Saturday, February 7, 2015

Lies, Damn Lies, And Normal Brain Function

I have listened to the past 48 hours of constant criticism and speculation about the implications of what is generally described as a "lie".  News anchor Brian Williams made a statement about remembering that he was shot at in a helicopter in Iraq and forced down after it was hit by a rocket powered grenade.  That statement occurred on an interview with David Letterman and several other venues over the past 12 years.   The actual section of the video is from the 2:50-7:20 of the 18:14 clip.  In the interview he was entertaining, self effacing and talks about himself as being an "accidental tourist".  He rejects Dave's suggestion that he be looked at in a different light because of this incident and praises the volunteer troops and emphasizes that he hopes the troops get what they need when they return home.    The statement and previous clips (3) have been scrutinized by various sources.  Today there are also a number of places looking closely at other statements for similar errors or possible "lies".  Conspiracy theorists always want to prove that there is a pattern.  The formal press and the blogosphere generally wants to see successful people fail in some way.  There are many stories suggesting that this has implications for Williams credibility as a journalist.

Notice how I slipped the word "error" in there.  One of the preconditions for classifying a statement as a "lie" is that it is a conscious effort to mislead.  Mistakes are not technically lies although I have been in settings in medical training where trainees were punished for mistakes and treated as if those mistakes were lies or at least the product of a significant character flaw. A little context is always relevant.  Williams typically reads the news every night for the past 11 years.  He has read more information during those broadcasts than most people will every speak to their colleagues and coworkers in a lifetime.  All of that information is probably vetted by another editor and the person entering the text.  He has presented that information in a way that has led him to have the reputation as being a very reliable source of news.  Secondly, he is under a great amount of scrutiny, much more scrutiny than an average person would expect because he is constantly recorded and easily recognized as a celebrity.  Finally, what can he be expected to gain from intentionally telling a misleading story.  What is his possible motivation?  He clearly dismissed Letterman's attempt to make it a big deal and immediately made it a story about the volunteer forces and returning veterans.  All of these factors seem to be ignored in the typical analysis of the statement and his apology.    

Mistakes like this are commonplace.  In the past month, I have had two very bright young colleagues recall my unusual eating habits from dinners that recently occurred.  One of them recalled me eating a large piece of prime rib, the other frog legs.  I have not eaten beef in 30 years and have never eaten an amphibian.  In those events my colleagues did not recall a feature of the event and there was a misattribution based on that lack of recall.  In many situations, my usually excellent memory does not match up with the recall of others from the same situation.  In 1975 (or so) I was in the Hotel Jacaranda in Nairobi, Kenya with a few of my Peace Corps friends.  We were all seated around a large rectangular table getting ready to order dinner.  I was particularly jumpy that night and when a waiter bumped into my elbow, I reflexively dumped a cup of cocoa on a friend sitting immediately to my right.  When I say dumped, I mean about 16 ounces of warm liquid poured right on top of his head and over his glasses.  I was very embarrassed at the time, but the incident was apparently forgotten by the other 5 friends sitting at that table.  I tried to revisit that event with my friend a few years ago and according to him - it never happened.  Whose recollection of the incident is likely correct, a person who has an associated memory of being embarrassed about it or the person who would just as soon forget about it?

None of my anecdotes matches one that is probably self aggrandizing to some extent but their are similiar examples in the literature.  Eye witness testimony comes to mind.  You are a star witness in the case and the fate of the defendant hinges on your testimony.  Psychologist Daniel Schacter points out in his book (1) that more than 75,000 criminal trials are decided each year on the basis of eyewitness testimony.  A recent analysis comparing eyewitness testimony to DNA evidence suggested that eyewitness testimony was mistaken in 90% of cases.  A more recent review (2) suggests that the number may be closer to one in three.  I have testified myself in courtroom situations where I was told by attorneys that I would not have to speculate on a specific question.  I was asked that question anyway, but with enough experience I knew the correct response was to say that I could not answer the question.  I have always wondered about what happens when people are witnesses in important cases and they have the expectation that they need to come up with an answer to every question whether they have an answer or not.  I am sure that I have seen this happen in real courtroom testimony.  That stress in combination with imperfect human memory has the potential to create a new story or at the minimum information that creates more noise than signal.

