By Karen Weese

Pacific Standard

Dr. Bryan Bledsoe was just trying to keep up. The emergency room at his small county 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 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.

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 by the varied needs of so many patients, he missed a diagnosis. It would haunt him for years.

While there’s no easy excuse for Bledsoe’s lapse, there is something of an explanation: We all have only a finite amount of mental bandwidth, and if we use that bandwidth to concentrate on one thing, it’s difficult to use it for anything else.

Given his profession, Bledsoe was in a privileged position at the time; this mental condition is even more difficult for those on the other end of the economic spectrum. While nearly all of us juggle work, our personal lives, and financial and other obligations, for low-income families the juggling involves constant, agonizing tradeoffs (“Should I pay the rent or the electric bill? Should I fill this prescription or buy food?”). The process of making those 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 in 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 like Bledsoe were transplanted into a life of poverty tomorrow, he’d lose the same bandwidth too — and his brain function would show it.

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Picture: Rennett Stowe from USA (Poverty) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)%5D, via Wikimedia Commons