People fail to take their medications properly and this leads to continuing and sometimes worsening health conditions. The largest reason is forgetfulness. If you are of an age, say under 50, this seems largely unbelievable. How can people forget whether they’ve taken their daily pill? An Evil Pharma once hired me to answer that question and since I was under 50 at the time, I thought they were crazy to even ask it. What? People can’t remember whether they’ve taken a pill! Then . . . time passes, I’m over 50 and I get it. Sometime after 50 you’ll understand this too and you can give me a friendly wave of acknowledgment. Perhaps I’ll even remember what it’s about!
But to the problem with pills. How do you make people behave like proper boys and girls and take their medicine? This article in the Wall Street Journal provides a nice description of the range of solutions. My favorite is the beeping container. Basically, researchers are testing a pill box that emits . . . ah, information to the user. Maybe it glows. Maybe it beeps. Perhaps an email reminder to your iGizmo.
Sounds like a solution and it is, but what problem does it solve? If you take just a minute to think about this, you should realize that Beep-Beep is a simple thing, but even simple things can function in a wide variety of ways. Is it a stimulus, a response, or a consequence? Something else? Consider.
Feedback. Of course! Pure feedback, right? You’ve got a goal state (taking the pill on schedule) and your current state (haven’t taken the pill) and some feedback (beep-beep) that alerts you to the difference between the goal and your current state. So, this thing should work pretty well because as I’ve noted before, Feedback Is A Good Thing.
Ding-Dong. Of course! Mere classical conditioning, right? You’ve got the ultimate stimulus (Beep-Beep) that elicits a response (gulp) that evolved from a simple pattern of unconditioned associations leading to conditioned S-R bonds. There’s not even a simple feedback analysis that compares the current state to the goal state. No thinking here at all. Beep-Beep is just Ding-Dong.
Why? Because. Of course! Every time you hear that Beep-Beep, you ask yourself, Why?, and begin the attributional search for meaning that boils down to an answer that is either Internal (I made this happen) or External (Somebody is doing this to me). Now, Beep-Beep is a lot more complicated. It’s not Feedback and it is not Ding-Dong, but a search for answers that forks the path and leads to either the Internal or External exit ramp.
If you go on the Internal exit ramp, Beep-Beep is a Good Thing. Why is that thing beeping at me? Because I am getting old and losing my short and medium term memory faster than my hair and it is damn near impossible to remember getting dressed this morning even though I’m wearing pants right now, but of course, I could have slept in them and wouldn’t remember that either and, oh, why is that thing beeping at me? I forget a lot and it reminds me to, to, . . . take a pill . . . or else check and see if Melanie has trapped herself in the basement again! The key point in this rabbit hole of memory is that the Beep-Beep elicits an Internal Attribution where you take personal responsibility for the medicine, the container, the beeper, everything. Then, it’s All Good.
But, if you take the External exit ramp, Beep-Beep may be a Bad Thing. It reminds you of that bossy, whippersnapper physician who’s always nagging you and that greedy whippersnapper pharmacist who’s pushing pills for profit and those Evil Pharmas owning the world, and Health Care Reform and on and on. Forces outside of you are beeping at you, pushing you around, controlling you, manipulating you. And you will likely take the External Exit Ramp because your body is falling apart and no one wants to own up to that!
So, Beep-Beep, a simple thing, is actually many things: Feedback, Ding-Dong, and Why? Because. And every time the container goes Beep-Beep, any one of these functions may arise making each time the First Time.
So, how do you handle it? Well, you could . . .
. . . hey, hire me, write a check, and let’s get serious. Do you really expect me to deliver the money shot for free in this blog post? Come on. This is worth millions of dollars. You didn’t take my advice in 2001 and look what happened then!