In a 1978 article in the New England Journal of Medicine, Massachusetts General Hospital psychiatrist James E. Groves categorized the patients “whom most physicians dread”:

“Dependent clingers” escalate from normal requests for reassurance to “repeated, perfervid, incarcerating cries for explanation, affection, analgesics, sedatives and all forms of attention imaginable.” They may have severe, even life-threatening disorders, or they may have no discernible illness at all.

“Entitled demanders” use “intimidation, devaluation and guilt-induction to place the doctor in the role of the inexhaustible supply depot.” They may even try to control the doctor by withholding payment or threatening to sue.

“Manipulative help-rejecters” appear almost smugly satisfied, returning “again and again to the office or clinic to report that, once again, the regimen did not work.” When one symptom is relieved, another appears in its place.

“Self-destructive deniers” show “unconsciously self-murderous behaviors, such as the continued drinking of a patient with esophageal varices and hepatic failure.” These patients “seem to glory in their own destruction. They appear to find their main pleasure in furiously defeating the physician’s attempts to preserve their lives.”

“Admitted or not, the fact remains that a few patients kindle aversion, fear, despair or even downright malice in their doctors,” Groves wrote, noting that the medical literature had largely failed to address this problem. “Emotional reactions to patients cannot simply be wished away, nor is it good medicine to pretend that they do not exist.”

(James E. Groves, “Taking Care of the Hateful Patient,” New England Journal of Medicine, April 20, 1978.)

Suppose that Schweitzer and Gandhi are equally saintly and that Green and White are equally unsavory characters with long criminal records. Suppose that on separate occasions Green gratuitously slaps Schweitzer in the face, Schweitzer gratuitously slaps White in the face, and Gandhi gratuitously slaps Schweitzer in the face. If guilt were proportional, not just to the offence, but to the moral uprightness of the offended party, then Green would incur more guilt and liability to punishment than would Schweitzer. For since Schweitzer is worthier than White, Green’s failure to show respect for Schweitzer was more grievous than Schweitzer’s failure to show respect for White. Similarly, Gandhi’s action would be more culpable than Schweitzer’s. In fact, I think we are more apt to consider guilt as directly proportional to the nature of the offender than to the nature of the offended party. Schweitzer’s action in slapping White is, if anything, more culpable than Green’s action in slapping Schweitzer. In view of Schweitzer’s long-standing habits of self-control and moral behaviour, we should expect more from him than from Green who has never developed these habits. Similarly, we should expect more from Gandhi. Nor would we say that Gandhi’s act was more culpable than Schweitzer’s. We might even have some inclination to be less outraged at Gandhi, since he was at least ‘picking on someone’ of his own moral stature.

— Marilyn McCord Adams, “Hell and the God of Justice,” Religious Studies 11:4 [December 1975], 433-447

Until 2006, a British ambassador leaving his post would write a valedictory despatch to be circulated among select readers in the British government. These “parting shots” tended to be appallingly frank, combining the diplomat’s real feelings about the nation he was leaving with his often wounded resentment at the indifference of his own government:

• Argentina: “All I knew of Argentines before coming here was that they were generally disliked by all other Latin Americans as unduly pretentious, snobbish upstarts. …. The per capita outlay on deodorants in the Argentine is the highest in the world.”
• Finland: “It could plausibly be argued that it is a misfortune for anybody but a Finn to spend three years in Finland, as I have just done. … Finland is flat, freezing, and far from the pulsating centres of European life.”
• Uruguay: “After living now for over two years among people who call themselves Orientals and who seem to have inherited nearly all the faults and none of the virtues of Spain (though they have many minor virtues of their own), I look forward to returning to what I conceive to be, at least by contrast, the speed and efficiency of my own country.”
• Saudi Arabia: “It is a great tragedy that, with all the world’s needs, Providence should have concentrated so much of a vital resource and so much wealth in the hands of people who need it so little and are so socially irresponsible about the use of it.”
• Thailand: “Decayed garbage left for months on the side of the roads; stagnant canals that serve both as cesspools and as the dumping ground for dead dogs; buses and lorries that belch uncontrolled clouds of diesel fumes; scarcely a pavement without potholes and open manholes to break the legs of the unwary; bag-snatchers in every block; assault and violence a way of life; prostitution and every form of natural and unnatural vice on a scale astonishing even in Asia; a city of 4 million with only one park, and that littered with refuse and infested by thieves; unplanned hideous ribbon development; no proper drainage, so that in the rainy season large areas of the city remain flooded for weeks on end; and the whole set in a flat mournful plain without even a hillock in sight for 100 miles in any direction: this is Bangkok, the vaunted Venice of the East.”

Matthew Parris, who published a whole collection of these in 2010, explains: “Beyond retirement there can be no reprisals.”

Suppose a local bar has 100 regular patrons. The bar is rather small, and going there is enjoyable on a given night only if fewer than 60 people show up. This is a problem: I want to go to the bar, but I expect to enjoy it only if you don’t come. But I know that you’re thinking the same thing about me. If no one communicates in advance, how many people will tend to turn up at the bar?

In a 1994 computer experiment, Stanford University economist W. Brian Arthur assigned each patron a set of plausible predictive rules on which it might base its decision. One rule might predict that next week’s attendance will be the same as last week’s, while another might take a rounded average of the last four weeks, and so on. Then, in practice, each patron would downgrade its badly performing rules and promote the more successful ones, and revise these ratings continually.

What he found is that the mean attendance converges to about 60, forming an “emergent ecology” that Arthur said is “almost organic in nature.” The population of active predictors splits into a 60/40 ratio, even though it keeps changing in membership forever. “To get some understanding of how this happens, suppose that 70 percent of their predictors forecasted above 60 for a longish time. Then on average only 30 people would show up; but this would validate predictors that forecasted close to 30 and invalidate the above-60 predictors, restoring the ‘ecological’ balance among predictions, so to speak.”

This is heartening to see, because life is full of such murky decisions. “There is no deductively rational solution — no ‘correct’ expectational model,” Arthur writes. “From the agents’ viewpoint, the problem is ill-defined, and they are propelled into a world of induction.”

(W. Brian Arthur, “Inductive Reasoning and Bounded Rationality,” American Economic Review 84:2 [May 1994], 406-411.)