Comments about technological history, system fractures, and human resilience from James R. Chiles, the author of Inviting Disaster: Lessons from the Edge of Technology (HarperBusiness 2001; paperback 2002) and The God Machine: From Boomerangs to Black Hawks, the Story of the Helicopter (Random House, 2007, paperback 2008)

Thursday, March 19, 2020

Mistake-Maker's Club, CV-19 edition

In a 2018 post, "The Lecture I Never Gave," I laid out the concept of the Mistake-Maker's Club. I chose that blog title because, at the time, I thought I wouldn't be giving any more lectures. As it turned out I've given several more disaster-prevention talks since then, with the next keynote talk postponed due to the you-know-what pandemic.

The last couple of weeks have reminded me to remind readers of noting their mistakes right away, so as to avoid repeating them. The kind of mistakes I mean are the ones immediately obvious in retrospect. 

Why the reminder? We're all stressed and for many reasons; yanked this way and that by bad news and changing directives from all directions; worried about friends and family and healthcare workers on the front lines, worried about jobs and savings ... the list goes on. 

Already doctors, PAs, technicians, and nurses in the hard-hit areas are warning that they are working extremely long hours with CV-19 patients, and therefore at risk of infection all the time. We've been reading a lot about the importance of having enough ventilators in ICUs, but less has been said about the need for well rested staff, because their expertise and good judgment is essential in using such machines. Ventilators, as well as other life-sustaining machines like ECMO devices, can cause complications even in ordinary circumstances. 

My point is not to remind you of things to worry about, but just to say that the sleeplessness, fatigue, and daily distractions we're all experiencing make mistakes more likely.  Some mistakes are silly: the other morning I found I had unknowingly added an extra belt on top of the first belt on my pants; twice I missed a routine step in the coffee-making chore and ended up with coffee grounds and hot coffee on the counter.  

Many other mistakes might not be silly, like grabbing the wrong prescription bottle.

So ... check twice before doing something you might regret! 


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