Ask More: The Power of Questions to Open Doors, Uncover Solutions, and Spark Change

CHAPTER 9

INTO THE UNKNOWN

Scientific Questions

WE LIVE IN AN AGE of instant answers. I googled this question: How do we know the earth is round? In less than one second, I had 168 million results at my fingertips. If I spent one minute on each, it would take me 320 years to get through them all.

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We live in an age of assertion. I can fire off a tweet or post an opinion, no matter how accurate or incendiary, and get the attention of the crowd, maybe even go viral. Politicians throw out untruths or half-truths and, even when proven wrong, they will double down and assert again. In 2015, Representative Lamar Smith, chairman of the House Committee on Science, Space, and Technology, declared authoritatively that climate data clearly showed “no warming” for the past two decades. He didn’t back down even though 14 of the 15 years from 2000-2015 logged in as the hottest on record, according to data from NASA. Truth is often eclipsed by attitude.

Instant answers and easy assertion populate our digital information age. I can surround myself with friends and associates, virtual or real, who will be my echo chamber, ratifying my ideas and validating my logic. I can live in a media universe where everyone will agree with me, and my social media tribe will cement my certainty.

How do we slow it down?

Can we allow ourselves to be wrong?

Can we ask in a different way?

Up to now, my quest to understand how we ask more of ourselves and one another had taken me through several lines of inquiry, each connected to its own distinct outcome, each calling for its own unique approach. In all of them, the artful question leads to information and awareness, understanding and answers.

But there’s a line of inquiry characterized by the slow question, the one that doesn’t yield an immediate answer and dares you to embrace uncertainty. I wondered, can the slow question, the kind that requires painstaking work and enduring patience, where you try to prove yourself wrong in order to see if you might be right, be a viable alternative in our world of instant answers? Can it prove to be a reliable path to truth?

The answer, of course, is yes. The slow question exists with a distinctly different approach. It is expressed through the inquisitive lens of science, which ventures into the unknown, seeking to explain the mysteries of the physical world. This questioning method represents a way of asking that recognizes the vastness and uncertainties of the unexplored. The method builds logically from the ground up.

Observe a problem, frame a question. Take what you see or know to be objectively and measurably true from the real world and ask a question. What’s going on here? What’s causing this?

Offer an explanation. Based on your observations, your experiences, and the facts and data that exist, put together a clear hypothesis that could explain the situation.

Put your hypothesis to the test. Experiment and measure over time. Try to prove yourself wrong. What else could explain this situation? What did you miss? What could be wrong with your approach and your data? If your hypothesis holds up, you are making progress.

Share. If you think you’re onto something, shop it around and show it to other knowledgeable people. Let them review it. Do they see something that you didn’t? Do they have any problem with your data or your methods? If not, you might just have a theory you can act on.

Scientific questioning drives a process that revolves around data, experimentation, and observable fact. It is a method that tackles a daunting quest and challenges attention spans in an instant-answer world. The discipline this line of questioning imposes makes for better inquiry and better decisions across the board. Think back to a choice you made or an action you took that didn’t turn out the way you hoped. Ever wonder how different things would have been if you had more information or looked at what you did have a bit more skeptically? Have you ever worked off an untested instinct or an unchallenged belief and then wished—knowing what you know now—that you could do it all over again, or that you could have road-tested your hunch before you acted on it? How would things have been different if you could have been more scientific in selecting the car you bought or the business you invested in? What if you could turn your search for answers into a science?

The Doctor’s Quest

I wondered: Can we inject a little scientific method into the questions we confront every day? How can scientific questioning be useful to the rest of us? First, I had to see how it works. I went to the sprawling campus of the National Institutes of Health (NIH) just outside Washington, D.C., to speak with one of the country’s leading scientists. He’s worked all his life trying to figure out the unknown, in a world where research is subject to criticism, hypotheses exist to be disproved, and answers leads to more questions.

The world of science in Bethesda, Maryland, stands in jolting contrast to the political world of Washington just down the road, where people expect questions to be answered quickly and decisively. But unlike the political world, science celebrates discovery and the unknown represents a challenge, not a weakness. In science, facts are things to be learned, not exploited. Data, not opinion, holds sway.

Dr. Anthony Fauci has led the National Institute of Allergy and Infectious Diseases for more than three decades. In a town where everyone picks sides, Fauci has mostly stayed out of politics. He sees himself as “an honest broker of science.” He gives little credence to political labels and has no patience for ideology that obscures discovery or stands in the way of cures. Fauci deals with medical fact and the painstaking, meticulous research of biological science. His questions grow out of his observations and insatiable thirst for research and for cures to disease.

