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That Daily Shower Can Be a Killer (nytimes.com)
371 points by danso on Jan 31, 2013 | hide | past | web | favorite | 245 comments

A handy technique for evaluating situations is this: how many mistakes am I away from death/injury? If I drive without a seatbelt, I've put myself 1 accident away in many cases.

My Scouts are young, and love to climb things. I tell them, I know you're strong and skilled. But a loose rock or slippery foothold puts you at risk anyway. So wear the harness - now it takes two mistakes to kill you (e.g. loose rock + badly rigged harness). The risk goes down drastically.

So put some non-skid floor mat in your shower, or a chair as advised in this thread. The mis-step no longer carries the same risk.

Sometimes you hear things that instantly change your views on the world.

I have to say that this above post, in about 10 seconds of reading it, has completely changed my views on assessing risk.

The idea of quantifying risk by counting the number of mistakes you are away from catastrophic failure is an excellent way to visualize risk. It's a simple way to calculate risk, and an even easier way to teach my kids. Thank you.

There's a similarly great passage in 'The Great Gatsby':

It was on that same house party that we had a curious conversation about driving a car. It started because she passed so close to some workmen that our fender flicked a button on one man's coat.

"You're a rotten driver," I protested. "Either you ought to be more careful or you oughtn't to drive at all."

"I am careful."

"No, you're not."

"Well, other people are," she said lightly.

"What's that got to do with it?"

"They'll keep out of my way," she insisted. "It takes two to make an accident."

"Suppose you met somebody just as careless as yourself."

"I hope I never will," she answered. "I hate careless people. That's why I like you."

You have convinced me I should re-read that book. I was young and foolish the first time, and not looking to learn lessons.

As a classic it's usually taught to teenagers... but I think you need to be out of school (probably late 20's), having seen some of the rhythm and trajectory of adult relationships/careers, to appreciate the characters.

Is that from the original? There's a lot of 'e's in that passage.

I had heard about "Gadsby" first, so when high school friends told me they were reading "The Great Gatsby", I was quite confused about why their English class would assign a book most known for not using the letter 'e'.

Yes, The Great Gatsby, published 1925, by F. Scott Fitzgerald, not the later lipogrammatic Gadsby, 1939, by Ernest Vincent Wright.

I am skeptical.

I am one street crossing away from death. You are one car ride with a seat belt away from death.

You really need to have some rough probabilities attached to things for this to be reasonable.

He is talking about mitigating risk, not avoiding it.

His life expectancy was 90, but they never say that this number is also accounting for people that fall in the shower.. Right?

So everyones risk goes down slightly too.

It's a good way to design software too.

Are you an engineer? Redundancy is basic stuff for websites.

In the climbing example as presented, you should be at least three mistakes away from injury. The belayer should check the climber's harness and knots before allowing the climber to climb. Naturally the climber should check that the belayer's harness is fastened securely and that the belay device is rigged properly before climbing too.

Realistically, there are still several single points of failure in the system:

1) The space between the belayer's ears 2) the rope if it has become damaged since it was flaked and inspected or gets cut while catching a fall. Yes, that happened, though not to me [1]. 3) The protection on the wall, due to improper use. although depending on how high you are, the next piece down might still keep you off the deck. 4) The harness itself, although barring invisible damage this should be caught by the belayer/climber him/herself and the cross check. 5) The protection on the wall due to gear failure.

The above are listed in what I would consider descending probability, although 2 and 3 are pretty close, with 3 probably jumping 2 in trad climbing. I would rate the probability of 5 being negligible barring manufacturing defects, the prevention and possibly detection of which is probably outside the expertise of virtually all climbers.

Moral of the story: safety is complicated. (edited to add) I'd believe that trying to get people to apply a simple model of "how many mistakes" is better than none, but I wonder to what extent it reduces safety by making people complacent about having done a risk analysis when the system is too complicated to be analyzed that way.

[1] http://www.redriverclimbing.com/viewtopic.php?f=21&t=132...

Thanks, yes, our climbing staff at camp is skilled at teaching correct climbing technique. I use this example to help 10-yr-olds understand why they cannot climb a random rock face during a hike.

I didn't mean to suggest otherwise about the teaching of safety if that's how you read my comment. I think the model you're teaching to the 10-year-olds is both well suited to the audience, and gives them a tool to use to analyze other situations they find themselves in. Sorry if I got derailed a bit from that point while fleshing out the safety system involved in climbing and the risks therein for the non-climbers.

