What people say about themselves can also be very confusing, for the simple reason that most of us aren’t very objective about ourselves. That’s why, when we measure personality, we don’t just ask people point-blank what they think they are like. We give them a questionnaire, like the Big Five Inventory, carefully designed to elicit telling responses. That’s also why Gottman doesn’t waste any time asking husbands and wives point-blank questions about the state of their marriage. They might lie or feel awkward or, more important, they might not know the truth. They may be so deeply mired—or so happily ensconced—in their relationship that they have no perspective on how it works. “Couples simply aren’t aware of how they sound,” says Sybil Carrère. “They have this discussion, which we videotape and then play back to them. In one of the studies we did recently, we interviewed couples about what they learned from the study, and a remarkable number of them—I would say a majority of them—said they were surprised to find either what they looked like during the conflict discussion or what they communicated during the conflict discussion. We had one woman whom we thought of as extremely emotional, but she said that she had no idea that she was so emotional. She said that she thought she was stoic and gave nothing away. A lot of people are like that. They think they are more forthcoming than they actually are, or more negative than they actually are. It was only when they were watching the tape that they realized they were wrong about what they were communicating.”

If couples aren’t aware of how they sound, how much value can there be in asking them direct questions? Not much, and this is why Gottman has couples talk about something involving their marriage—like their pets—without being about their marriage. He looks closely at indirect measures of how the couple is doing: the telling traces of emotion that flit across one person’s face; the hint of stress picked up in the sweat glands of the palm; a sudden surge in heart rate; a subtle tone that creeps into an exchange. Gottman comes at the issue sideways, which, he has found, can be a lot quicker and a more efficient path to the truth than coming at it head-on.

What those observers of dorm rooms were doing was simply a layperson’s version of John Gottman’s analysis. They were looking for the “fist” of those college students. They gave themselves fifteen minutes to drink things in and get a hunch about the person. They came at the question sideways, using the indirect evidence of the students’ dorm rooms, and their decision-making process was simplified: they weren’t distracted at all by the kind of confusing, irrelevant information that comes from a face-to-face encounter. They thin-sliced. And what happened? The same thing that happened with Gottman: those people with the clipboards were really good at making predictions.

Let’s take the concept of thin-slicing one step further. Imagine you work for an insurance company that sells doctors medical malpractice protection. Your boss asks you to figure out for accounting reasons who, among all the physicians covered by the company, is most likely to be sued. Once again, you are given two choices. The first is to examine the physicians’ training and credentials and then analyze their records to see how many errors they’ve made over the past few years. The other option is to listen in on very brief snippets of conversation between each doctor and his or her patients.

By now you are expecting me to say the second option is the best one. You’re right, and here’s why. Believe it or not, the risk of being sued for malpractice has very little to do with how many mistakes a doctor makes. Analyses of malpractice lawsuits show that there are highly skilled doctors who get sued a lot and doctors who make lots of mistakes and never get sued. At the same time, the overwhelming number of people who suffer an injury due to the negligence of a doctor never file a malpractice suit at all. In other words, patients don’t file lawsuits because they’ve been harmed by shoddy medical care. Patients file lawsuits because they’ve been harmed by shoddy medical care and something else happens to them.

What is that something else? It’s how they were treated, on a personal level, by their doctor. What comes up again and again in malpractice cases is that patients say they were rushed or ignored or treated poorly. “People just don’t sue doctors they like,” is how Alice Burkin, a leading medical malpractice lawyer, puts it. “In all the years I’ve been in this business, I’ve never had a potential client walk in and say, ‘I really like this doctor, and I feel terrible about doing it, but I want to sue him.’ We’ve had people come in saying they want to sue some specialist, and we’ll say, ‘We don’t think that doctor was negligent. We think it’s your primary care doctor who was at fault.’ And the client will say, ‘I don’t care what she did. I love her, and I’m not suing her.’”

Burkin once had a client who had a breast tumor that wasn’t spotted until it had metastasized, and she wanted to sue her internist for the delayed diagnosis. In fact, it was her radiologist who was potentially at fault. But the client was adamant. She wanted to sue the internist. “In our first meeting, she told me she hated this doctor because she never took the time to talk to her and never asked about her other symptoms,” Burkin said. “‘She never looked at me as a whole person,’ the patient told us. . . . When a patient has a bad medical result, the doctor has to take the time to explain what happened, and to answer the patient’s questions—to treat him like a human being. The doctors who don’t are the ones who get sued.” It isn’t necessary, then, to know much about how a surgeon operates in order to know his likelihood of being sued. What you need to understand is the relationship between that doctor and his patients.

Recently the medical researcher Wendy Levinson recorded hundreds of conversations between a group of physicians and their patients. Roughly half of the doctors had never been sued. The other half had been sued at least twice, and Levinson found that just on the basis of those conversations, she could find clear differences between the two groups. The surgeons who had never been sued spent more than three minutes longer with each patient than those who had been sued did (18.3 minutes versus 15 minutes). They were more likely to make “orienting” comments, such as “First I’ll examine you, and then we will talk the problem over” or “I will leave time for your questions”—which help patients get a sense of what the visit is supposed to accomplish and when they ought to ask questions. They were more likely to engage in active listening, saying such things as “Go on, tell me more about that,” and they were far more likely to laugh and be funny during the visit. Interestingly, there was no difference in the amount or quality of information they gave their patients; they didn’t provide more details about medication or the patient’s condition. The difference was entirely in how they talked to their patients.

It’s possible, in fact, to take this analysis even further. The psychologist Nalini Ambady listened to Levinson’s tapes, zeroing in on the conversations that had been recorded between just surgeons and their patients. For each surgeon, she picked two patient conversations. Then, from each conversation, she selected two ten-second clips of the doctor talking, so her slice was a total of forty seconds. Finally, she “content-filtered” the slices, which means she removed the high-frequency sounds from speech that enable us to recognize individual words. What’s left after content-filtering is a kind of garble that preserves intonation, pitch, and rhythm but erases content. Using that slice—and that slice alone—Ambady did a Gottman-style analysis. She had judges rate the slices of garble for such qualities as warmth, hostility, dominance, and anxiousness, and she found that by using only those ratings, she could predict which surgeons got sued and which ones didn’t.