Practising your scales

Pain is very hard to describe.  My sister-in-law, for instance, recently went to the dentist and was told that the abscess in her tooth should have left her howling and writhing on the floor.  “It’s a bit sore,” she admitted, “but I didn’t like to make a fuss.”  On the other hand, I’m known for saying “Owwww!” before I walk into something, just in case.  Over the years, medical people have devised numerous pain scales in an attempt to get an accurate reading of a patient’s level of discomfort – from ooo to aaaaargh, I suppose.

Likewise, suspicion is hard to describe.  It’s one of the most common questions I get during AML training: how do I know when I am suspicious, as opposed to simply a bit curious, or bemused, or even prejudiced?  In the past, I’ve talked about using a spectrum of suspicion – but the problem here is that all of the words in that spectrum (unease, concern, curiosity) are just as subjective as the word “suspicion”.  After all, suspicion rather depends on your viewpoint and, to some extent, personality: in the marvellous “Endeavour” (the prequel to the “Morse” series on telly), a jaded DI Thursday comments to the young Morse that “you’d find something suspicious in a saint’s sock drawer”.

So perhaps a numerical scale would be better.  One of the most popular pain scales is Numeric Rating Scale 11, which asks patients to rate their pain from 0 (no pain) to 10 (disabling, and unable to perform the activities of daily living – imagine the agony of not being able to open the biscuit tin).  Could we do something similar for suspicion?  “Rate your money laundering suspicion about this client from 0 (entirely trustworthy – would happily marry him to your youngest daughter) through 5 (a touch of the Arthur Daleys but more roguish than evil, sailing close to the wind but not crossing the line) to 10 (sound the klaxon – but silently, of course, so as not to tip him off)”.  Quite why more clients don’t get me to write their in-house procedures, I can’t imagine.

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