Fauci greeted me outside his spacious office a few minutes after 7 a.m. This wasn’t his first piece of business for the day; he’d been at his desk since 6. He had a reputation as a workaholic, a nonstop guy. A small, super-fit man in his seventies who never lost his Brooklyn accent, Fauci still ran and worked marathon days. His suite of offices was crammed with books and journals and offered a gallery of his life. Pictures with patients, presidents, doctors, and researchers from around the world hung from the walls. They highlight Fauci’s work against killer diseases: HIV/AIDS, SARS, malaria, Ebola, and the Zika virus.

Fauci was especially proud of one picture. Taken around 1989, it shows him with President George H. W. Bush and his wife, Barbara, sitting in a crowded semicircle with researchers and AIDS patients. President Bush had just approved a large increase in AIDS funding that Fauci had sought. It was a sharp turn from Bush’s predecessor, Ronald Reagan. The funding opened a research pipeline that led to effective treatments for HIV/AIDS and brought dramatic and desperately needed breakthroughs. They came, however, only after years of suffering, controversy, and research.

A Mystery Killer

I first encountered Fauci in the early 1980s when he briefed on a mysterious ailment that seemed to be targeting gay men. The disease didn’t even have a name yet. I was covering the White House, where President Reagan was reluctant even to talk about it. He and his wife, Nancy, had plenty of gay friends from their days in California. The actor Rock Hudson, the first major celebrity to die of the disease, had attended a state dinner hosted by the Reagans just three weeks before he was diagnosed. But the ailment, with its implications of homosexuality, was a taboo subject in politics at the time.

Fauci had always been a questioner, an explorer. Like other scientists and researchers, he would see a problem—a disease or an illness—become fascinated by it, and turn it into a research question, derived in some fashion from the most fundamental question in the universe:

What’s going on here?

The autoimmune system had been Fauci’s specialty in medical school. Trained in immunology and infectious disease, he was absorbed by the question of why the human immune system sometimes turned on itself, robbing the body of its ability to fight off illness and infection. In his early work as a young researcher at NIH, Fauci had been researching an autoimmune disorder known as Wegener’s granulomatosis. The disease inflames the blood vessels in the lungs, kidneys, and upper airway. Symptoms include nosebleeds, sinus pain, coughing up blood, skin sores, and fever.

In a laboratory two floors above him, cancer researchers were conducting groundbreaking research into Hodgkin’s disease. Fauci regularly ran into his colleagues in the hallways or over a meal. They compared notes, shared observations, and told stories as doctors do. One thing his colleagues told him in particular caught his attention. It seemed cancer patients were prone to infectious diseases as a result of their chemotherapy. The chemo not only suppressed the cancerous tumors, but also the patients’ own immune systems. So Fauci wondered:

Could you turn off the immune system without killing the patient in order to cure a disease?

Fauci hypothesized that a delicate balance of low-dose, anticancer drugs could suppress the immune system in Wegener’s patients. He knew Wegener’s had no cure; treatments had so far been ineffective. Doctors had tried corticoid steroids and prednisone, but patients remained dangerously prone to bacterial infection or the flu.

To test his hypothesis, Fauci’s research team began experimenting with low levels of chemo drugs in control groups. They conducted clinical trials and pitted the new drugs against placebos. They tracked their patients over months and kept meticulous records about their health, age, condition, and progress.

“To my incredible gratification and I think a little luck,” Fauci told me, “it turned out that the drugs that we picked were just right.” The drugs also proved effective for other autoimmune diseases, and Fauci quickly made a name for himself. He appeared to be on track for an extraordinary career in the field of immunology. Then something unforeseen happened that changed Fauci’s life.

It began in his office on a Saturday morning early in June 1981. Fauci was scanning the Morbidity and Mortality Weekly Report, put out by the Centers for Disease Control (CDC). He read an item about five gay men in Los Angeles who had died as a result of a pneumocystis pneumonia. Caused by a fungus commonly found in the lungs of healthy people, this form of pneumonia can become deadly in those with weakened immune systems. Fauci did a double take and asked himself:

What is going on?

Why all gay men?

Why pneumocystis pneumonia in otherwise healthy gay men?

At first, Fauci thought recreational drugs might be the problem. That wasn’t his field of expertise, however, and he was busy with Wegener’s research. “What the hell,” he figured. “Forget it.”

