Every once in a while you learn something new from the field you work in that is completely unfamiliar and raises your eyebrows just a little.
Despite 22 years in healthcare, many of which were associated with the field of psychology, I learned of a concept yesterday called “jamais vu”. Maybe you knew this, but I learned that it is a psychological condition where a person looks at or experiences someone or something that should be familiar but which they believe they have never experienced before. Basically, it’s when a person’s current perceptions become disconnected from their long-term memory and that which they should recognize seems new and unknown. We have all experienced this at least once or twice, but who knew it had a name?
The term “jamais vu” itself comes from the French for “never seen.” It is considered the opposite of deja vu, the feeling that something you are seeing for the first time is actually familiar. My favorite use of the term deja vu is in the movie Top Secret, where Val Kilmer is introduced to a character named Deja Vu who turns to him and says, “haven’t I seen you somewhere before?” Hilarious.
But anyway, according to University of Leeds researcher Chris Moulin, jamais vu is a condition that can be induced in people as the result of particular types of fatigue (e.g., when you write the same word over and over and it suddenly looks like it’s spelled wrong or when a musician stops in the middle of a concert because they feel like the music they are playing for the thousandth time just doesn’t seem right). Often jamais vu can be the result of amnesia or an epileptic seizure that seems to “clear the mind” of what it usually knows.
While I have used the phrase “deja vu” hundreds of time in my life, I feel like I have been missing an essential element of communication not knowing the term “jamais vu.” What a perfect concept for describing that feeling of looking in the mirror, seeing those lines on my face and thinking, “who the hell is that old person with the wrinkly eyes?”
I think the Talking Heads nailed this concept best in their song Once in a Lifetime where the guy is standing in his house thinking “…this is not my beautiful house! …this is not my beautiful wife!” Jamais vu with a killer bass line.
In the field of healthcare we are currently surfing a gigantic wave of jamais vu in the discourse around healthcare reform. As I touched on in a previous post called Deja Vu All Over Again: Healthcare Industry Concepts Rise from the Grave, many in our field are acting like their ideas for changing the way our healthcare system works are sudden epiphanies never before visited on mankind. While such things as capitation (dressed up as “payment reform”), sub-capitated HMOs (dressed up as Accountable Care Organizations) and Physician Practice Management (dressed up as Medical Homes without Walls) are actually classic cases of deja vu, some of those out fighting on the front lines of healthcare system reform are talking like they have never seen or tried these concepts before (this is not my beautiful sub-capitated IPA!).
Jamais vu to the max, as they say. Or had better say, anyway. If these ideas are going to have a positive outcome the second time around, they are going to have to be implemented in entirely new ways to avoid last decade’s pitfalls. Management guru Charles Handy once said, “New ways of thinking about familiar things can release new energies and make all manner of things possible.” All I can say is, thank God humans have short memories. If we didn’t, we would never try anything twice.
And for the record, I found out there there are actually “three vu’s” as they are actually called when thought of in their entirety. Following deja and jamais in the hit parade, the third “vu” is presque vu, which means almost, but not quite, remembering something; in other words, it’s that “it’s on the tip of my tongue” feeling.
I hope when the healthcare system has been “reformed” that we aren’t all sitting out on the nursing home porch in our wheelchairs, covered by blankets saying, “Deary, I can almost remember what it was like when I could afford to see the doctor…can you remember what was that called? Oh yeah, health insurance!” Presque vu indeed.
Seems jamais vu is in very much in vogue these days (or, as they say, très au courant). The financial markets move along in their sinusoidal pattern while we ride along in a state of euphoria or panic, depending on where we sit on the curve. Most recently, we all made lots of stuff, bought lots of stuff, kept making and buying until we had enough stuff, then too much. So now we are buring off the oversupply. When it burns off, and we want more stuff again (and think we can afford it, because that matters to us at the moment), then up the curve will go again. Hard to keep this in mind when we are in the midst of it. But last night I helped my daughter study for a social studies test and was impressed to (re)learn that some of the early hominins, like Australopithecus afarensis, were around for MILLIONS of years. Now THAT gives perspective on the current economic downturn, and other decade-or-two cyclical events like efforts at healthcare reform. Let’s recognize these cycles for what they are, and, instead of jamais vu, experience (to quote Yogi) “déjà vu all over again.”