The title of this post is a twist on one of my favorite songs, “Once Bitten, Twice Shy”, by Ian Hunter, former lead singer for the British band Mott the Hoople.
If you’re not familiar with the phrase, here is the definition from the Cambridge Dictionary:
said when you are frightened to do something again because you had an unpleasant experience doing it the first time
The phrase was the first that came to my mind as I read the following letter to Dan Ariely in this week’s advice column:
Earlier this year my brother decided to have cosmetic surgery. He understood that there was some risk involved, although it was low. Unfortunately, there were complications during the surgery and he ended up even more dissatisfied with his appearance than before. Now he’s considering a second surgery to correct the first one, but he’s worried that he’s making the same mistake twice. Do you think he should go ahead? —Lee
And here is Dan’s response:
Learning from past decisions is important, but it’s tricky to be sure we’re learning the right thing. In your brother’s case, the fact that his decision to have surgery led to unfavorable results doesn’t necessarily mean the decision was wrong. It’s easy to be swayed by “outcome bias”—using our knowledge of how a decision turned out to judge whether it was right in the first place. Based on the available information at the time, having the surgery could have been the right decision even if it turned out badly.
Likewise, your brother has to decide about a second surgery based on the information that’s available now, not knowing what the future will bring. My advice is for him to talk to his surgeon and learn everything he can about the probability of new complications. He should only go forward with the surgery if he’s willing to live with that risk, knowing that it can be reduced but not eliminated.
It seems to me that if the risks are exactly the same as they were the first time, and he is willing to take the risk then, then Lee should be willing to go through with the second surgery as well.
However, it may be that there are a couple of confounding factors to consider before Lee makes his decision.
First, the original risk may have been for an average person, while there may be something unique about Lee that was not known prior to the first surgery that may have increased the odds of an unfavorable outcome (e.g., weight, blood pressure, bone structure). Now that the impact of this characteristic is known, it could change the odds of whether the surgery would be successful the second time around.
Also, Lee may not want to get advice from the same surgeon he used the first time. Perhaps while Lee was given overall averages as to what the success rate is for the surgery he is getting done, this specific surgeon may not have the same odds. The surgeon could be inexperienced, or it may have been along time since he or she has done such a procedure. If that is the case, Dan may want to get a second opinion, and the possible follow-up surgery, from a different doctor.
(And finally, it could have been the surgeon’s birthday).
So it’s understandable that Lee could be hesitant the second time around, after the surgery was unsuccessful the first time. You know, once botched, twice shy.
Here’s the song: