Where to Put Your Rightness── From "from me" to "from you" — how a black-and-white reviewer learned to sail a gray sea

Do materials review work long enough and your grounds for being right keep piling up. But the more grounds you have, the harder your sense of "I am right" becomes. In installment 19 I wrote about the direction of the motive behind our effort. This is the sequel: the direction of the argument itself. I stopped starting from "here is what I think" and tried starting from "how does this look to you." That one change altered the whole view.

01The Rightness of the Red Pen

It was a Friday afternoon, the third case in the review meeting. On a single graph in a new product's explanatory material, I marked three comments in red pen. The vertical axis did not start at zero. The difference from the control group (= the group of patients who did not receive the drug, used for comparison) was emphasized without the test statistics (= the numbers that check whether a result could be chance). And the patients in the cited trial did not match the readers the material was written for. Every comment had grounds. I could cite the exact clause of the regulatory notice, down to the page number. I felt not a shadow of doubt about my work.

When I looked up, the person in charge let out a small sigh. The colleague next to him looked away and pretended to flip through his papers. The air in the room was clearly heavier than it had been a few minutes earlier. Inwardly, I was puzzled. I had made correct comments — so why did the mood turn bad? The answer came quickly. Since the comments were correct, being upset about them was the unreasonable part. The fault was on their side. Back then, that certainty was all I had.

The red pen on my desk had an odd feel to it. A plastic barrel that should have been light felt slightly heavy in my grip. I read that weight as "the weight of responsibility." We are the last line of defense for information that reaches patients, I told myself, so of course it feels heavy. Walking back to my seat after the meeting, I passed the person in charge in the hallway; he gave a quick nod and hurried away. Watching his back, I still suspected nothing.

Looking back now, one assumption sat squarely in my head at the time: "I see the graph exactly as it is. So anyone who disagrees with what I see must have something clouding their eyes." Sales targets, deadlines, the boss's mood. I assumed the distorting circumstances existed only on the other side. The possibility that circumstances existed on my side too never even made it onto the list of options. This assumption, it turns out, has a name — but I would not learn it until much later.

02A Ruler with Two Marks

My verdicts were fast. Approved, or rejected. Even in gray cases where the meeting split, I tipped the call one way or the other and answered on the spot. I never said "let me take this back and think it over." A vague answer, I sincerely believed, was a reviewer's way of dodging. Since I never kept people waiting, I even thought I was being kind. People around me did say "he decides quickly," and I took that as proof of ability.

The numbers, however, said something else. My rejection rate (= the share of materials sent back for rework) was the highest in the department, yet the quality of the resubmitted materials was barely improving. The same kinds of problems kept reappearing in different materials. I was judging fast, and nothing was getting better. At the time I filed this contradiction under "the makers are slow learners." The idea of doubting the ruler had not occurred to me yet.

Years later, reading Aaron Beck, the founder of cognitive therapy (= a form of psychotherapy that finds and corrects habits of thinking), and David Burns, who carried his work forward, I recognized what my speed really was. At the top of their list of "cognitive distortions" sits dichotomous thinking (= seeing everything as a two-way choice between black and white; also called all-or-nothing thinking). The key point is that this is not a character flaw but a thinking habit anyone can fall into. When we are tired, when we are pressed for time, the mind drops the in-between shades and runs to a two-way choice. Research has also shown, again and again, that this habit tends to go together with depression and friction in relationships. The bad air around people who judge in black and white was no coincidence.

• The speed of a fast verdict does not necessarily come from precision. A ruler with only two marks finishes every measurement instantly — that alone explains the speed.
• The two-way choice of "approved or rejected" drops the single most important piece of information: how to fix it so it can be approved.
• If your rejection rate is high but quality is not rising, the thing to doubt is not the other side's ability to learn but the coarseness of your own ruler.

My red pen never wrote anything wrong. Its marks were just too coarse. If a ruler carries only two marks — "long" and "short" — measurement takes an instant. Fast, yes, but nobody can build anything with that kind of speed. What I had been calling decisiveness was the coarseness of my tool. It took me a very long time to admit that.

03Whose Sake Is Your Rightness For?

It was a case I had sent back three times. The wording of the new material's approved indication (= the effects and uses of the drug that the government has approved), the way the data was shown, the placement of the footnotes. Every comment of mine came with the supporting clause attached; there should have been no room for argument. At the end of the fourth meeting, the young staff member in charge closed his papers and said quietly, "I think every one of your comments is correct. But not once have you asked what we were trying to say with this material."

I had no reply. Lining up correct comments, and understanding what the other person is trying to do — I had assumed these were the same task. They were not. Across three rounds of rejection, I had never once asked, "What is this material trying to achieve?" I had felt no need to ask. I thought I could tell just by looking.

Social psychology has a term for this: naive realism (= the conviction that you see the world exactly as it is). Lee Ross and colleagues at Stanford described it as a habit built into how humans see things. What I see feels like "objective fact," so anyone who looks at the same thing and reaches a different conclusion must either lack information or have distorted judgment. That was exactly how I felt. I filed the staff member's objections under "resistance from someone who doesn't understand the regulations."

But the same material must have looked like an entirely different landscape to him. He had information he wanted to get to the clinical front line, had spent weeks working out how to convey it, and then brought it to my desk. What I saw was a candidate list of deviations (= places that stray from the rules); what he saw was a blueprint of what he wanted to say. Both of us were looking at the same sheet of paper. What we saw was different. And the frightening thing about naive realism is that the difference in what we see is itself invisible. You do not think the other person is seeing a different landscape; you think they are looking at the same landscape and getting it wrong. That is where the misunderstandings and collisions begin.

In the hallway outside the meeting room, I stood still for a while. Every comment had been correct. And yet I had gotten something badly wrong. What that "something" was, I would find out that same night.

04Thinking About the Self That Is Thinking

That night, after getting home, I spread the comment lists from those rejections across my desk. It was not the first time I had reread them. But that night I changed how I read. I no longer checked whether the comments were correct. Instead, I looked at them while trying to remember how my own mind had been moving while I wrote each one.

A pattern appeared. Every time I read a sentence in a material, I was pouring it into one of two boxes: "approved" or "rejected." I thought I was judging, but what I was actually doing was sorting. Because I had prepared only two boxes, "I see the intent but the wording overreaches" and "this would pass with a different phrasing" both fell into the "rejected" box. All the person in charge ever got back was the label on the box. Three rejections were three notifications of sorting results. Until that night, I had never once looked at the shape of my own ruler.

In the 1970s the developmental psychologist John Flavell named this faculty metacognition (= the ability to look at your own thinking from one level up), and laid out the idea in a 1979 paper. "Cognition about cognition" — that is, thinking about the self that is thinking. It sounds difficult, but all I did was the humble act of rereading a list. What I changed was the object of observation. Not the correctness of the comments, but the movement of my mind in the middle of making them. A normal rereading looks at the material and the comments. That night's rereading looked at my own mind at work. That alone made visible something I had not seen in ten years.

The realization did not come from willpower, I think. However many times I told myself "put yourself in their shoes," by the next morning I would have been sorting the same way again. What changed was not my attitude but the object of my observation. As long as you are looking at the material outside yourself, your own ruler stays out of view. The only way to see the ruler is to watch yourself using it. What the young staff member's remark gave me was the place to stand and watch from.

05Gray Is Not Laziness — It Is the Terrain

One evening I reread the Guidelines for Sales Information Provision Activities (= the health ministry notice that governs pharmaceutical sales materials and how drugs are explained), as if reading them for the first time. It is a document I had cited hundreds of times at work. But reading with a pencil in hand, I found the wording had more give than I remembered. "Risk of misleading." That "risk" cannot be settled by looking at the material alone. Who will read it, in what setting will it be handed over, what does the reader already know? It stretches and shrinks with context and reader. In other words, the notice itself does not pin the answer to a single point.

For a long time I had considered this a defect in the regulation. If only it said black or white, review would be easy. But that evening the picture flipped. Between white and black stretches an endless range of shades. It had looked like a defect, but it was in fact the terrain of this work itself. Clinical settings are not uniform, and neither is readers' understanding. So the language of regulation has no choice but to carry width. Review turned out to be the work of walking that terrain and searching for the one point that best answers to conscience for this material, right now. It is hard because the map has no "here" printed on it — and the absence of a printed answer does not license deciding carelessly.

Aaron Beck, the founder of cognitive therapy (see section 02), named "all-or-nothing thinking" (= being able to think only in a two-way choice of black or white) as one of the chief habits of thought that make people suffer. The practice he prescribed against it is thinking in degrees. Not "completely safe" versus "completely dangerous," but "in this context, how many points out of ten is the risk of misreading? Fix which part, and how many points does it drop?" Abandon the two-way choice and think on a continuum (= a scale with no breaks). This is not training in vagueness. Quite the opposite: it is higher-resolution cognition, measuring reality with a finer scale than two marks allow.

One distinction deserves careful placement here. Acknowledging gray and loosening the standard are two different things. They are easily confused, but they point in different directions.

Reviewing in black and white is, in truth, the easy way. On this side of the line, you never have to think. Reviewing with an eye for gray means reading the context of each case, gauging degrees, and putting reasons into words. The work increases. But that added work is exactly what the notice entrusted to us with a word as wide as "risk." Gray is terrain that becomes visible only to those who walk it honestly.