The second aspect of the Williams scenario involves the binding of certain events in the correct order across a number of situations.  Watching the NYTimes montage in reference 3 illustrates what I am  talking about.  Earlier footage clearly illustrates that he was on the ground with helicopters that had taken small arms fire when he landed in a helicopter that was probably doing what he described in the  Letterman clip.  Is it possible that this was binding failure?  Schacter's definition of which would be "the gluing of the various components of an experience into a whole.  When individual parts of an experience are retained but memory binding fails, the stage is set for all kinds of source misattributions....".   It is easier to recall actions and scenes presented together but significantly more difficult to recall which action occurs in which scene (4).  That experimental finding is interpreted to mean that information about scenes and information about actions are stored in different parts of the visual memory system (4).  Further binding is adversely affected by age (5) and other sources of interference (6) with both the features of a scene and the bindings.  Psychiatrists who keep detailed notes on their patient encounters will easily observe these binding failures and different histories being given at different points in time.  It is also likely that the longer you live, the more you will encounter this phenomenon in your own life.

People lie and people forget - so what?  In the final analysis, very few observers have access to all of the information necessary to determine what is a lie and what is not a lie.  By definition the only discriminating factor is a conscious awareness on the part of the liar.  I have no access to information more than anyone else and no conflict of interest when it comes to Mr. Williams or NBC.  The current situation requires some reflection on why it has the appearance of being so important.  Is it possible that this is a case of faulty recall and misattribution?  I think it is and most of the analyses to the contrary are not based on how human memory works.  There are a number of questions that can be asked about these analyses.  Why is there an opinion based on very scant information?  Is it possible that emotional bias is involved in the complex decision-making of the author?  Is the author denying the fact that these kinds of experiences have happened to them?  Or is jumping to conclusions an aspect of the author's character that they would just as soon not look at?  Is it really that surprising that thousands of journalists and bloggers want to add their own sensational spin to this story?

Those may be much more relevant questions than the one being asked today.

George Dawson, MD, DFAPA


1:  Daniel L. Schacter.  The Seven Sins of Memory.  Houghton Mifflin Company; Boston, 2001, 272 pp.

2: Wise RA, Sartori G, Magnussen S, Safer MA.  An examination of the causes and solutions to eyewitness error.  Front Psychiatry. 2014 Aug 13;5:102. doi: 10.3389/fpsyt.2014.00102. eCollection 2014. Review. PubMed PMID: 25165459

3:  Jonathan Mahler, Ravi Somayia, Emily Steele.   With an Apology, Brian Williams Digs Himself Deeper in Copter Tale.  New York Times February 5, 2015.

4: Urgolites ZJ, Wood JN.  Binding actions and scenes in visual long-term memory.  Psychon Bull Rev. 2013 Dec;20(6):1246-52. doi: 10.3758/s13423-013-0440-1. PubMed PMID: 23653419.

5: Pertzov Y, Heider M, Liang Y, Husain M.  Effects of healthy ageing on precision and binding of object location in visual short term memory.  Psychol Aging.  2014 Dec 22.  [Epub ahead of print] PubMed PMID: 25528066.

6: Ueno T, Allen RJ, Baddeley AD, Hitch GJ, Saito S. Disruption of visual feature binding in working memory.  Mem Cognit 2011 Jan;39(1):12-23. doi: 10.3758/s13421-010-0013-8.  PubMed PMID: 21264628.

