Half Moon

Michael Metzger

What’s with those bathroom signs reminding employees to wash their hands? How many do it? Not many writes Stephen Dubner, co-author of Think Like a Freak. His research agrees with scripture (as well as science) regarding why the signs don’t work.

Dubner and co-author economist Steven Levitt challenge many taken-for-granted assumptions about how people behave in their new book, Think Like a Freak. Bottom line: you alter people’s habits by altering their perception of their environment. To prove his point, Dubner likes to tell a story about hand sanitation in hospitals.

Ask a roomful of people whether they wash their hands after visiting a restroom, and a great number will lie. “People produce an answer that they think you want them to give. Self-reporting data can be very misleading.” For instance, in an Australian hospital, 73 percent of staff doctors claimed that they soaped up before interacting with patients. But a study based on observed behavior showed that only 9 percent of them did. Yecch.

To improve the rate, hospital administrators at Cedars-Sinai Medical Center in Los Angeles tried everything from a strongly worded memo (which had zero effect) to an incentive of Starbucks gift cards (which the doctors loved, though it did not increase the hand-washing rate). Then a hospital epidemiologist came up with a better idea.

She had each administrator – the people who were telling others how to behave – place one hand in a petri dish. She sent the hand-printed dishes to the lab, where analysis turned up a bumper crop of bacteria. An IT guy emailed a bacteria-laden photo as screen saver to the entire hospital. “Literally overnight,” Dubner reports, “the hand-hygiene rate shot up to about 100 percent.” Why did this work?

In the first place, the epidemiologist and IT guy (let’s call them E&I) recognized that you solve problems by reframing them. “Human behavior is much harder to change than we think,” Dubner says. “To alter people’s habits, you almost always have to shift something in their environment.” E&I reframed perceptions.

Second, E&I addressed the conundrum of conscience. Scripture notes our human propensity for self-deception (Jer.17:8-9). Conscience is the culprit. Designed to defend good behavior while judging bad, a corrupt conscience upends the equation. It defends bad behavior while judging ourselves to be good. This is why self-reporting hand-washing rarely works. If the individual is guilty, they’ll self-report washing their hands more than they actually do. E&I circumvented self-reporting.

If E&I knew scripture, they’d recognize that the remedy for self-reporting is self-suspicion. William Wilberforce recognized this, urging his 15 year-old daughter Elizabeth to cultivate to a clear conscience by accustoming herself to self-suspicion. He cited Jeremiah 17:8-9.1 Self-suspicion opens us to correction by others, a prerequisite for reframing our perception of problems such as hand-washing.

Those who lack self-suspicion tend to be supremely confident. They lead with the left hemisphere, the lobe that David McNeill of the University of Chicago describes as “disconnected” from reality.2 It thinks in abstract categories, often getting time sequences wrong and conflating episodic behaviors (occasional hand-washing) into routines (claiming to always wash hands). This is why self-reporting doesn’t work.

Self-reporting is also a form of control. In his opus, The Master and His Emissary: The Divided Brain and the Making of the Western World, Iain McGilchrist writes, “The left hemisphere thinks that it is in control.” It can be corrected by push-back from the right hemisphere acting as “bullshit detector.” Vilayanur Subramanian Ramachandran, a neuroscientist known primarily for his work in the fields of behavioral neurology, has a gentler term. He refers to the right hemisphere’s activity as the “devil’s advocate.” Either way, self-suspicion opens individuals to correction by contrarians.

In King Arthur’s Roundtable, the devil’s advocate was the court jester. His name was Dagonet. In neuroscience, he represents the contrarian contributions of the right hemisphere. In today’s business (or hospital) world, hardly any corporate roundtables feature a court jester. Their absence allows C-leaders to operate in la-la land, lying to one another (and themselves) about such things as whether they wash their hands after visiting a restroom. There’s no one in the roundtable to say bullshit.

In truth, the typical corporate roundtable is a half moon. CEOs generally operate out the left-hemisphere, which is entirely appropriate. But they tend to gather only like-minded left-hemisphere C-leaders, leaving the other half of the roundtable, the half representing the right hemisphere, vacant. Half a roundtable looks like a half moon. A half moon sheds less light than a full one. That’s why bathroom signs are like most corporate roundtables. Neither one is particularly effective in solving problems.

Follow me on Twitter: @Metzger_Mike

1 “Private Papers of William Wilberforce,” published by Burt Franklin, (New York, NY), pp. 165-68.
2 Iain McGilchrist, The Master and His Emissary: The Divided Brain and the Making of the Western World (New Haven: Yale University Press, 2010), loc. 5130.


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  1. The tendency for self-deception obviously abounds. I also wonder as a result of much personal wrestling, is there such a thing as an overactive conscience? I feel like I wrestle with moving forward on almost anything major in my life for fear that I am out of the will of God or doing something that is based upon the wrong motives. How does one discern rationalization, which I could also certainly be doing with feelings of guilt that seem to abound?

  2. MP: Too much of almost anything is not healthy. I subscribe to the theory that it’s harder to get out of God’s will than most folks imagine. God seems to stitched a great deal of ambiguity into creation. He apparently wants us to try, experiment, innovate – and not take ourselves too seriously in the process. Failure is rarely fatal.

    I’d also suggest you complete your roundtable by including a certified crap detector.

  3. Hey, Mike. Any idea how long the 100% hand washing continued after the email was sent? I am curious to know if it was simply a short-lived, reactive response from seeing something shocking or if there was actual long-term change in behavior.

  4. Wanted to click “like” on Gerard’s comment – and then thought that Barnabas’ comment about walking in the light might help establish the long-term change, by way of having a spot-check – or an opportunity to spot-check oneself – to repeat the initial experiment. Perhaps that would maintain the required level of self-suspicion?


    I find myself wanting to know more about Dagonet. . . .

  5. Gerard: Short answer – I don’t know. Good question, however. To you and marble, let me add that spot-checking oneself is less effective than having two or three friends spot-check. Daniel Kahneman (“Thinking Fast and Slow”) writes about the enormous difficulties in doing self-analysis. Better to rely on what he calls the “outside view” that sees more clearly. The Bible calls it the wisdom of many counsellors. I rarely see this in organizations (or with individuals), as this requires a healthy sense of security. Individual who rely on the outside view routinely hear about their failures. Self-analysis folks generally don’t. They often enjoy a higher opinion of themselves than the facts warrant.

  6. “No moon”
    What do you think about the research that Henry Cloud quotes in Boundaries for Leaders, arguing that when we are living or working in toxic environment we operate out of our first or primitive brain. So, we insufficiently accesses either our Right or Left brains…accounting for much poor performance and selfish decisions. Does this relate to the research you related?

  7. Sorry, not familiar with Cloud’s work. As for accessing left or right, I think McGilchrist’s work is most often cited here. He would suggest that Westerners are enculturated to operate mostly out of the left lobe. It’s less a matter of choosing or accessing and more a matter of cultural conditioning.

  8. Looks like phases of the moon to me. Dependent on how much true light is shining. How many counsellors is enough ? If we look in the mirror is that not enough ? How long would Wilberforce endured if he was to be dependent on the cultural counsel ? Crucifixion met the true light.

  9. Brilliant, Mike….though I am also interested in the point Gerard made. Please let us know if you find out. I wonder if a new photo needed to be sent. Or, if it was sent, would the impact decrease over time as people became used to it?

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