Selflessness versus Selfishness: Either Extreme Can Be Bad

[div class=attrib]From the New York Times:[end-div]

Some years ago, Dr. Robert A. Burton was the neurologist on call at a San Francisco hospital when a high-profile colleague from the oncology department asked him to perform a spinal tap on an elderly patient with advanced metastatic cancer. The patient had seemed a little fuzzy-headed that morning, and the oncologist wanted to check for meningitis or another infection that might be treatable with antibiotics.

Dr. Burton hesitated. Spinal taps are painful. The patient’s overall prognosis was beyond dire. Why go after an ancillary infection? But the oncologist, known for his uncompromising and aggressive approach to treatment, insisted.

“For him, there was no such thing as excessive,” Dr. Burton said in a telephone interview. “For him, there was always hope.”

On entering the patient’s room with spinal tap tray portentously agleam, Dr. Burton encountered the patient’s family members. They begged him not to proceed. The frail, bedridden patient begged him not to proceed. Dr. Burton conveyed their pleas to the oncologist, but the oncologist continued to lobby for a spinal tap, and the exhausted family finally gave in.

As Dr. Burton had feared, the procedure proved painful and difficult to administer. It revealed nothing of diagnostic importance. And it left the patient with a grinding spinal-tap headache that lasted for days, until the man fell into a coma and died of his malignancy.

Dr. Burton had admired his oncology colleague (now deceased), yet he also saw how the doctor’s zeal to heal could border on fanaticism, and how his determination to help his patients at all costs could perversely end up hurting them.

The author of “On Being Certain” and the coming “A Skeptic’s Guide to the Mind,” Dr. Burton is a contributor to a scholarly yet surprisingly sprightly volume called “Pathological Altruism,” to be published this fall by Oxford University Press. And he says his colleague’s behavior is a good example of that catchily contradictory term, just beginning to make the rounds through the psychological sciences.

As the new book makes clear, pathological altruism is not limited to showcase acts of self-sacrifice, like donating a kidney or a part of one’s liver to a total stranger. The book is the first comprehensive treatment of the idea that when ostensibly generous “how can I help you?” behavior is taken to extremes, misapplied or stridently rhapsodized, it can become unhelpful, unproductive and even destructive.

Selflessness gone awry may play a role in a broad variety of disorders, including anorexia and animal hoarding, women who put up with abusive partners and men who abide alcoholic ones.

[div class=attrib]Read more here.[end-div]

[div class=attrib]Image courtesy of Serge Bloch, New York Times.[end-div]