Supplementary 1:  

It  turns out that I was able to think of a better anecdote after I penned the above post.  On Tuesday September 11, 2001 I was doing what I did every morning as an inpatient psychiatrist for 23 years.  I was sitting in a team meeting with all of the representative disciplines including social work, occupational therapy and nursing.  At about 8:15 a nurse came in to give us a report and she happened to mention:  "We just heard that a plane hit one of the Twin Towers in New York City.  It's on the news right now."  When she said that my recollection was that I said: "If I was there right now I would be trying to get as far away as possible.  That was a terrorist attack and there may have been something else on that plane."  The rest is history, but for the purpose of this post did I really make that statement?  I had just tried to run an early Internet campaign for US Senate and one of my overriding concerns was terrorism.  My campaign could be best described as an abysmal failure.  I seemed to be one of the few people in the state interested in terrorism.  Almost everyone else had been concerned with spending the imaginary federal surplus, something I considered to be the product of capital gains taxes on the Internet stock bubble.  For that matter, do I really remember all of the people in the room at the time?  I am pretty sure I do, but it would not surprise me at all if I struck up a conversation with somebody who I thought was there only to learn that they were not.  Nobody who I thought was in the room ever approached me after the incident and asked me about my statement.  I took that as pretty good evidence that I should keep my mouth shut.  I also remembered something I read about Harry Stack Sullivan.  He was a psychiatrist who specialized in the interpersonal psychotherapy of people with schizophrenia.  He had a number of therapy experiences that he wrote about that were very striking and unique.  In his writing at one point he said that he realized that he just needed to stop writing and talking about those experiences because he could not say for  sure what had actually happened versus what was embellished.  I always remembered that cautionary note as well as the slang term "power story" from my youth in the North.  A power story was assumed to be an embellished story to make one look good.  A typical response might be (in a mildly sarcastic tone): "OK Paul Bunyan - where is Babe the Blue Ox?"  It is probably not a good thing to be remembered as the psychiatrist who tells power stories unless you are retired and sitting in a bar in northern Wisconsin.  


  1. "People lie and people forget - so what?"

    The issue goes beyond this with news organizations. They have the ability and obligation to fact check at least domestically if not during wartime (which I still think was possible but I'll give them the benefit of the doubt at least while the war was going on).

    If his employers are pillorying him now it is only to remove focus from their own responsibility in the whole matter.

    1. RB - thank you for bringing up the New Orleans issue. I actually saw an interview of a physician saying that there were absolutely no cases of GI illness after the hurricane. That does not match my recollection of the incident (just watching the news) and it makes no sense at all to anyone who knows anything about sanitation measures. Fortunately the CDC collected a large number of facts about infectious disease after the hurricane:

      It is also well known that Americans can get at least one episode of diarrhea per month that is related to food poisoning. So I think it is another case of how we can prove the so-called lies rather than look at all of the data. I have been getting sick from viruses at least 4-6 times a year from working in health care facilities.

      Is it really surprising that you might get acutely ill when the sanitation infrastructure of a major city is destroyed?

  2. And, thanks for your post.

    You often provide a fresh perspective on a subject and an angle I wouldn't have thought to entertain had I not been presented with it.

  3. I found Dr. Dawson's points, examples, and reasoning very made me put my stone down.

  4. He lied. He made it up and when it got positive attention he embellished. And he kept doing it. But let's stipulate for a moment that the neurocognitive argument is correct.

    Then he still isn't fit to be a journalist. Other journalists don't have this problems. Find a replacement who doesn't have that issue. Because it is something neurocognitive it will happen again.

    It's like repeat DUI alcoholism as a vice vs. disease. It doesn't matter. Take away the keys.

    1. Every person in the world has this problem

  5. I am not as easily seduced into this argument:

    Beware the use of junk neuroscience in the upcoming years...

    There is a difference between not remembering a dinner and an elaborate confabulation for obvious secondary gain.

