The League

Dr. Matthew Prowler
Resident Psychiatrist

Dr. Matthew Prowler

Resident Psychiatrist at The Hospital of the University of Pennsylvania

Decisions Decisions

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To play or not to play - that is Dwight Freeney's question: Whether 'tis nobler in the mind to suffer the pain of a 3rd degree ankle sprain or to heal and miss the glory of the Super Bowl moment? It's possible that Freeney, like Hamlet, is having an existential crisis over his agonizing decision.

After all, he's trying to play two weeks after sustaining an injury from which it takes the average patient around 2 months to recover. But Freeney is not your average patient -- his stoicism is widely reported and NFL players are routinely asked to do the superhuman.

In weighing this decision, Freeney must consider the value of short-term reward versus long-term performance (and potentially additional future rewards). While most will never face Freeney's specific choice, we make similar decisions every day.

These decisions classically involve money. A multidisciplinary field - behavioral economics - actually analyzes how 'irrational' factors, like emotion, affect decision-making. One concept in the field is called time discounting - that future monetary outcomes are undervalued relative to immediate ones. The theory is that humans seem, whether consciously or not, to care less about a future consequence (think credit balances).

A landmark study by collaborators from Princeton, Harvard & Carnegie Mellon (October issue of Science, 2004) found that we actually use different regions of our brain when we consider presently available versus delayed rewards.

Using functional MRI, the study examined the brains of subjects making immediate monetary choices versus those with a reward involving a 2 week or 1 month delay. The researchers found that for immediate rewards, the limbic system - the brain's "emotion center" - was preferentially activated. In contrast, the prefrontal cortex and parietal cortex - areas involved in logical reasoning and planning - are engaged by choices involving delayed gratification.

Freeney's choice may not be primarily monetary. And many factors will be involved in the outcome of Sunday's game. However, the Lombardi trophy represents the pinnacle of the profession, a significant immediate reward. Next year's season? Well that feels like the distant future.

My bet is that, for better or worse, Freeney, like Hamlet, will go limbic.

By Dr. Matthew Prowler  |  February 4, 2010; 6:05 PM ET  | Category:  Dr. Matthew Prowler , Medical Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati  
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