Dr. Bryan Bledsoe was just trying to keep up. The ER at the small rural hospital was always packed and the top brass had urged him to move patients through more quickly, so when a woman in her sixties came in complaining of head and neck pain, he briskly examined her, hustled her off for an x-ray, gave her some pain medication for a pulled muscle, and dispatched her home.
The next morning, though, she was back—this time in an ambulance. Bledsoe had missed the signs of an impending stroke. The woman died in the hospital that day.
Dr. Bledsoe didn’t lack training or a desire to help; the doctor, who today serves as a faculty member and physician in the trauma center at the University Medical Center of South Nevada in Las Vegas, was as eager then to see his patients get better as he is now. But in the moment, strapped for time and overwhelmed with the varied needs of so many patients, he missed a diagnosis. It would haunt him for years.
Whether we’re doctors, or teachers, or anything else, we all have a finite amount of mental bandwidth, and if we use that space to concentrate one thing, it can’t be used for something else. Sounds obvious, but emerging research show that it has profound implications, especially for people who are financially barely scraping by. While everyone juggles work, family, and financial obligations, for low-income families these decisions involve constant, agonizing tradeoffs(“Should I pay the rent or the heating bill? Should I fill this prescription or buy food?”). And the process of making those painful, fraught tradeoffs day after day comes at a cognitive cost—the equivalent, researchers say, of living each day as if you hadn’t slept the night before.
Living in poverty, having so much bandwidth wrapped up just making it from one day to the next, decreases a person’s—any person’s—cognitive function, making it harder to solve problems, resist impulses, and think long-term. If a well-off professional were…