Lecture Notes: Pre-Mortem Thinking

Introduction

• Personal anecdote about breaking into own house during cold winter in Montreal.
• Realization of forgetfulness under stress.
• Experience led to thoughts on preventing future mishaps.

Understanding Stress and the Brain

• Under stress, the brain releases cortisol, leading to:
  • Increased heart rate
  • Modulation of adrenaline levels
  • Clouded thinking
• Personal experience of cloudy thinking during stressful situations.

The Concept of Pre-Mortem

• Originated from a discussion with Danny Kahneman.
• Definition: A pre-mortem is a strategy to foresee potential failures before they happen and take preventive measures.
• Contrast with Post-Mortem: Post-mortem analyzes what went wrong after a disaster.

Practical Applications of Pre-Mortem Thinking

Everyday Life

• Designate places for easily lost items:
  • Example: Hooks for keys, drawers for passports, tables for glasses.
  • Backed by scientific understanding of spatial memory (e.g., hippocampus).

Travel Tips

• Take cell phone pictures of important documents (credit cards, passports) and store them in the cloud.

Medical Decision-Making

• Importance of rational assessment in healthcare decisions.
• Example of high cholesterol management:
  • Doctors may prescribe statins without discussing risks effectively.
  • Number Needed to Treat (NNT): Number of people needed to be treated for one person to benefit.
  • For statins, the NNT is approximately 300 (one heart attack avoided per 300 people treated).
  • Side effects occur in about 5% of patients.
  • Calculation of risk vs. benefit: 15 people likely harmed for every one helped.

Importance of Quality of Life Decisions

• Engage in conversations about quality of life with loved ones.
• Example of prostate surgery NNT: 49 surgeries to help one person, with significant potential side effects.

Conclusion

• Acknowledgment that everyone makes mistakes; the goal is to minimize risks and prevent disasters through forward-thinking.
• Implemented a combination lock at home as a preventive measure.
• Emphasis on organization as a gradual process.