Preparing for Stressful Decisions

Aug 22, 2024

Lecture Summary: Pre-Mortem Thinking and Decision Making

Introduction

  • Personal story of breaking into own house during extreme cold.
  • Discusses the impact of stress on thinking.

Stress and the Brain

  • Stress releases cortisol, affecting heart rate and clouding thinking.
  • Personal experience: forgot passport due to stress-induced cloudy thinking.

Prospective Hindsight / Pre-Mortem

  • Discussed with colleague Danny Kahneman.
  • Definition: A method to anticipate potential problems before they happen.
  • Contrast with postmortem analysis: postmortem looks back at what went wrong, while pre-mortem looks ahead to prevent issues.

Systems for Prevention

Home Organization

  • Designate specific places for easily lost items (keys, passport, glasses).
  • Importance of spatial memory and the hippocampus in remembering locations.

Travel Tips

  • Take photos of important documents (credit cards, ID, passport) and store them in the cloud.

Medical Decision-Making

  • Importance of having clear systems in place for making medical decisions.
  • Example: cholesterol levels and statin prescriptions.
  • Key Statistic: Number Needed to Treat (NNT) - how many need treatment before one person benefits.
    • Statin NNT = 300; side effects affect 5% of users.
    • Risk of side effects vs. benefits.

Critical Questions for Medical Conversations

  • Ask about the NNT when prescribed medication.
  • Discuss potential side effects and quality of life considerations.
  • Importance of informed consent and access to information.

Broader Implications

  • Pre-mortem thinking applies to financial and social decision-making as well.
  • Recognize that under stress, rational thinking diminishes.
  • Importance of preparing in advance for potential stressful situations.

Conclusion

  • Everyone makes mistakes; key is to anticipate failures and mitigate risks.
  • Personal takeaway: installed a combination lock for future readiness.
  • Emphasis on gradual organization and improvement.

Remember that preparation and anticipation can significantly reduce the impact of stress and poor decision-making in critical situations.