The Crumbs of Pluralistic Ignorance

Vein Magazine Medical Director, Dr. Steven Elias, Introduces the Summer 2015 Issue.

The crumb cake is one of mankind’s gastronomique conundrums—pieces of inconsequential little things held together for our enjoyment. Who thought to use these leftover crumbs for something so ubiquitous in many cultures? I ponder this as I walk through the ruins of Knossos on the island of Crete. Crumbs of a very ancient civilization held together by the physical and emotional efforts of a country and people. Greece is crumbling. Really. There are ruins everywhere; in America, we get rid of our ruins even if they are not crumbling because we need room to build new things to ruin. In the U.S., no one is interested in seeing a partially or almost totally collapsed building in ruin. The Greeks embrace this concept. They are proud of their heritage. It is a country that has been falling apart for thousands of years. They love the legacy. They embrace the legacy. And now we are embracing the ruins and history of the Minoan civilization as we tour Knossos. The wonderful course directors and organizers (my good friend, Nicos Labropoulos being one of them) of the LIVE meeting, always held in Greece, have taken the faculty to Knossos on a beautiful spring Greek evening as the sun is setting. Mostly Greek, mostly proud and all so warm and friendly.

My grandparents were born in Greece. And somehow, the pluralistic ignorance of loving ruined buildings and letting broken things stay like that was still in the collective unconscious of my grandfather. I now understand why anything broken in his house usually stayed that way. Or if it took anything more than a hammer or duct tape to fix it stayed that way. Maybe he was recreating Greece in his own way: pluralistic ignorance (more about this later). Don’t get me wrong, I loved him more than anyone else growing up. Just as I love the history of Greece.

As I love the history of the ruins in the Hamptons. The Hamptons are crumbling. Crumbling under the weight of its own excess. There are houses for rent for $80,000 a month, or the bargain small three-bedroom house overlooking the town waste disposal yard for $25,000 a month. There are also homes for sale almost equal to the Gross National Product of Greece. I know this because one day I innocently used the website to see what may be for sale or rent in East Hampton. Now I keep getting emails from Zillow to remind me how excessive things are and how the ruins of the Hamptons are not within my reach. Zillow was a big mistake.

But you will not make a big mistake. You will read this issue of VEIN. There are hardly any mistakes and nothing is crumbling. In Greece, age is not an issue. The older something is, the more it is valued. Tom O’Donnell Jr. and Bob Kistner are good examples of the value of experience and relevance over the course of a venous career. They are nowhere near crumbling. Although I do hear that Tom loves crumb cake and Bob is not buying a home in the Hamptons.

One very practical, yet scholarly article is contributed by Marc Passman. The article sheds light on guidelines for managing superficial venous disease and the management of difficult C6 patients. This is practical, evidenced-based advice at its best. Take the time to read this one. Cyanoacrylate adhesive, glue, VenaSeal has completed the U.S. clinical trial. Nick Morrison, the PI, elucidates the early results and they are promising. Much more promising than the rent or buy options in the crumbling mess of excess in the Hamptons.

When it comes to homes in the Hamptons, pluralistic ignorance reigns. What is this pluralistic ignorance? It occurs when anyone taking any survey doesn’t answer truthfully but rather answers in the way that they think others are going to answer. A good example is sex. In Esquire magazine last month, Stacey Woods in her monthly column “Sex” had a reader ask, “Why is it that it seems everyone else is having more sex than me?” Her answer was “pluralistic ignorance”. When people answer this question in surveys, they assume that everyone else is going to exaggerate so they do as well. The survey doesn’t get to the truthful answer but the pluralistic ignorant answer. No one wants to be truthful and answer, “not that much.” Everyone taking the survey assumes everyone else is having more sex than they are, so they give the answer they think everyone else will give: “a real lot, just like everyone else!” Pluralistic ignorance. It would be more helpful if they would just do what John Lennon asked for in his song entitled “Just Gimme Some Truth.” At VEIN, we aren’t crumbling and we don’t engage in pluralistic ignorance. We give you the truth. Now that I know about pluralistic ignorance, I’m not taking any surveys anymore, especially those about sex. Vein disease? Maybe. Sex? No way.