Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

“Wild Problems” Book Review


When it comes to the big decisions in life, abandoning a rational, algorithmic approach—and going back to guiding principles—may be the secret to happiness. 

Every human beingwhether a clinician, learner, patient, and/or family/friendis faced daily with the need to make multiple decisions, some of which are weightier than others. An algorithmic approach can be helpful with certain clinical decisions, like which chemotherapy agent to use. But this rational approach, so familiar to us in medicine, will be of little use in helping us tackle other big life decisionslike what specialty of medicine to pursue, or whether and whom to marry. How we tackle these more challenging decisions is the topic of Russ Roberts’ latest book, “Wild Problems.” An economist from Stanford who is now president of Shalem College (think St. John’s College with its great books curriculum, only in Jerusalem,) Roberts reveals through an amusing anecdote that, when it comes to the really important decisions in life, even economists abandon the rational, algorithmic approach that they themselves laud. 


Wild problems are those that get to the very essence of what we want out of life. One important point that Roberts makes early on is that the reason an algorithmic approach doesn’t help us solve wild problems is because when we are faced with big decisions like making a major career choice, getting married, or having children, we will never have all the information we need to make a rational decision. If you’ve never been a neurosurgeon (or married or a parent), your decision is being made from the perspective of someone who is not a neurosurgeon (or married or a parent) so your pro-con list, by definition, will be based on inadequate information. When faced with big decisions and incomplete data, many of us will delay making any decision while waiting for more data to arrive, which in the case of wild problems will likely never come. While waiting, we become paralyzed and stuck. 


“Wild Problems” is a delight to read. Roberts offers many amusing historical examples to support his argument. He presents the pro-con marriage lists from both Charles Darwin and Franz Kafka, for example. He discusses how NFL draft pick decisions are made and shares personal anecdotes about his own life and professional career. Roberts shows us that when facing wild problems, helike most of usthrows out the rational, pro-con approach and makes decisions based on his core values and principles. He urges us to do the same. To avoid decision procrastination or paralysis, he recommends taking a hard look at ourselves. This self-reflection, aimed at answering the question of what a good life looks like to us, guided by our values and principles, will lead us to make decisions that ultimately will bring happiness and life satisfaction. 









This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.