A month later, another CDC morbidity report hit Fauci’s desk. It featured another alert about the same mysterious illness. Now it reported that twenty-six men had died, and not just in Los Angeles. Victims were in New York City and San Francisco as well. All were gay. All had seemed in perfect health before coming down with deadly pneumonia. Fauci was alarmed.

“This is going to be huge,” he said to himself.

Cultures Clash

Science, medicine, and experience drove Fauci to conclude that we were on the verge of a full-blown health crisis, a new and frighteningly unpredictable illness whose dimensions were completely unknown. He responded as a scientist and as a doctor, thinking in terms of public health. He had been trained to observe a problem and ask about it in a methodical way, putting impulse and judgment to the side.

Outside the gates of science and the NIH, however, there was an altogether different response. I was the White House correspondent for Associated Press Radio. I had recently returned from London, where I’d been based as a foreign correspondent. Now I was assigned to a noisy, cramped, show-offy place where reporters strutted their stuff to show how tough or influential they were, and the press secretary played power politics, leaking stories to those he liked and freezing out those he thought were unfair, unfriendly, or overly hostile. Welcome to the White House Briefing Room. We were just a few miles from NIH but we were in another universe.

On this day, in October 1982, someone in the press corps asked about this new and deadly illness that few others wanted to talk about. The reporter, Lester Kinsolving, was with WorldNetDaily, a conservative news organization committed to “exposing wrongdoing, corruption, and abuse of power.” His questions to Reagan’s press secretary, Larry Speakes, produced a surreal moment.

KINSOLVING: Larry, does the president have any reaction to the announcement [by] the Centers for Disease Control in Atlanta, that AIDS is now an epidemic [in] over 600 cases?

SPEAKES: What’s AIDS?

KINSOLVING: Over a third of them have died. It’s known as “gay plague.” (Laughter.) No, it is. I mean it’s a pretty serious thing that one in every three people that gets this has died. And I wondered if the president is aware of it?

SPEAKES: I don’t have it. Do you? (Laughter.)

KINSOLVING: No, I don’t.

SPEAKES: You didn’t answer my question.

KINSOLVING: Well, I just wondered, does the president—

SPEAKES: How do you know? (Laughter.)

KINSOLVING: In other words, the White House looks on this as a great joke?

SPEAKES: No, I don’t know anything about it, Lester.

KINSOLVING: Does the president, does anybody in the White House know about this epidemic, Larry?

SPEAKES: I don’t think so. I don’t think there’s been any—

KINSOLVING: Nobody knows?

SPEAKES: There has been no personal experience here.

In retrospect and with full knowledge about the suffering to come, the words and laughter from that White House “briefing” ring especially cruel. The exchange revealed ignorance, fear, and the disconnect between politics and science. A deadly disease appeared to be striking young gay men. Did the president have a reaction? No, the press secretary replied, implying: None of us around here are gay enough to have had that experience. Speakes made no comment about the health dimension or the research that was needed to solve the crisis. He made no reference to public health or education. He addressed the questions through his peculiar political filter.

It’s impossible to look back on this exchange and not find it appalling. But a variation of it happens with alarming frequency. We often respond emotionally or dismissively to problems we don’t understand. Science, on the other hand, teaches us to step back, slow down, and ask, simply and dispassionately.

What’s going on here?

Why is it happening?

What is causing or influencing it?

Test but Verify

The methodical, logical approach to scientific investigation provides a blueprint for inquiry that rewards reality, not emotion, one step at a time.

Start with the facts. What have you observed or what do you know with a high degree of certainty? Fauci knew from the CDC reports that young gay men were dying of a form of pneumonia that only strikes people whose immune systems have been compromised.

Formulate your question. What’s going on and why? Why were these young men dying of a disease that wasn’t supposed to attack healthy people? Fauci’s team wanted to know.

Develop a hypothesis—your explanation for what you’ve observed—and test it. In many ways, this hypothesis is the crux of scientific inquiry. The ancient Greek origins of the word offer an explanation. Hypo means “foundation,” and thesis means “placing.” Many people confuse hypotheses with theories, thinking they’re one and the same. But a hypothesis comes before a theory or explanation. It’s the soil below the basement of scientific thought. Charles Darwin had a hypothesis, that plant and animal species originated through competition and “natural selection.” Only half a century later, after vast amounts of research and observation, did scientists elevate that hypothesis into a theory: the foundation of an entire field of science. Fauci’s hypothesis was that an autoimmune disease was killing these young men, and it was a new disease the world had not previously seen.

