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59. Aim To Be A Zero

What does your life have in common with that of an astronaut? A lot, it turns out. Dan Mccollum returns to Stimulus to break down the skills learned by International Space Station commander Chris Hadfield as explained in his autobiography An Astronaut's Guide to Life on Earth.



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Guest Bio: Dan Mccollum, MD is an emergency physician, associate professor, and associate residency director at the Medical College of Georgia. Hear more of Dan on Stimulus episodes #1 Verbal Judo #14 Stoic With A Capital S and #25 Digital Minimalism.

We Discuss:

The pitfalls of thinking too highly of yourself [1:46];

The importance of being a “plus one” and the wisdom of not proclaiming your plus-oneness. “If you’re really a plus one, people will notice” [2:23];

“Over the years, I’ve realized that in any new situation, whether it involves an elevator or a rocket ship, you will almost certainly be viewed in one of three ways. As a minus one: actively harmful, someone who creates problems. Or as a zero: your impact is neutral and doesn’t tip the balance one way or the other. Or you’ll be seen as a plus one: someone who actively adds value. Everyone wants to be a plus one, of course. But proclaiming your plus-oneness at the outset almost guarantees you’ll be perceived as a minus one, regardless of the skills you bring to the table or how you actually perform. This might seem self-evident, but it can’t be, because so many people do it. During the final selection round for each new class of NASA astronauts, for example, there’s always at least one individual who’s hell-bent on advertising him- or herself as a plus one. In fact, all the applicants who make it to the final 100 and are invited to come to Houston for a week have impressive qualifications and really are plus ones—in their own fields. But invariably, someone decides to take it a little further and behave like An Astronaut, one who already knows just about everything there is to know—the meaning of every acronym, the purpose of every valve on a spacesuit—and who just might be willing, if asked nicely, to go to Mars tomorrow. Sometimes the motivation is over-eagerness rather than arrogance, but the effect is the same.” ― Chris Hadfield, An Astronaut's Guide to Life on Earth



Aim to be a zero -- having neutral impact [5:08];

  • There's a lot of wisdom of just being part of a system, doing things right and not trying to be a superstar.

  • People who start as a plus zero are more open to learning.


“One benefit of aiming to be a zero: it’s an attainable goal. Plus, it’s often a good way to get to plus one. If you’re really observing and trying to learn rather than seeking to impress, you may actually get the chance to do something useful.” ― Chris Hadfield, An Astronaut's Guide to Life on Earth


What Mccollum looks for in EM residency applicants: people who treat the receptionist or program administrator well [8:00];

Why we should focus on the simple core things which are most likely to save lives, as opposed to shooting for the stars with cutting edge treatment [8:48];

How the weight and power of ego impairs our ability to learn and harms patients [11:04];

Sweat the small stuff [13:01];

“Looking on the dark side, sweating the small stuff, viewing your colleagues as the last people in the world, knowing the bold face and recognizing when to use it -- in the end, none of it may save you. But in a real crisis, what other hope have you got? The more you know and the keener your sense of operational awareness, the better equipped you are to fight against a bad outcome right to the very end.” ― Chris Hadfield, An Astronaut's Guide to Life on Earth



The quintessential nature of EM and how they’re similar to flight rules: solving complex problems rapidly with incomplete information [13:49];

  • We should be using checklists, particularly when we think we don’t have time for them.

“Flight rules are the hard earned body of knowledge recorded in manuals that list, step by step, what to do if X occurs, and why. Essentially, they are extremely detailed scenario-specific standard operating procedures.” ― Chris Hadfield, An Astronaut's Guide to Life on Earth

The fact that perfectionism and zero likelihood of failure is not part of the flight rules for anything [15:49];

  • Even when you follow all the rules, sometimes bad things happen. We need to expect that.

Why early success is a terrible teacher. If you’ve always been the star and never experienced failure, this can be a barrier to learning [18:27]

“Early success is a terrible teacher. You're essentially being rewarded for a lack of preparation, so when you find yourself in a situation where you must prepare, you can't do it. You don't know how. Even the most gifted person in the world will at some point during training cross a threshold where it's no longer possible to wing it.” ― Chris Hadfield, An Astronaut's Guide to Life on Earth

The Jocko Willink video, Good. When bad things happen and you get knocked down, “get up, dust off, reload, recalibrate, re-engage, and go out on the attack” [20:13];



How to behave when you're in a position of leadership [22:00];

  • Be careful with your words. Don’t ridicule. The small things we do or say can have a big impact.

“It was a happy day for me when that astronaut left the office, but in retrospect, I learned a lot from him. For example, that if you need to make a strong criticism, it’s a bad idea to lash out wildly; be surgical, pinpoint the problem rather than attack the person. Never ridicule a colleague, even with an offhand remark, no matter how tempting it is or how hilarious the laugh line. The more senior you are, the greater the impact your flippant comment will have. Don’t snap at the people who work with you. When you see red, count to 10.” ― Chris Hadfield, An Astronaut's Guide to Life on Earth

Expeditionary behavior, which is the willingness to endure hardships for the sake of the mission, and why whining poisons the pool [24:13];

  • The internal locus of control is really where we need to look when things aren't going our way.

Whining is the antithesis of expeditionary behavior, which is all about rallying the troops around a common goal.”― Chris Hadfield, An Astronaut's Guide to Life on Earth

“If you have a problem with everybody and if it seems like everybody gives you a hassle. Maybe everybody isn't the problem.” Christiaan Maurer

And more.


Shownotes by Melissa Orman, MD

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