The speaker recounts a frigid Montreal night when, locked out of his home, he smashed a basement window to retrieve his keys and passport—only to later forget his passport at the airport because stress‑induced cortisol clouded his thinking. From this experience he introduces the “pre‑mortem” (prospective hindsight) technique: imagining future failures ahead of time and putting simple systems in place to prevent or mitigate them. Examples include designating fixed spots for easily lost items (keys, passport, glasses), photographing important documents and storing them in the cloud, and, for medical decisions, asking for the number needed to treat (NNT) and side‑effect data so that risks and benefits can be weighed rationally before stress impairs judgment. The overarching message is that acknowledging our cognitive limits under stress lets us create habits and safeguards that reduce the likelihood of small mishaps turning into major catastrophes.
1. A few years ago I broke into my own house.
2. I had just driven home around midnight in the dead of Montreal winter.
3. The thermometer on the front porch read minus 40 degrees.
4. Minus 40 is where the Celsius and Fahrenheit scales meet.
5. It was very cold.
6. I stood on the front porch fumbling in my pockets and found I didn’t have my keys.
7. I could see my keys through the window, lying on the dining‑room table where I had left them.
8. I tried all other doors and windows; they were locked tight.
9. I thought about calling a locksmith and I had my cellphone.
10. At midnight a locksmith could take a while to arrive.
11. It was cold outside.
12. I couldn’t go back to Jeff’s house for the night because I had an early flight to Europe the next morning and needed my passport and suitcase.
13. Desperate and freezing, I found a large rock and broke through the basement window.
14. I cleared out the shards of glass.
15. I crawled through the window.
16. I found a piece of cardboard and taped it over the opening.
17. I planned to call my contractor in the morning to fix the window.
18. Repairing the window would be expensive, but probably no more than a middle‑of‑the‑night locksmith.
19. Under the circumstances I figured I was coming out even.
20. I am a neuroscientist by training.
21. Under stress the brain releases cortisol, which raises heart rate, modulates adrenaline, and clouds thinking.
22. The next morning I woke up with too little sleep, worrying about the window, a mental note to call the contractor, the cold, and upcoming Europe meetings.
23. With cortisol in my brain my thinking was cloudy, but I didn’t realize it was cloudy because my thinking was cloudy.
24. At the airport check‑in counter I realized I didn’t have my passport.
25. I raced home in snow and ice (≈40 minutes), got my passport, and raced back to the airport.
26. I made it just in time, but my seat had been given away.
27. I ended up in the back of the plane next to the bathrooms, in a non‑reclining seat, on an eight‑hour flight.
28. I had eight hours with no sleep to think.
29. I wondered what systems could prevent bad things or reduce the chance of catastrophe.
30. My thoughts didn’t crystallize until about a month later.
31. I was having dinner with my colleague Danny Kahneman, a Nobel Prize winner.
32. I told him about breaking the window and forgetting my passport.
33. Danny said he had been practicing prospective hindsight, also called the pre‑mortem, from psychologist Gary Klein.
34. In a pre‑mortem you look ahead, list what could go wrong, then decide how to prevent or minimize those problems.
35. Around the home, designate a specific place for items that are easily lost.
36. This is supported by science on how spatial memory works.
37. The hippocampus evolved to track locations of important things (e.g., water, food, tribes).
38. The hippocampus is enlarged in London taxicab drivers.
39. The hippocampus lets squirrels find their nuts.
40. An experiment showed squirrels could still find nuts after olfactory nerves were cut, using the hippocampus.
41. The hippocampus works well for stationary objects, not for moving ones.
42. This explains why we lose car keys, reading glasses, and passports.
43. In the home, put keys on a hook by the door or in a decorative bowl.
44. Keep your passport in a particular drawer.
45. Keep reading glasses on a particular table.
46. If you designate a spot and are scrupulous, your items will always be there when you look for them.
47. For travel, take a cell‑phone picture of credit cards, driver’s license, and passport, then email it to yourself (cloud storage).
48. If those items are lost or stolen, the pictures help you replace them.
49. Under stress the brain releases cortisol, which is toxic and causes cloudy thinking.
50. Part of the pre‑mortem practice is recognizing that stress impairs performance and putting systems in place beforehand.
51. One of the most stressful situations is making a medical decision for yourself or a loved one.
52. At some point everyone will face an important medical‑care decision.
53. A doctor might say your cholesterol is a little high.
54. High cholesterol is linked to increased risk of cardiovascular disease, heart attack, and stroke.
55. The doctor may suggest prescribing a statin to lower cholesterol.
56. Statins are among the most widely prescribed drugs worldwide.
57. You should ask for the number needed to treat (NNT).
58. NNT is the number of people who must take a drug or undergo a procedure before one person is helped.
59. GlaxoSmithKline estimates that 90 % of drugs work in only 30‑50 % of people.
60. For the most widely prescribed statin, the NNT is 300.
61. Three hundred people must take the statin for a year to prevent one heart attack, stroke, or other adverse event.
62. For this statin, side effects occur in about 5 % of patients.
63. Side effects include debilitating muscle and joint pain and gastrointestinal distress.
64. Five percent of 300 equals 15 people experiencing side effects.
65. Thus you are 15 times more likely to be harmed than helped by the drug.
66. Medical ethics requires informed consent; you have the right to this information.
67. For the most common surgery in men over 50 (prostate removal for cancer), the NNT is 49.
68. Side effects occur in 50 % of patients after this surgery.
69. Side effects include impotence, erectile dysfunction, urinary incontinence, rectal tearing, and fecal incontinence.
70. If you experience these side effects, they may last only a year or two.
71. The pre‑mortem encourages thinking ahead about questions to ask so you don’t have to reason on the spot.
72. You also want to consider quality of life when making decisions.
73. You may choose a shorter pain‑free life versus a longer life with possible pain at the end.
74. Discussing these trade‑offs now with family and loved ones is advisable.
75. You might change your mind in the moment, but prior practice helps.
76. During stress, cortisol release causes many body systems to shut down (e.g., digestion, libido, immunity).
77. This has an evolutionary basis: facing a predator, you don’t need those systems if you must react quickly.
78. Rational, logical thinking also diminishes under stress, as shown by Danny Kahneman and colleagues.
79. We should train ourselves to think ahead for stressful situations.
80. Recognizing that all of us are flawed and will fail sometimes helps us prepare.
81. The goal is to anticipate possible failures, put systems in place to reduce damage, or prevent problems altogether.
82. After returning from my trip, I had my contractor install a combination lock next to the door, with a key inside and an easy‑to‑remember combination.
83. I still have unsorted piles of mail and unread emails.
84. I am not completely organized, but I view organization as a gradual process and am improving.