Now I just wish that some of the people I see climbing outside (and inside!) would think as much as you're asking the 10-year-olds to. If they did that much they'd be much safer, nevermind a fuller analysis of the system.

No offence taken; it was instructive to see the whole analysis. I may take that to a meeting and read it to the Troop if you don't mind?

You're certainly welcome to, so long as you don't scare them off climbing ;-)

I should also note that I am in no way professionally qualified to talk about safety in climbing, or risk analysis in general. I just like to climb, and prefer to do so safely.

No problem, I'll frame this as a 'Scoutmaster's Minute' where we talk philosophy and do Q&A. Give them something to think about as the go out the door.


Harnesses are redundant, too. About a year ago, I watched someone get half way up the wall and fall, only to have her harness come unbuckled. Fortunately, the leg loops kept her suspended and she just down-climbed and fixed her harness.

(Part of the problem in this case was not understanding how the mechanism worked, which is not a good idea when it's the mechanism that stops you from falling 30 feet onto the ground.)

I'm pretty sure it's climber error and mis-rigging by at least 10x.

Gear failures of all kinds are extremely rare.

Edit: objective hazard is significant, too: rockfall, afternoon thunderstorms, etc.

That would be pretty accurate, according to ANAM[1]. It's almost never due to equipment failure.


I'm not a very serious climber but have friends who really are. Apparently the lessons from reading this book: http://americanalpineclub.org/p/anam are that the vast majority of climbing deaths are due to one of two reasons:

1. Belaying off the end of your rope (Always tie a safety knot!)

2. Not wearing a helmet.

So, yes: climber error.

Lynn Hill: amazing profession climber. Mis-tied her knot (figure 8 with a follow - she forgot to finish the follow so it was useless) and fell 60 feet into trees to live and keep on climbing. Her advice at a talk a few years ago was "always tie a stopper knot". A stopper knot is an extra "useless" knot that takes seconds to tie and will secure your figure 8 if you threaded it wrong.

While climbing at the Gunks in NY about 8 years ago on a spring day, we heard this massive thunder a few hundred yards away. A small volkswagon sized boulder had broken free from the wall and fell smashing trees below. My friends were about 3 routes away from it when it fell.

Lynn Hill actually failed to tie any knot. She got distracted just as she was starting to tie in:


There's good and bad news on the figure 8 itself. The good news is that they're visually easy to check -- any screw up will make the knot look very different. The bad news is that they invert at relatively low loads. That's mitigated with a long tail.

However, I've never seen any evidence that those single fisherman's people tie in the tail actually do anything. The key is making sure the tail is long enough that the knot is still tied if it inverts.

That's crazy about the rockfall -- lucky you guys weren't standing underneath!

Thanks for the correction -- i was completely wrong! I heard the story 2nd hand from my friend who heard her talk at Rock and Snow in New Paltz.

I oversimplified my knots explanation so i wouldn't bore anyone. Isn't the fisherman's knot supposed to jam up the knot if you missed a loop of the figure 8?

Here is a story is about equipment failure.


There are also errors in judgment, but the gear is the center of this story.

The final paragraphs are still hard for me to read, six years on.

edit: adding National Park Service summaries


NPS Morning Report for October 26, 2006

  Yosemite National Park (CA)
  Noted Climber Falls To His Death
An experienced rock climber fell to his death this past Monday while climbing near Bridalveil Fall in Yosemite Valley.

Todd Skinner, 47, of Lander, Wyoming, was climbing a route on the Leaning Tower when he fell approximately 500 feet to his death. Skinner's climbing partner reported the fall at around 4 p.m.

Skinner was pronounced dead at the scene. He is survived by his wife and three children. The exact cause of death is under investigation.

[Submitted by Adrienne Freeman, Public Affairs]


NPS Morning Report for October 30, 2006

  Yosemite National Park (CA)
  Follow-up On Fatal Climbing Fall
On the afternoon of October 23rd, dispatch received a telephone call reporting a fatal climbing fall.

Jim Hewitt reported that he and his partner, well-known climber Todd Skinner, had been working on a first free ascent of the "Jesus Built My Hotrod" route on the overhanging west face of the Leaning Tower. Skinner's fall occurred when he was rappelling.

