How to stay calm when you know you'll be stressed

Several years ago, I found myself in a predicament where I had broken into my own house. It had been a freezing winter night in Montreal, and I had just returned home from visiting my friend across town. I was about to head to Europe the next morning, so I needed to grab my passport and suitcase. However, when I arrived home, I realized that I didn't have my keys with me. I tried all the other doors and windows, but they were locked tightly. I couldn't go back to my friend's house as I had an early flight, and I didn't want to wait for a locksmith to arrive. So, I resorted to breaking into my house through the basement window with a large rock. I cleared out the shards of glass, crawled through, and taped a piece of cardboard over the opening. The next morning, I had to rush to the airport, but I realized that I had forgotten my passport. I raced back home, got my passport, and rushed back to the airport. Unfortunately, I missed my flight, and I had to take the back seat of the plane for an eight-hour flight. That's when I started thinking about ways to prevent bad things from happening and minimize the damage if they do happen.

As a neuroscientist, I know that our brain releases cortisol under stress, which can cloud our thinking. I spoke with my colleague, Danny Kahneman, who introduced me to a concept called prospective hindsight, which is also known as the pre-mortem. In the post-mortem, we look ahead and try to anticipate all the things that could go wrong. Then we try to figure out what we can do to prevent those things from happening or minimize the damage. I want to talk about some things we can do in the form of a pre-mortem to prevent bad things from happening.

One of the things we can do is designate a place for things that are easily lost around the house. Our spatial memory is good at remembering the location of things that don't move around much. Designating a spot for keys, passports, and reading glasses can save us time and frustration. We can also take a cell phone picture of our credit card, driver's license, and passport and email them to ourselves so that we can facilitate replacement if they're lost or stolen.

When it comes to medical decision-making, we need to ask questions and get informed about the risks and benefits of a medical procedure. For instance, when a doctor prescribes a statin to lower our cholesterol, we need to ask for the number needed to treat (NNT). The NNT is the number of people who need to take a drug before one person is helped. For statins, the NNT is 300, which means 300 people have to take the drug for one person to be helped. We also need to ask about the side effects of the drug. For statins, the side effects occur in 5% of the patients, which means that 15 people are harmed for every one person helped. We need to remember that our brain releases cortisol under stress, which can cause us to make irrational decisions. We must think ahead and prepare for medical decision-making by discussing our options with our loved ones and healthcare providers.

In conclusion, we need to recognize that we're all flawed, and we're all going to fail at some point. However, we can think ahead and put systems in place that will help us minimize the damage or prevent bad things from happening in the first place. For instance, we can designate a spot for easily lost things, take pictures of important documents, and ask questions about medical procedures. By doing so, we can make better decisions and avoid unnecessary stress and frustration.