Your Mind Makes Accidents Inevitable

https://www.psychologytoday.com/articles/201705/eccentric-s-corner-the-risk-taker

Eccentric’s Corner: The Risk Taker
By Gary Drevitch, published on May 2, 2017 - last reviewed on July 3, 2017

There’s a chart at the front of research psychologist Steve Casner’s book, Careful, depicting the rate of fatal accidents, or “unintentional injury deaths,” in the United States. It displays a sharp and steady decline, from about 110 such deaths per 100,000 people in the 1930s to just about 40 per 100,000 by 1990. But then the rate plateaus, and declines only a little further; in fact, around the start of the 21st century, it begins to creep upward. It seems that in spite of the efforts of people like Casner, who has devoted his career to safety, primarily in aviation through his work at NASA and elsewhere, we simply can’t seem to make ourselves any less accident-prone. And Casner is pretty sure our brains are to blame.

People often joke that they didn’t have car seats or bike helmets when they were kids and everyone “still turned out fine.” Are they right?

No. The people who are not in those conversations are the people who weren’t fine. They died. So you have a sort of selection bias there. If you have 1,000 people and 997 of them are wiped out, the other three could sit around and say, “What’s the problem? We’re fine.” If you look at the number of children injured or killed in car crashes back then, it was pretty bad, and those of us who survived should probably credit luck rather than an amazingly safe lifestyle. We’re in a much better place today,

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How has aviation safety changed since your career began?

In the cockpit of a major airline, you can hear the change in the pilots’ language. The captain will say to the first officer, “I’m going to do this and then I’m going to do this and in case I screw it up, you’re going to let me know.” That’s out on the table. There’s no shame or ego. They recognize that to err is human, and that they are human: “I’m going to make an error, and that’s where you come in.”

Have other fields made similar advances?

In 2009, Atul Gawande’s book, The Checklist Manifesto, about using checklists to prevent errors in intensive care, came out, and those of us in aviation were blown away. We thought, This is like the 1940s. If a pilot ever did anything without a checklist, they’d be told, “It’s over. You’ve failed.” It’s not even a possibility for us. And Gawande was talking about how these ideas were just starting to get out in medicine eight years ago.

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http://www.newyorker.com/books/page-turner/be-careful-your-mind-makes-accidents-inevitable

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Even so, Casner argues, we’re in the midst of a safety crisis. In 1918, one in twenty people died in an accident of some kind; by 1992, that number had been reduced to one in forty, through regulations, innovations, and public-awareness campaigns. But then the decline in the accidental-death rate stopped—and, since 2000, it has actually risen. In 2015, after almost a century of steady decline in car fatalities, driver, pedestrian, and cyclist deaths shot up eight, ten, and twelve per cent, respectively. Other kinds of accidents are more common, too, and we are now, Casner says, about as safe as we were thirty years ago. Casner has some theories about why this is happening. One is “risk homeostasis”—our tendency, once we’re safer, to take more risks. (Bicyclists who wear helmets, for example, tend to ride closer to cars than those who don’t.) New inventions play a role—smartphones that distract us, medications that confuse us; so does the new popularity of adventure sports, such as rock climbing. There’s the ascendant culture of D.I.Y.: “People are once again building their own furniture, blowing glass, upgrading their homes, and chopping and chainsawing their own firewood,” Casner writes. Many injuries happen when people are trying to “cook, make, decorate, or fix something.” Another significant factor is that people are living longer, into frail, accident-prone old age.

“We have come to the end of a really good run,” Casner concludes. “We have wrung all the big gains we’re going to get from putting rubber corners on stuff and saying, ‘Hey, don’t do that.’ ” From here on out, if we want to be safer, we will have to do it ourselves, by making better decisions. We’ll have to become the kinds of people who, before trampoline-bouncing into the pool, think twice (or, more likely, for the first time).

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Casner finds the word “accident” misleading; he distinguishes between “mistakes” and “errors.” A mistake is “the flawless execution of a mostly dumb idea”—it’s what happens when you should have known better. Many of the hundred and forty thousand people who fall off ladders every year do so because they stand on the rung that says “Not a step.” That’s a mistake. But errors are inevitable: even a competent and well-trained pilot will, eventually, glance at a lever in the “On” position and think that it is actually “Off.” The psychologist James Reason has found that people are aware of their own errors only eighty-five per cent of the time. Even workers in nuclear power plants make “errors in reading gauges, interpreting indicator lights, and selecting the wrong button to push,” Casner writes. The core problem is that minds wander. A French psychologist surveyed E.R. patients who had been in car accidents; he found that half of them were lost in thought at the moment of the crash. [Happened to me.]

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