There are three television doctors who have written media history: Dr. House, Doogie Howser and Dr. Fox – the latter is probably known the most and will not be forgotten even if Dr. House shares Doogie Howser’s fate.
What is meant?
Let’s say you’re a medical student or a doctor and you’re sitting in a lecture or a seminar, and suddenly Gregory House steps up on the podium and gives a presentation – would you notice that or would you take him for a real doctor when he suddenly speaks about science? He would definitely be recognized, because Dr. House is a common cultural heritage and popular to publicity.
In the early 1990s, Doogie Howser felt the same way. The story of the sixteen-year-old practicing doctor was on everyone’s lips and delighted the public for four years. Nevertheless, the now aged teenager physician would have the best chances of surviving in front of a professional audience as a real medical doctor.
Really? From where do we know that? From Doctor Fox.
Michael Fox played the pathologist in the then hit television series “Perry Mason” from 1957 to 1963. Nevertheless, he was able to write history at the University of Southern California School of Medicine only seven years later, when he disguised the fact that he wasn’t acting a doctor but a real one by three courses of students, psychiatrists and psychologists: Dr. Myron Fox, graduate of the Albert Einstein College of Medicine on the East Coast and well-known author who has already published in „Science“ magazine.
In contrast to Doogie Howser and Doctor House, Michael Fox played only a supporting role in „Perry Mason“, but the question of this article is not why he wasn’t recognized as a prominent actor, but how it is possible that people without a corresponding degree can pretend to be doctors. And in this respect the Dr. Fox experiment is quite interesting.
First of all, Michael Fox had a big advantage on his side: he himself didn’t have to explain who he is and what he is famous for. He got his credits from someone else – a scientist from the University of Southern California introduced him to his audience. Dr. Fox himself didn’t have to contribute anything but to wear a suit.
This says a lot about initiation rituals and acts of deception: the credibility that Doctor Fox possesses does not come from who he is, but from how others see him, after how someone depicted him. The instructor described him as a well-known East Coast scientist, and that’s how Myron Fox appeared: he stood out visually from his West Coast colleague – the instructor wore shorts and a T-shirt, Dr. Fox, on the other hand, looked like you’d expect the audience to imagine a doctor – neat, with glasses, suit and tie.
Had Dr. Fox been announced as being from the West Coast, the optical difference to the instructor could have caused confusion, but because East Coast scientists are considered to be more rigid than West Coast people, his appearance corresponded exactly to the image that West Coast people have of the East Coast scientists. This means that the audience was probably used to their own scientists giving lectures in summer outfits, but in the case of an East Coast scientist it would have confused them deeply because it wouldn’t have matched to their conception.
From this it can be concluded that Dr. Myron Fox had to wear a suit, while the real scientist from the West Coast was free to wear whatever he wanted. The latter was firstly known, secondly came from the West Coast and thirdly, if necessary, would have convinced by his lecture. Three things Dr. Fox didn’t have. He just had the instructor’s introduction and the suit what gave him credibility.
Let us now come to Dr. Fox’s lecture and go through it step by step:
His topic was „Behavioural Games as Applied to Physician Education“ and he was heralded as an absolute expert in this field. His listeners were prospective and established scientists in psychology/psychiatry, but none of them belonged exactly to the field Myron Fox was talking about.1 This was an advantage for the bogus doctor, because no matter how educated the audience is and no matter how little they understand about a lecture, hardly anyone would admit this publicly or interrupt the lecturer. The lecture format itself, along with its ritual rules, protected Dr. Fox from exposure so that he could talk undisturbed.
The first three movements were dedicated by Myron Fox M.D. to the difference in clothing between the scientists of the East Coast and the West Coast. He emphasized that in the East you have to wear a suit and tie, while in the West you can sit like a beach boy in front of the audience, in shorts and a Turtleneck shirt.
The question is why Dr. Fox brought this to the attention of the audience. There are two possible explanations: either he tried to distract from the obvious by offering the audience an explanation. The second possibility would be a judgemental assessment. But the latter seems unlikely, because no matter whether Fox wants to express praise or blame through his judgmatic statement, the audience will be split: if he praises his host’s casual style, he brings both those in the audience against himself who believe that he criticizes their West Coast professor and those who believe that he praises him when they themselves consider his casual dress style to be unworthy of a scientist. This means that Myron Fox immediately lost the audience with a jugdemental statement, because it’s not him who makes a judgement but the audience that is affected by his words. And with regard to the instructor in the beach boy look, everyone has an opinion. In doing so, Fox risked that his critics would listen very carefully and weigh every single sentence with the inner desire to refute it.2
So Myron Fox was surprised. Otherwise he wouldn’t have made such a grave acting mistake. At least not right at the start of his performance. Therefore one can assume that the cheating doctor was surprised by his own „wrong acting“ and therefore tried to calm the audience.
Then Dr. Fox started his introduction and said that today he wanted to lecture on the application of Game Theory in the field of medicine, in the field of teaching. He literally said “the applicability of Game Theory in the field of medicine, in the field of teaching”, and this is unusual: the meaning of the words corresponds to the same statement made by the teacher, „Behavioural Games as Applied to Physician Education“. However, Dr. Fox used very simple words. And with this Dr. Fox contradicted the first rule of the Dr. Fox effect: if you want to be recognized, you have to stand out from your audience by expressing even simple facts as complicated as possible. Otherwise you are considered inferior.3
Again, one can ask why Myron Fox did this: either he simplified his statement for the audience so that they can follow the meaning of his lecture more easily. This would be presumptuous, however, because this procedure is again preceded by an adjudication: Doctor Fox may only mean well, but he still thinks his audience is so stupid that he believes he has to explain the meaning of „Behavioural Games as Applied to Physician Education“ to them. No wonder – they’re taught by dudes in shorts.
The second possibility is that Myron Fox forgot the text because of his surprise about the clothes themselves, and for a moment he didn’t know what he was talking about. So he mentally built himself a bridge, and staggered over „the field of medicine“ into „the field of teaching“. This one makes more sense.
In the third section, Dr. Fox begins with Game Theory and first mentions “von Neumann and Morgenstern”, the founders of the scientific research area of “game theory“. In 1944, the two jointly published a book about this topic, which is still regarded as well known today (in non-natural science fields at least). He then talks for a few seconds about Game Theory and its significance as Theory of Strategy, before he loses the plot again and contrasts Game Theory with „Gambler’s Choice“ – this may sound scientific, but it’s a movie from 1944.
He then changes the subject to poker and briefly discusses how the game works. It’s been 2:12 minutes since the video started.
He goes on to say that Game Theory consists of two areas: the Zero Sum Area, where two people play against each other and one can only win if the other loses. The easiest game to play is TicTacToe, but this is not included, because in the long run it should always end in a draw. It should be in Game Theory as well, because this is the question the theory deals with: is it more sensible to cooperate with each other or to cheat on each other to achieve a higher result in the short, medium and long term? And that’s why his TicTacToe example fit the bill, whereby his own negation nullified it.
The second area of Game Theory, he left open.
In this way, Dr. Fox stumbles further through the lecture. He talks about a well-known chess opening and tells that the Cuban world champion Capablanca didn’t let himself be thrown off balance and kept control by the surprising move of his American challenger Marshall, and that the author, where he read about it, made a mistake because he didn’t consider luck to be a relevant factor in chess (Min. 3:00-4:00). This also made little sense with regard to the topic of the lecture, but a lot if one relates the statement to Fox himself: the first move of the course instructor with the shorts had surprised him and he had, like Capablanca, waved briefly. But he believes in his chances and doesn’t let it throw him off balance. A hidden message to himself or to the instructor, so that he doesn’t break off the experiment.
And Fox succeeded in doing so, because after he stumbled another three minutes, the strongest part of the whole lecture begins, when the audience actually takes something away: Fox relates Game Theory to the triangle relationship between Tosca, Cavaradossi and Scarpia from Puccini’s opera. And this part is impressive. Because Fox spoke fluently about the subject for almost four minutes, and so the listener automatically had the feeling that he knew what he was talking about. Namely Tosca. It was further assumed that he also knew something about Game Theory in this respect, after all he was considered an expert (Min. 7:42-11:18).
Fox then tried unsuccessfully to improvise further before relying on his script and draining the last minutes on reading text primarily, before he surprisingly ended the lecture after eighteen minutes.
If you ask yourself what this tells you about fake doctors in real life, as you often meet them in everyday life as a fraud, the lecture tells you a lot: Doctor Fox had the advantage that a “colleague” introduced him to his audience. Nevertheless, he became insecure because he thought he was dressed inappropriately. That’s why he first becomes close and all of a sudden distant (arrogant). Then, he throws names in context and incoherent technical terms around. In the midst of all this, he encourages himself and finds his way back to his own line, because he gets the opportunity to talk about a topic he really knows about – Tosca. And he exploits this moment to the full, profiting from the fact that, because of their own ignorance, the audience benevolently assume he would know what he’s talking about. Nevertheless, he doesn’t find his way into the track and finally limits himself to reading from his manuscript. And before he can be exposed because of this, he breaks off the performance and disappears. Because the part he read off sounded much more coherent than anything he had previously given free from himself, and that doesn’t speak for a doctor, but for an actor who’s playing a monologue.
For a non-scientist it’s difficult to play a real doctor. Even a professional actor falls out of balance in this role. And especially a professional audience sooner or later notices that something is wrong with the fake doctor. The only chance he has is to limit himself to superficialities in his remarks, to be brief on the subject and to use every opportunity to distract from the subject. Or that he flees when he’s at a loss.
This is the Doctor Fox effect: the opposite of what the prevailing opinion says. And therefore, Doogie Howser would have fled like Dr. Fox did.
1 See Naftulin et al. 1973: 631-633
2 See Füllgrabe 1999: 7
3 See Füllgrabe 1999: 5f.; see also Hakes 2009
- Füllgrabe, Uwe (1999): Der “Dr. Fox” – Effekt. Oder: Welchen diagnostischen Wert haben Bewertungen von Vorlesungen. Hannoversch Münden. Online verfügbar unter http://www.xn--uwe-fllgrabe-hlb.de/mediapool/42/428554/data/Artikel/Wissenschaft/DR_FOX_-_EFFEKT.pdf, zuletzt geprüft am 09.02.2016.
- Hakes, David R. (2009): Confession of an Economist: Writing to Impress Rather than Inform. In: Econ Journal Watch (EJW) – A Journal of the American Institute for Economic Research. Vol. 6 (3), September 2009, S. 349-351. Online verfügbar unter https://econjwatch.org/File+download/11/ejw_wat_sep09_hakes.pdf?mimetype=pdf, zuletzt geprüft am 26.05.2020.
- Naftulin, Donald H.; Ware, John E., JR.; Donnelly, Frank A. (1973): THE DOCTOR FOX LECTURE: A PARADIGM OF EDUCATIONAL SEDUCTION. In: Journal of Medical Education 48, S. 630–635.