Through experimentation, testing, measurement, and documentation Fauci worked to see if his hypothesis held up. Only by submitting ideas to rigorous experimentation, measurement, and scrutiny could he know if the hypothetical ground was stable enough to support the foundation of theory. This meant sharing findings with peers who in turn set out to disprove the hypothesis. Think how different this line of inquiry is from politics and business and so much else in life. So many questions tend to be rhetorical, seeking answers that prove people right—or, at least, on the “right” side. In science, you are trying to prove yourself wrong. The triumph comes when you cannot. It means you have a reasonably stable hypothesis.

If your hypothesis survives this scientific trial by fire, you have an explanation. But even then you haven’t achieved total certainty. In science, no answer is ever complete because after your “Why?” is answered, it breeds an infinite number of “Whys.” There is more research to be done, new discoveries to make.

These principles—facts, hypothesis, test—can be your guideposts to bring science into your questioning. They will apply in different ways as you connect your observations and facts to your experiments, trying to determine whether your answers hold up to scrutiny. Be prepared to think differently because you have to go into the process embracing uncertainty, reaching into the unknown, knowing answers will take time.

Stretch Yourself

Let’s say you had a bad car accident. You came out of it with three broken ribs, whiplash, bad bruises, and persistent pain. You know you’re lucky to be alive and still able to move at all, but you hurt like hell. You go to physical therapy and that seems to help, but the pain doesn’t go away. Your doctor prescribes pain meds, but you hate them. They send you into orbit, and they don’t relieve all the pain anyway. Some friends tell you to try yoga. You read up on it and decide to give it a go. You’re desperate, so it’s worth the effort. It’s not exactly fun and it wipes you out, but after a couple of months, you think you’re feeling a little less pain.

Is it the yoga that’s making the difference or is your body just healing over time?

You think yoga is working. Maybe yoga can move your body and joints and muscles in ways that minimize the pain from your injury. That’s your hypothesis.

You decide to try a little experiment and see if your hypothesis holds up. You stop the yoga. Within a few days, you’re pretty sure the pain is getting worse. Sometimes it’s hard to tell because it’s been such a constant part of your life since the accident. Every day you chart your pain—rating it on a scale of one to ten—when you wake up, at lunchtime, before dinner, and when you go to bed. After a few weeks, you see a trend: Your pain is worse in the morning, after you get up. It goes down around lunch, picks up again around dinner, and ticks up a little more before bedtime. It follows this pattern over several weeks.

You wonder if the morning pain is due to stiffness from sleeping or because you’re going to bed with more pain and sleeping poorly. You wonder whether the increase in pain in the evening is because you’re just tired and feeling it more, or whether you’re feeling the effects of a day’s worth of activity. You decide to start the yoga again, this time doing it twice a day—in the morning when you wake up and again just before bed.

After another couple of weeks, you see a change. Your pain still peaks in the morning, but it’s down from where it was when you weren’t doing the yoga. It still ticks up around dinner, but now it goes back down before bedtime. You conclude yoga twice a day is helping. You can’t be 100 percent sure that it’s just the yoga. But your chart and your experience indicate a connection between more yoga and less pain.

Congratulations. You did your own simple scientific experiment. And you feel better.

Nina Fedoroff, a plant biologist and former president of the American Association for the Advancement of Science, explained scientific inquiry to me by putting it in terms of “mental constructs,” the various ways that disciplines have of interpreting reality. In literature, imagination does the work of making sense of the world. In law, judges use precedents to interpret the law. Science, she says, links ideas to repeated observation and repeatable results of experimentation. The scientist, Fedoroff explains, says okay I have this idea, then asks:

How do I test my idea?

How can my idea be wrong?

In the practical world, there are few incentives to incorporate the mindset that accompanies this type of questioning into our lives and our work. It could be awkward to stand up in front of your boss and say, “Okay, I’ve got this idea for a new product. But maybe I’m wrong.” It would be odd to hear someone at the city council meeting declare, “I know how to make trash pickup more efficient. But we need to test it because I want to see if I’m wrong.” Imagine hearing a political candidate say, “I have a plan to raise taxes that will reduce the deficit and save Social Security. But there is some real uncertainty here.”

In most cases, we are rewarded for decisiveness and quick answers. The person at the meeting who speaks up with authority and offers to “fix the problem” is often the one who is praised and promoted. When we propose an idea, we don’t say to the boss or the shareholders, “I think I’m on to something here, but I’m doing my best to prove it wrong.” We’re expected to defend our point, not openly invite others to attack it.