06From "From Me" to "From You"

At the next review meeting, I changed just one thing: my opening line. The old me would have led with "this expression is not acceptable." That day I said, "What do you want doctors to take away from this material? If that is the goal, this expression carries a risk of being read this way in the field." The substance of the comment was identical. The supporting clause was the same, and so was the part I wanted fixed. All I changed was the starting point. I began not from my verdict (from me) but from the other person's goal (from you).

Something strange happened. The maker dropped his defensive posture. "What we want them to take away isn't efficacy — it's the administration procedure," he said, and began talking about the goal; then, on his own, he proposed that a different figure might convey it better. We were no longer two opposing parties but two people searching for the same destination. The content you want to deliver can stay the same, and still arrive differently when the arrow points the other way. That day I learned it in my body.

This is a capacity developmental psychology has chased for a long time. Piaget (= the Swiss psychologist who studied how children's thinking develops) called the process by which small children escape the stage of assuming "the scenery I see is the scenery everyone sees" decentration — the developmental discovery that your own viewpoint is not the whole world. Downstream of that research lies perspective taking (= the act of imagining how a situation looks from the other person's position), and even in adults it rusts without deliberate use. The reviewer who opens with "not acceptable" is not malicious. He has simply mistaken the view from his own seat for the whole world. As I once did.

There is one more technique, usable before a meeting even starts. The psychologist Ethan Kross and colleagues studied self-distancing (= viewing yourself from a slight remove, in the third person, as you would view someone else). In their experiments, asking "why is he (or she) angry?" using your own name or the third person calmed the emotional waves and allowed a cooler rereading of the situation than asking "why am I angry?" in the first person. Before a meeting that looks likely to turn contentious, I now ask myself one question in the hallway: "How does that reviewer look, right now, to the person who made this material?" What usually comes into view is not a guardian of justice but a wall gripping a red pen. Once I can see that, the first words out of my mouth change on their own.

From "from me" to "from you." Shift the starting point, and the same rightness can arrive as a gift instead of a sentence. Beside the years I had spent polishing the substance of rightness, another job had been sitting untouched the whole time: choosing where to put it.

07Keep the Principles, Change the Grip

I do not want to be misunderstood, so let me say this plainly at the end. Since I started shifting my viewpoint, I have not discarded a single principle. Exaggerated claims: not acceptable. Assertions without evidence: not acceptable. Suggestions beyond the approved indication: also not acceptable. That line has not moved once, from my first day in materials review (= the work of checking that pharmaceutical advertising and explanatory materials follow the regulations and the evidence) until today. What moved was not the line but how the line is shown. Do you throw it back — "this expression breaks the rule, fix it" — or do you think together: "how will this expression look to the doctor who reads it?" What you protect is the same. How it arrives is completely different.

I will not line up the three borrowed ideas again in summary form. Metacognition (= looking at your own thinking from one level up), perspective taking (= the imagination to see things from the other person's position), and self-distancing (= viewing yourself from a slight remove) all point, in the end, to one thing. Growth is neither adding principles nor discarding them; it is a rise in the resolution of the landscape between the principles and reality. The rulebook I have now is the same one I had as a rookie. What I lacked was never rules. It was eyes that could see the faces of the people on the far side of the rules.

Only after I could see myself as I appeared in the other person's eyes did I notice something. Beyond my red pen, there were always people. The staff member who built the material while chased by deadlines; the MR (= medical representative — the person who carries drug information to hospitals and clinics) waiting for that material; and beyond them, the doctor who hears the explanation and considers a prescription, and the patient who takes the drug. When I wrote "from me," I saw only the head of that line: whether my comment was correct, nothing more. Writing "from you," the whole line came into view. The substance of the rightness did not change. Who the rightness was for — that, at last, I could see.

In installment 19 I wrote about the direction of motive: do we point things out to display our own ability, or to make the material better? Today's direction of argument is its continuation. Even if the motive faces the other person, words will not reach them while the argument is still built facing yourself. And if only the framing is polished while the motive faces inward, the result is well-dressed self-assertion. Only when the two directions align does a comment finally become an invitation: let's fix this together. For me, the days when they do not align still outnumber the days when they do. On tired days, on rushed days, the red pen slips straight back to "from me." That I can now notice the slip — that may be the entire sum of twenty years of progress.

I have no intention of asking grandly what conscience is. But after all these years in this work, I have come to think that conscience is not the power to brandish rightness; it is the power to choose, again and again, how rightness is delivered. Keep the principles. Change the grip. Turn the tightly clenched fist into an open hand, palm up, offering. What rests on it is the same single rule. And yet the face of the person receiving it becomes a different face. Tomorrow I will pick up the red pen again. Only the way I hold it will be a little more careful than yesterday.