    1. I think context is important and interestingly second gain issues of the critics. In many ways it is similar to the types of criticisms of psychiatry that I focus on in this blog. Williams is not a prototypical journalist like Huntley, Brinkley or Cronkite. When he is - reading a highly edited stream of information off a teleprompter he is like all the rest. When he takes on a celebrity status he is not the guy reading perfect information and is like anyone else and subject to the same memory lapses.

      That information is as fallible as anyone else's, although looking at two different reconstructions of those events even with eyewitnesses on CNN today - it is clear that there is no single narrative - even one that is based on recorded information from the time. When that happens there are only two explanations - either the recollection of other people involved at the time was problematic or there were an improbable number of people colluding to construct the event to look as good as possible for him in the future.

      I don't think there is any way to construe what is known about the frailties of human memory as junk neuroscience. This is basic psychology even without without the neuroscience. It is also all speculation at this point since I hope that nobody ever examines Williams for the purpose of detecting "the truth". I offer these points up as a counterpoint to the masses saying that this is a clear lie. At this point that fact will never be knowable. Who knows what will need to be done in terms of the overall "investigation" in order to keep him on the air.

      My point is that the media overreaction to this and the apparent consensus is absurd. As I pointed out in my original post - I have seen people accused of lying and that has probably sensitized me to this issue. I don't accept for a second that is what is going on here and it is obvious to me that the incoherent case by the media changes on a day to day basis.

      But I am sure at some point they will have it all spliced into a nice neat package.

  6. George,

    You know I respect your intellect but you need to think through the implications of this.

    Neither you nor I now anyone I know has ever concocted such an elaborate falsification and repeated it over a decade.

    Buying into this line of thinking means the end of accountability. Basically anyone who lies can essentially claim a brain fart so to speak. We might as well not have a judicial system. Or clinical research. Or anything where we have to count on character and honesty.

    We all know memory isn't perfect. No one is disputing that. But to come up with an elaborate story and repeat it over an over again...there is clearly some kind of Axis 2ish problem here...most people don't do this...I know it is tres unfashionable to talk about character these days and instead blame everything on neuroscience....but Williams clearly got off on the positive reaction to his BS story...

    Please read Sally Satel's book on junk neuroscience, really is a huge problem...and Insel is making it worse...

  7. We've gone from one extreme to another, "the children never lie" (false memories) to the idea that detailed fabulations can simply be misremembering:

    Williams was told many times by his staff and producers to knock it off but he kept on going after he was shown evidence of falsification. He liked the stories because they made him feel important.

    False memories as defined by Loftus involves the influence of a biased second party like an incompetent therapist or family member. Williams need no assistance in coming up with his tall tales.

    He's Jon Lovitz in the liar sketch. The only thing he didn't say is, "yeah, that's the ticket". And that he was dating Morgan Fairchild.

    No, this false memory defense wouldn't stand up under any standard of evidence and especially not Daubert.

    Not that six oclock news matters anyway, who even watches that anymore?

    1. I see false memories as being much different from not remembering accurately. The tone of this blogpost is rhetorical - the author posts data that clearly shows that memory can be inaccurate and he concludes that people are suggesting that somebody is "perpetrating the myth that human memory is as fragile as a butterfly and as malleable as clay." The experiment with tampering with eyewitness accounts is interesting considering that the Am Psychological Assoc believes that 1 in 3 eyewitness accounts is inaccurate.


      Unfortunately that is the state of blog debates.

      I hope to post a rejoinder to the Satel piece this weekend. But in general I would encourage anyone to avoid debating neuroscience like it is the Democrats versus the Republicans. You will miss most of what is going on from that angle.

      A useful question to consider might be why an elegant and efficient processor like the brain would jump to an all-or-none/yes-or-no scenario?

  8. It's not political, it's factual. I've been on the other side of the debate when people claimed in McMartin that children never lie. Arguing that Williams has false memories or didn't remember accurately does not comport to what we know about false memories and what those deficits reflect. I don't the author I cited had any political agenda. I certainly don't in this case. The argument that this isn't deliberate and calculated doesnt jibe with the fact that most people, who indeed have flawed memories, don't go out and do what Williams did.