The discipline of scientific questioning, however, moves us toward a more methodical form of inquiry, inviting more data and better measurement into the questions we ask and the answers we get. In Silicon Valley, where most everything is measured, one of the most important tools for improving online products is a simple form of experiment called A/B testing. Tech companies try out new features by offering a small percentage of users an updated app while most others use the old one. If the new version performs better—determined by metrics such as how many clicks it gets or how many purchases are made—it’s crowned the winner and becomes the version that everyone sees. If not, the better-performing original stays in place. This data-driven approach favors empirical results to pick winning ideas instead of the slickest sales pitch or the most confident employee.

As data becomes more accessible, we can expect more science and more metrics in the decision and questioning process. You have a new product you’d like to put into production. You think you should expand your business overseas to take advantage of a rising global middle class. You’re thinking of buying a salmon hatchery in Alaska. Applying some scientific inquiry would force you to slow down in order to observe, hypothesize, experiment, and quantify before leaping to conclusions. Maybe that bed and breakfast in Vermont is the better investment after all.

Slow Answers to Slow Questions

For Tony Fauci, HIV/AIDS research was heartbreakingly frustrating because time was on no one’s side. People died while he and other scientists painstakingly went about their work conducting experiments and proving themselves wrong. While researchers were testing and observing, AIDS activists were criticizing and protesting, bearing grim signs reading SILENCE = DEATH. Too little funding, they complained, and too little urgency. Fear and grief and frustration hit hard.

Finally, President George H. W. Bush, who spoke about a “kinder, gentler” America, boosted funding. Fauci put research in high gear. Still, it took three years of intense research before Robert Gallo of NIH and Luc Montagnier from the Pasteur Institute announced that they had identified the virus that causes AIDS—a retrovirus that could incubate in the body for years before erupting into full-blown AIDS.

Once the virus was isolated, researchers went to work to defeat it. Molecular virologists started sequencing it. They examined the genetic code. Then researchers discovered the antibody test, which allowed for prompt diagnosis. They started experimenting with off-the-shelf compounds to see which might inhibit the virus. But it was by no means a straight line. There were false hopes, setbacks, and flat-out failures.

A promising drug, AZT, emerged from this work, and the medical community felt a sudden, uncharacteristic burst of hope that the disease might be reined in. But clinical trials and experience established that AZT lost effectiveness over time because the virus developed resistance to it. Researchers discovered the virus could replicate and mutate, getting around AZT. A setback, which led to a question.

How do we stop the mutation and replication?

Researchers tested more drugs and found that a cocktail of medications, if taken together, could backstop one another and prevent the virus from mutating. The new regime, approved in 1996, increased a patient’s expected remaining life from eight months to as much as fifty years. HIV/AIDS still kills, especially in poorer parts of the world. But decades of methodical research—slow questions—paid off. The disease is no longer an automatic death sentence.

Science bases itself on the measurable world. But we can incorporate its method into the way we ask and answer other types of questions to become more precise, more focused, and more accurate. We can slow down, pose our questions more deliberately, and bring more data and facts to the discussion. We can challenge our hypothesis and invite others to do the same in a conscious search for problems with our findings and assumptions.

Scientific questioning can be applied in business, in daily life, and in our communities. Imagine how much more interesting a staff meeting, corporate board retreat, or a policy debate might be if people brought up an idea they had tried to prove wrong before they concluded it was right.

You’re thinking about putting money into your company because the competition is out-hustling you. What do your customers want? Where is the demand? What are they buying? As you answer these questions you develop a strategy—a hypothesis—that you can test.

You’re not sleeping well. You wake up at two in the morning or can’t get to sleep at all. Is it the caffeine, the food, or stress? Before you go to the doctor to do one of those involved sleep studies, what can you figure out on your own? How can you experiment to narrow down the cause of your own insomnia? Perhaps creating a spreadsheet or gathering your data on your own digital fitness tracker, which will tell you when you sleep and how you sleep, will help. Chart your caffeine and exercise, your diet, and your stress level to look for patterns. Come up with a hypothesis and test it.

From outer space to the subatomic particle, scientific questioning probes the real world, trying to figure out real mysteries. It relies on observation and measurement, and it demands patience. It is a humbling form of questioning because it is endless, dwarfed by the universe it seeks to decode.

After studying this line of inquiry, I find myself questioning differently. I think more deeply about what I can see for myself—the observable. I ask more about data, separating what I know from what I think I know. I want to hear more about uncertainty and how we explain and accommodate it. I ask:

What do we see and what do we actually know?

How do we know what we know and how might we explain it?

Could we be wrong, and what’s the next question to ask?