Remember the Darwin Awards story about the poor guy who threw a lit stick of dynamite only to have his Labrador retriever go fetch it? Whether he’s mythical or not, I’ve always felt that we were too hard on him. Did he really do anything all that stupid? Throwing the dynamite seems smarter than holding onto it. Let anyone who hasn’t done something stupid step forward.
No fewer than 40 million of us Americans show up to an emergency room each year after doing something that, when reviewed on the instant replay, doesn’t seem like such a great idea. But before we start handing out Darwin Awards to the unlucky, we need to realize that these ER visits are a reflection of our collective attitudes toward everyday caution. Nobody wants to live a bubble-wrapped life, consumed by worry. We want to have some fun. And so we strike a balance. We accept those 40 million trips to the hospital as the cost of going about our business. But during a pandemic, our everyday risk-taking takes on a whole new weight.
Right now, our health care resources are stretched to their limit and beyond. That means that a common mishap might earn you more than a scar to show off and a good story to tell. Without a functioning health care system, an everyday injury could end your life. A pandemic is the time to start being a kind of careful that you’ve likely never considered before.
Let’s start with the tried-and-tested practice of standing on a chair to get something from a high shelf or cabinet, instead of going down to the basement or garage to get the ladder. In 2017 I wrote a book called Careful that, among other things, explicitly tells the reader to never, ever stand on a chair because of how unsafe it is. Yet somehow, years later, I’m still doing it. What’s the worst that could happen? One thing that happens thousands of times per year is that people fall and fracture a rib. I’ve broken a few ribs and they sure do hurt, especially when you laugh. But imagine showing up to an emergency room right now complaining of chest pain and difficulty breathing. Even worse is what’s called follow-up pneumonia. If you’re young, you’re looking at about a 10 percent chance of developing pneumonia after a rib fracture. That rises to about 35 percent once you hit age 65. Suddenly, standing on a chair seems as dangerous as naked motorcycling.
Now, maybe you got down off that chair safely, and you’re ready to chop some vegetables or attempt a far more risky stunt such as slicing a bagel. Kitchen knives alone account for roughly 400,000 ER visits each year, but there are plenty of other ways to cut yourself too. The numbers for all cuts and pierces come in at about 2.4 million per year, or almost 6 percent of all ER visits. Hatchets and axes: about 15,000 per year. Food processors: 21,000. Blenders: 10,000. Screwdrivers: 7,500.
It might be best to assume that everything in your house is trying to kill you. Imagine a wineglass that needs to be washed—it whispers to you, “Do you want a piece of me (sticking out of your palm)?” A drinking glass isn’t usually a sharp implement, but how many people show up to an ER each year after cutting themselves with one? About 50,000.
It isn’t practical to avoid touching sharp objects until the pandemic passes. Glasses need to be washed; vegetables need to be chopped. But you can approach things more carefully. When handling any implement capable of doing damage, be aware of the direction in which you’re pushing. Imagine a knife being pushed through a bagel, a carrot, or a cardboard box. Or a sponge being pushed against the inside of a wineglass. Now imagine that implement going farther or wider than you had planned. If you do, you’ll realize that your line of intended travel isn’t a line anymore: It becomes a cone of possibility. What’s in the cone zone? If it’s anything important, like your other hand or your leg or face, move it.
Now is a good time to realize that we humans commit more small errors than we notice or care to admit. When they happen, we tend to quietly pardon ourselves and just keep working. Listen to someone chop with a kitchen knife. It doesn’t take long for a break to occur in that rhythmic progression, which means that they at least committed a small slip. But next time, the slip could be bigger. It’s not a question of if—it’s a question of when and whether you are prepared for it.
A time of crisis is also a good time to realize that most of us suffer from a mental condition known as CRS (we Can’t Remember Shit). We all wildly overestimate our ability to remember things we need to do. And so we forget to blow out candles and then light our houses on fire (15,600 fires per year). We lose track of what’s cooking on our stovetops (172,100 fires per year).
Before attempting to do anything, do what we pilots are now trained to do. We say to ourselves: “Name three ways that this is going to go wrong for us know-it-alls with failing memories and the attention span of a gnat—who are being artificially kept alive by lukewarm coffee.” After that exercise, we pull out a checklist to make sure we haven’t missed anything, and then double-check one another’s work. So: Ask someone in your house to help you keep an eye on the stove. Set a timer on your phone to remind you to blow out a candle. Use backup plans to deny every small oversight the opportunity to develop into a full-blown disaster.
With 40 million injury-related emergency room visits per year, each of us is looking at a roughly 1 percent chance of requiring a visit each month. By exercising caution, you can lower your odds significantly. But you have to make an effort.
Our common sense hasn’t caught up with the world we have created for ourselves. Our ancestral instincts know about bears and floods and huge boulders rolling our way, but they don’t know the rules for calculating repeated small risks, and they don’t understand how the complex modern world can place the consequences of our actions far beyond our purview. So don’t dismiss the possibility of doing something disastrous as the private domain of the especially incompetent. Strange circumstances can lower the bar we need to leap over to win that Darwin Award. The last thing I want is for my tombstone to read: “Here lies Steve ‘Careful’ Casner. He survived the pandemic but he stood on a chair.”