In March 2005, Elaine, 37, went to the hospital for sinus surgery. This is a minor operation. The chief surgeon has more than 30 years of experience, and the anesthesiologist has 16 years of experience. No one thought that there would be any problems in advance.
But the problem really appeared – Elaine suddenly stopped breathing during the anesthesia, and the chief surgeon quickly put a so-called “laryngeal mask” on Elaine and inserted an oxygen tube from her throat, but she couldn’t insert it. After a few tries, Elaine’s situation became more and more critical. At this time, the trachea can be cut, and the oxygen tube can be connected from the neck. The nurse told the surgeon that the equipment for cutting the trachea was ready.
The chief surgeon was not reconciled and said, “Let me try again.”
He tried several times, but it was still unsuccessful. When I looked up, it was broken, and 20 minutes had passed. It was too late to cut Elaine’s trachea again. The hypoxia time was too long, and Elaine’s brain had been destroyed and became a vegetative state.
It’s one story, and we’ll tell another story. In December 1978, United Airlines Flight 173 took off from New York to land in Portland.
Before landing, when the landing gear was lowered, there was a sudden loud noise and violent vibration, and the indicator light showed that the nose landing gear was not lowered. The captain responded quickly and immediately pulled the plane up, circling the airport while trying to figure out a way. The mechanic reminded him that the plane had only 5% fuel left. The captain is very experienced and said that at least 15 minutes of flight with 5% fuel, the most urgent task is to find out whether the landing gear is down or not. For a veteran like the captain, he could land safely without the gear down, but he didn’t want to take the risk.
The plane kept circling, and the captain kept trying to find a way. While thinking about it, he looked at his watch: it’s broken, it’s 15 minutes. As a result, the plane crashed. Fortunately, the captain was highly skilled and made a forced landing. Only 10 people were killed, but this was also a major air disaster. These two accidents happened in different fields, but they have a lot in common, for example, they are both experienced car rollovers, and they are both low-probability events.
The biggest difference between the two incidents is that the aviation industry has mandatory regulations that all aircraft must be equipped with two black boxes, which will record the entire operation process, but there is no such regulation in the operating room.
By analyzing the black box of flight 173, experts found a major problem: in an emergency, people will feel that time is slowing down. The operator thinks that there is enough time, but in fact time has run out.
This is not the operator’s problem, it is a flaw of human nature, and training may not solve it. The airline has specially designed a “four-step reminder system” for this purpose.
If applied to the case of the first operating room, that is: the first step is to remind ,
the nurse said to the surgeon: “Is there any other solution?”
Tracheostomy”.
The third step is the challenge, “If the trachea is not cut, the patient will die.”
The fourth step is a serious warning, “I’m going to call the emergency team to cut the trachea”.
Since intuition is unreliable, it can only rely on tools.
In the early days of American aviation school students, 1 in 4 people died in air crashes, but now the number of people killed by air crashes in the world has dropped to hundreds every year, the lowest among all means of transportation.
Why is the aviation industry effective in reducing accident rates? Because through the black box, they summed up a lot of experience and lessons, and implemented thousands of procedures into specific operations. Since Flight 173 in 1978, no civil airliner has crashed because the captain forgot to run out of fuel. This is progress.
Of course, I can’t answer these professional questions if I can make a simple analogy between medical and aviation. All I want to remind is that black box is very important to modern people and we should have black box thinking.
It turns out that without a frame of reference, we cannot make any progress without trial and error.
Reviewing mistakes and self-reflection is the best gift that reason gives to human beings. As human beings, we should cherish every mistake and constantly correct our behavior through a clear frame of reference.
At present, all kinds of economics books fill the prominent positions of major bookstores, and the topics discussed by the people around them will also involve more or less. But when these books are bought home, most people will be intimidated and stopped when they see the thick content and the proper nouns like heavenly books. When I was chatting with the people around me, I heard the contents of the book by several “big takers” Hai Kan, and I felt that I was shorter by three points, and the frustration was even deeper. However, in fact, these “big winners” probably haven’t actually read much more book content than you. They may have only mastered a certain skill and pretended to have read an economics book vividly.
99% of the “big takers” in economics are “foreword bibliographers”, and a little better than them are book reviewers. Taking half an hour to read a preface, table of contents or book review of an economics book is just a small effort for you, and the benefits far outweigh the efforts. Next time when “Dana” points out a certain economic work in front of you, you just need to insert a few sentences at the appropriate time “I remember that the author expressed a very interesting view in Chapter XX”, Or “Actually, the author expresses some other opinions on the content of chapter XX in the preface”, which will have an immediate effect. As for what “interesting opinions” and “other opinions” are, damn it, the “big takers” only read so much anyway.
If you are familiar with the “Dictionary of Economics”, there are no more than 50 professional terms in common use. Refuse to use any words like “hot money”, “inflation” and “scissors difference” that will seriously lower the level. For example: when you can skillfully express the phrase “the influx of hot money into the Chinese market leads to inflation, which further widens the scissors gap between urban and rural areas” as “the liquidity overflow of the currency further amplifies the quantitative easing policy, while the As a result, the comparative advantage of labor costs between urban and rural areas is further enlarged.” The time when you can come out of the mountains.
In fact, this step can be further simplified to only need to know two schools: interventionism and Libreville field – all schools of economics will be grouped under these two categories anyway. Also, memorize the names of four or so economists, preferably two from each faction.
Having mastered the above points, although it is enough to pretend that one has read economics books, it is limited to being able to sit on an equal footing with the “big men” and to be able to chat and laugh. Essential. Don’t be intimidated by the words “appropriate” and “precise”, in fact you only need to come up with a few universal sentences. Something like “Starting from Marxism, current economics is ultimately vulgar economics”, or “The economic model proposed in this book is very interesting, but I still have some doubts and concerns about its generalizability”, such as “A rational person is not a person after all, and I don’t think that the development of economics alone can equate the two in the end.” This kind of common and often new all-purpose golden sentence can be used to decorate the facade at any time. These are the Totally correct crap. In the end, you just need to control your expression, take a deep breath, and let it out slowly, pretending to be deep and tangled, and slowly say the following sentence: “This is the biggest crux of contemporary economics, and perhaps the whole of economics can’t provide anything. The answer.”
Congratulations, when you’ve got the hang of it, you can pretend you’ve read an economics book anytime, anywhere.
