Last Wednesday, I attended GRF Magdala’s very fascinating Rose Cafe on medicine in French literature, and on the concepts of “normal” versus “pathological.” Early on in the discussion, Magdala asked the group what we believed the word “normal” to mean. The answer that we arrived at was that it was just another word for “average” or “mean” (I am referring to these words in a purely statistical way). While I think that many people, myself included, do not always use the word “normal” in this context, I suspect that this is due to a lack of understanding, whether conscious or not, of what the word means. I think that if we truly treated the word “normal” as a synonym for “average,” we would have a much different reaction to the word than we do now.

This difference in how we view the words “normal” and “average” can be seen through the binary that exists between the concepts of “normal” and “pathological.” According to this binary, if something is not “normal,” then it is “pathological.” However, statistics never suggests that there is something “pathological” about being away from the mean. Statistics treats those above the mean and those below the mean in the same way, while society treats them differently. For example, consider intelligence. Society considers those with above-average intelligence to be “smart” or “a genius,” both of which are considered to be good things, while those with below-average intelligence are deemed “stupid” or “dumb,” which are considered to be bad things. Yet there are the same number of people with above-average intelligence as below-average intelligence.

Furthermore, consider the word “outlier.” In statistics and data analysis, this word refers to a data point that is far out on one extreme, and does not seem to follow the general trend. In the “normal” vs. “pathological” binary, outliers would be considered to be pathological. Indeed, the outliers in our society are often viewed poorly by the masses. However, the word “outlier” itself has far less of a negative connotation than the word “pathological,” even though the outliers in society would be considered to be the most pathological.

A large part of our discussion was on whether or not we should utilize the concept of “normal” in medicine, or if we should focus on the individual’s narrative. Personally, I believe that the concept of “normal” does belong in medicine, but we are often using it wrong. The example of the normal body temperature was brought up during the discussion. While it is true that not everybody has the exact same standard body temperature, it could still be useful for a doctor to have a general idea of what a patient’s body temperature should be under healthy conditions. This is especially true if a patient comes in because they believe that they may be sick, and the doctor may not know what the patient’s body temperature should be. Knowing the average body temperature can help a doctor decide if the patient has a fever or not.

Finally, consider this statement: On average, smokers have a lower life-expectancy than non-smokers. Sure, it is possible to smoke and live a long life, just as not smoking does not guarantee that one will not have a short life. Yet this statistic can help us realize that it is probably healthier to abstain from smoking than it is to smoke. Averages can be very useful. But we should not treat everyone as if they should be the average.