Inside Intuition sets out to apply recent findings in social and cognitive psychology, neurosciences and neurobiology to the phenomenon of intuition. Rather than a mystical phenomenon, SadlerSmith argues that discoveries in empirical science have made intuition explicable and manageable. As a consequence, it can now be harnessed for application in professional contexts. Although the book is intended for a business management audience, there are evident extensions to medicine and the health professions. As with any book review, the central task is to convey to the reader whether the book is worth purchasing and reading. I must, at the outset, declare my biases. To be honest my initial response to the book was highly negative. Coming from a background in logic and philosophy I have always been suspicious of ‘psychologism’ when it comes to accounts of inference and reasoning. I found the breezy style somewhat off putting. The book is clearly the work of someone who has enthusiastically embraced the neuroscience revolution and has no philosophical qualms about neurophysiological reduction. One is hard-pressed to find critical accounts of the science put forward, doubts cast on the reliability of the gut feeling, and in every case creative (almost always synonymous with intuition) approaches triumph over the plodding and methodical application of reason. With a little hard work we can all be Mozarts and Einsteins. However, I must admit to being somewhat won over in the end. The book is readable, particularly in small aliquots. It contains innumerable engaging and diverting diagrams and flow charts, photographs of famous intuitives (though the eyes of Igor Stravinsky and Sir Michael Tippett in the photographs on pages 16–17 have a certain otherworldly glow) and enough quotations from the world’s literature on intuition to populate a decades worth of powerpoint presentations. Its readability is assisted by its format. It is organized around 12 chapters. The book is not really a sustained scholarly argument, but resembles a tour guide of recent cognitive science. Each chapter has an introductory text box with the main idea of the chapter and a concluding text box with the takeaway messages organized under the headings of key ideas, an intuition quote, and an action point. Medical readers familiar with the translational literature will appreciate these bottom line summaries, which means that they could likely read all the main idea and take away sections of the book, check out a few nifty flow charts, look at a few famous people with intuition in about 10 minutes and save the price of the book. So will the book be of interest to clinicians? No doubt to some, and particularly to those who resist algorithmic accounts of medical reasoning. Medical examples abound in the book, though they are not particularly deep or insightful. For example, we are told: ‘The clinical judgement exercised by healthcare professionals is another example of an area of practice in which it is difficult to account for effective performance in purely technical and rational terms.’ True, no question. But does invoking intuition bring us closer to the sort of account we desire of clinical judgement? Does it make it capable of being expressed explicitly, and more importantly taught? Later in the book, he favourably cites Trish Greenhalgh’s praise of intuition in the diagnosis of disease. Most clinicians accept the idea of diagnostic hunches, but this type of hunch only makes sense if you have experience as a clinician. We would be very sceptical indeed (or at least I hope we would) of claims of non-clinicians to have accurate diagnostic hunches (though these days with google doctors in great abundance, I should perhaps not be overly confidant.) My final concern is that this book packs far too many diverse and heterogeneous human capabilities under the rubric of intuition. In the concluding section Sadler-Smith writes: Many CEO’s in major companies claim to have made multimillion dollar decisions based on their gut instincts. Nor is this behaviour confined to senior executives in multi-national companies who have the power to wield intuition: composers, artists and scientists, teachers and doctors, firefighters, neonatal nurses, HR managers, chief financial officers, students, biomedical and aerospace scientists, entrepreneurs, and inventors across organizations testify to the role intuition plays in creative, entrepreneurial, professional social and moral judgements. No doubt, so do hackers, spammers, fraudsters and mobsters. Such cognitive riches cannot only be for the good, but one would be hard pressed to believe such after reading this book. Journal of Evaluation in Clinical Practice ISSN 1356-1294
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