    No one believes that memory is infallible except for the recovered memory crowd. That is a straw man. There is a qualitative difference between not remembering something accurately and coming up with a self serving elaborate story that you continue to repeat when confronted with the facts.

    I really think you might want to tee up a mulligan on this one. In any court of law this would fail to meet Daubert standard. I would encourage you to read more about how many times Williams did this and how many times he was confronted by his bosses and told to knock it off.

    The recovered memory people used to think memory was infallible, trendy neuroscientists that false memories can't ever be distinguished from lies. They are both wrong.

    In any case, it doesn't matter. Seizures are not under voluntary control, and yet you can't drive with uncontrolled epilepsy. If Brian Williams has truth epilepsy, someone else should do his increasingly vestigial job.

  9. BTW

    That CV does not appear to be that of a right winger with an agenda. I interpret the current memory neuroscience in much the way she does.

  10. Reading the pharmacy journals "medication error of the month" articles which highlight how a particular mistake happened and how easily it could happen anywhere made me realize two things.

    One, working in pharmacy is really scary, and two, people make mistakes therefore systems need to be created to catch them.

    This comment is largely a repeat of my earlier comment with the addition that it is interesting to ponder how Brian Williams made these mistakes. But ultimately the problem is, why was he was allowed to make them in an industry that should be endeavoring to tell us the truth.

    1. RB,

      Two thoughts on that:

      1. Pharmacy systems appear to be finite and therefore it should be easy to create a system to catch errors. In reality it is not for a number of reasons. Errors are not reported especially if it involves doing additional paper work or jumping through more hoops. EHRs are not intelligent software programs. They are a series of hard stops that can be easily defeated. The best example is the drug interaction software. There is usually a hierarchy of drug interactions of increasing severity. Some physician groups disable some of those stops because of the sheer number of mouse clicks that it adds. Finally, the total number of combinatorics in a polypharmacy environment is staggering and after the first two interactions it is anyones guess.

      2. I guess you have a lot more faith in the news than I do. It is pretty clear to me that there are always conflicts of interest present in the news - the most palpable one is making the news as sensational (and less objective) as possible in order to sell mouse clicks. It happens all of the time and the cost is significant. In my lifetime we have basically fought 3 unnecessary wars with the associated mortality and morbidity based in a large part by the lack of adequate reporting and investigations by the press. I will provide the Gulf of Tonkin incident and the escalation of the war in Vietnam as one example. Anything that Williams may or may not have said is trivial by comparison unless you are just trying to sell the controversy. Add the governments credit reporting system and health care as an obvious and hidden tax on all Americans and I would say - if there is some credible journalism in this country where is it. They just missed the top three stories in my lifetime.

      Endeavoring to tell the truth is as close as they can come. I think they have a history of believing they are much more important than they really are but they consistently speaking for the government and their partners in the business world. They have an excellent track record of discrimination against psychiatry superimposed on a larger track record of discriminating against physicians in general while supporting all kinds of "reforms" by new money making industries in health care.

  11. Ok, point taken and a good point it is.

    Whether or not a dead body floated by him in New Orleans or he imagined himself shot down in wartime is nothing compared to the "crimes" committed against the public by the press on the subjects that really matter.

  12. On the issue of health care, not only did Gruber lie repeatedly but he repeatedly bragged about lying. In terms of the impact of those lies, I agree with you the consequences are far worse since this changed 1/7 of the economy. As I've said, I think the 6 oclock news is irrelevant.

    But the answer is not to let Brian Williams off the hook, it's to go after the Grubers even harder for what they've done. BTW, how does he still have a job at MIT? How does he get more research opportunities given that he admitted he fudged numbers to get the result he wanted? And why did no one in the room raise bloody hell when he started talking like that?