though it had thought of it over breakfast.

Robert Goddard suggested a rocket might work in the vacuum of space, and in January 1920 The New York Times gravely informed its readers that the professor appeared to lack the basic physics handed to any high-schooler. The paper printed its correction in July 1969. Three days before Apollo 11 reached the moon. Forty-nine years is a long time to mark your own homework and discover you failed.

You can run the pattern up to last week. Katalin Karikó spent two decades being demoted, defunded, and shuffled sideways by her own university for the offence of believing messenger RNA could be turned into medicine. She was not deluded, in the language of the institution. She was simply a poor financial risk. Her poor financial risk later went into several billion arms during a pandemic, and she shared a Nobel for it in 2023, whereupon the university that had spent years trying to misplace her began listing her among its luminaries, which takes a particular kind of cheek.

All of which would make a marvellous fridge magnet. The fridge magnet would also be a lie.

For every Semmelweis there is a cemetery, and it is enormous, and nobody visits. It is full of people who were told exactly the same thing, refused to listen with exactly the same magnificent stubbornness, and were simply, comprehensively wrong. History keeps none of their names, because being certain and wrong is the least remarkable thing a person can do. You can manage it from bed. Grandiosity is real; I have sat across a small table from it, and listened to a man narrate a destiny that his own life was busily disproving in the next room. Conviction is not a truth detector. Believing hard does not make a thing so, whatever the self-help shelf is charging for the opposite view this week.

So here is the knot, and I will not pretend to untie it neatly. The visionary who is right and early and the bloke who has read one book and decided it was secretly about him look identical from the front. Both are certain. Both are alone. Both give off precisely the same heat. Conviction runs at one temperature regardless of who is holding it, which is the whole trouble with mistaking it for evidence.

There is one thing that tells the two men apart, and it is the one thing the institutions kept declining to do.

Look.

Eddington could have checked the maths. The medical faculty could have counted Semmelweis’s corpses, which were lying about being eminently countable. The New York Times could have telephoned a physicist. In each case the thing that would have settled it was right there, free, faintly boring, and comprehensively ignored. Checking costs you an afternoon and the small, mortal risk of being wrong in front of colleagues. The label costs one sentence and protects everything you own. Offered that trade, a genuinely impressive number of clever men reach for the sentence.

That is the failure, and it is duller and worse than the heroic version, because nobody in it is a villain. No moustaches. They simply discovered that “deluded” was easier to pronounce than “let me get back to you,” and far easier to live with than “I appear to have been wrong, in public, since 1935.”

I think about this more than is good for me, and not from a safe distance. I am a counselling psychologist. I have sat on the issuing side of the label, in the quiet of a clinical hour, trying to sort justified conviction from the other thing and knowing exactly what it costs to call it wrong. I also spent most of my adult life on the receiving side of one that was. Bipolar II, said the profession, repeatedly, with the serene confidence of men who had a form to complete and a drawer to file me in. The actual answer, that I am autistic and ADHD, that my nervous system was built to a different specification and had been quietly paying the surcharge the entire time, did not turn up until I was sixty-six. I wrote a book about it. I called it Misdiagnosed, which is the least surprising title I have ever put on a cover.

It does something to a person, being told what they are by someone who never quite got round to finding out. It makes you quieter than you should be. It made me quiet for a very long time.

What I keep returning to is the timing of the apologies. The Nobel turns up after the asylum. The correction turns up after the moon. The university remembers its luminary the instant a pandemic has done the convincing on its behalf. The institution always comes good in the end, you will have noticed, generally about five minutes after coming good has stopped costing it anything.

The grave is a very forgiving place to be proven right. Mine came at sixty-six, which is late, but on the right side of the grass, and I have filed it under luck rather than justice. I would rather it were neither. I would rather we did the looking while the person was still in the room.

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Sources

Miller, A. I. (2005). Empire of the stars: Obsession, friendship, and betrayal in the quest for black holes. Houghton Mifflin.

The New York Times. (1920, January 13). Topics of the Times [Editorial].

The New York Times. (1969, July 17). A correction [Editorial].

The Nobel Assembly at Karolinska Institutet. (2023, October 2). The Nobel Prize in Physiology or Medicine 2023[Press release].

Science History Institute. (n.d.). Ignaz Semmelweis. https://www.sciencehistory.org/education/scientific-biographies/ignaz-semmelweis/

Wali, K. C. (1991). Chandra: A biography of S. Chandrasekhar. University of Chicago Press.