This the third of three book reviews on the general topic of human fallibility. The first two were The Invisible Gorilla and Why We Make Mistakes. This book, Careful—A User’s Guide to Our Injury-Prone Minds was written by Steve Casner, a psychologist, technologist and helicopter pilot. His work is taking an interdisciplinary approach to injury prevention.
Careful
Life expectancy in the U.S. was 52 years in 1918.Then lots of safety measures were introduced, including driver training, OSHA, safety devices for cars and other machines, etc. By 1992, life expectancy had increased by almost 25 years. Then the improvement stopped.
More safety devices were introduced since 1992, but we also have more hazardous activities, such as driving while texting, etc. The author argues that we have come to the end of a really good run. The next safety improvement will need to come in our minds. We need to think about the risks we take and make up our minds to be more careful.
Our injury-prone minds are full of reasons for our vulnerabilities. The first half of the book is about these vulnerabilities.
Paying Attention
This is really about our inability to pay attention. It is hard to pay attention at all but paying attention to more than one thing is impossible. We can switch tasks, but it takes longer than we think. Talking on a cell phone and driving are two tasks and we can’t do them at the same time.
There are ways to do better. First, accept that we are poor at paying attention. We can take classes to improve. Second, don’t try to do two things at once. Third, get someone to help. If you have two things to do, get someone else to do one of them. Fourth, if you can’t get someone else to do one of the tasks, prioritize the tasks and/or postpone one task. Finally, learn to pay attention when it is really important.
Making Errors
Slips are mistakes doing something we’re very familiar with. We do them all the time. With a lot of practice, we develop automaticity. A skill becomes something that doesn’t require much conscious thought. Forgetting to do something in the future is called prospective memory. We are not good at this at all.
A mistake is when we execute well a bad idea, such as gambling or investing in a particular stock.
There are ways we can do better. First, accept that to err is human. Second, while we can never eliminate errors, we can reduce them. Reminders can help us remember things. This can be developing routines, electronic reminders, using checklists or forcing function. An example is putting your car keys on top of something you want to take with you.
Taking Risks
This part looks at a third vulnerability that leaves us open to unintentional injury—the way we think about risk. We end up in risky situation due to not understanding the real risk, thinking the risks don’t apply to us, being accepting of risk, emotional decision making, and group think.
Thinking Ahead
We often do things without much advanced thought. Psychologist Daniel Kahneman says we have two thinking systems. System 1 thinks fast. It uses intuition, snap judgments and effortless routines that we have developed over years. System 1 is our autopilot. System 2 thinks slowly. It is deliberative, contemplative and responsible. It doesn’t jump to conclusions. System 2 considers all the risks, alternatives and possible consequences. We love System 1 and use it every chance we get. System 1 is great for most of our activities.
About half way through the book, the author changes direction and the rest of the book is to be about how to stay out of trouble in real life.
Around the House
About 50 percent of all unintentional injuries and deaths happen while using tools inside our homes. The number of emergency room visits due to home accidents is staggering. The most common injuries are related to kitchen knives, pots and pans, food processors, blenders, washing machines, hammers, hatchets and axes, saws, screwdrivers and power tools. Falling off ladders is another common one. Many of these injuries are due to using the wrong tool for the job or using the right tool in the wrong way.
Watching Kids
This chapter is about keeping children safe. A lot of progress has been made in the last hundred years. Still, injury is a leading cause of death for children. We have child-proof pill bottles, car seats and lots of other safety devices. Still, suffocation is a common cause of death, usually this is related to something in their crib.
From Here to There
Travel, especially in cars is among the most dangerous part of our lives. Hurrying is a big cause. People drive faster and take more chances when they are late. Talking on the phone while driving is accepted, but even hands-free is dangerous. We’re not able to do two things at once. It is the mental involvement with the conversation that is the problem, not the hand holding the phone. Of course, younger people tend to text, which is far worse.
At Work
The safest place for us is at work. Office workers are rarely injured. Those in more dangerous situations are protected by institutionalized safety programs. There are OSHA rules, safety cultures and rigorous controls around most dangerous work environments. As a result, home and traveling between home and work are far more dangerous.
Getting Older
Cognitive decline is real but there is the opportunity to use aids, such as writing notes to ourselves or using Outlook to keep calendar reminders. Physical decline is real too, but the biggest danger comes from falls as we age. Here exercise programs can help. After age 75, falls become the leading cause of death. We can help by engineering our environment to make falls less likely.
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