Hewitt told investigators that he had been above Skinner when he fell. As he was rappelling on the low-stretch ropes that they had fixed on the route, Hewitt came to Skinner's Grigri descent device on the rope at the point where he had fallen.

The Grigri had a still-locked carabiner attached which had been connected to Skinner's harness. When Skinner's body was recovered, the belay loop on his harness was missing.

The next day, rangers recovered a broken harness belay loop in vegetation at the base of the wall. It was very worn at the spot where the break had occurred.

Hewitt later told investigators that Skinner was aware that the belay loop on his harness was in a weakened condition prior to the climb, and that they had talked about its poor condition three days earlier. ... .

[Submitted by Keith Lober, Emergency Services Coordinator]

Did you know Todd Skinner? (I didn't except by reputation & his accomplishments). That was a tragic accident and definitely shook every climber I know.

I think it's the exception that proves the rule though. Word when it happened was he'd been cleaning loose rock on rap, and was not only wearing a blown-out harness (with a replacement on order at the time) but also apparently had a haul bag full of rocks clipped off to himself.

So -- if you are one of the world's most prolific climbers, use gear you have already decided to retire, and have an unusually high working load, you can maybe get your gear to fail. But it's still incredibly rare.

No, I did not know Todd, except by celebrity reputation. We climbed in different circles.

He was a widely known and well-regarded big wall guy who had freed gigantic routes in Pakistan, Greenland and the Yukon. I read his trip reports with awe. I would have felt out of place carrying his rack from the truck to a picnic table, much less talking climbing with him.

I had not heard that he was tidying up. He was also reputed to be very generous with his time and expertise. I find the idea of him carefully cleaning up a new route (while passing an increasing load through a frayed harness) almost intolerably painful to think about.

This is reminiscent of Benjamin Graham's "margin of safety" idea in investing. Get yourself in a position where you think the stock you want to buy is cheap and certainly worth buying. Then buy it if it only if it becomes even cheaper.

Put yourself in a position where you think you are unlikely to get hurt by a single mistake, and then insert an additional layer. So really it should be three :)

Reminds me of skydiving statistics. Something like 1 in 1000 chutes fail, so you pack two. The chance of both chutes failing is 1/1,000,000. Consider the fact that most skydiving accidents are due to human error and you can expect an accident roughly once every 100,000 jumps or more, which it turns out is pretty accurate.

That's a good metric. You can make it slightly more involved by not only counting mistakes, but also when those mistakes would have to occur.

For the climbing: The loose rock can occur while you are distracted. But you can tie up the harness at your leisure and with friends checking.

From a software development perspective, that's also why automated testing is better than manual testing. You can write the automated tests when you have time, and they will work even when you are under stress.

This is a bit of an aside, but I have to say this: even as a young person, take falls very seriously. I was 22 or so when I slipped in the shower. I was falling to the side and was going to hit my head, so I decided to twist so that I'd fall flat on my back, figuring I'd be fine. Well, I was, until a few hours later, when I started having chest pain and my left arm went numb and started getting shooting pains.

Thinking it was a heart attack, I went to the ER and was told I was fine, and it was probably just a pinched nerve from the fall. Three years later, the pain hasn't stopped -- the chest pain isn't so bad these days usually, but my left arm is almost continually numb and, well, the body doesn't really get used to the pins-and-needles feeling. If I had taken it more seriously, had a CT scan taken at the time, etc, it may have been caught early. Unfortunately, now that so much time has passed, doctors are at a loss as for what's going on.

I'm still finding new doctors and doing my own research into what's going on, but this process has been excruciating. So, please, if you have a fall: go to the doctor, and have them do a real examination immediately. When I went, they focused on my heart and didn't even so much as look at my neck or my shoulder; had I gone after the fall, they may have figured out what it was, and I wouldn't be in pain years later.

Hope this cautionary tale helps someone!

I some similar problems along with significant pain, also caused by falls (and a fairly serious injury that compounded things).

I had pain for years, until I stumbled onto a combination of things that completely resolve the issues as long as I stick to them.

I'm telling you in case they help. If nothing else it shouldn't hurt anything.

In order of importance:

1. Develop & maintain significant muscle mass, specifically in my upper & lower back. I'm not a huge musclehead by any stretch, but I can do 20+ pull-ups (not chin-ups) in a row and deadlift over 350 lbs. This had the biggest impact, and if I stop working out, the pain/symptoms come back. It literally took me years to get here, but is completely worth it to live pain/numb free. Health/aesthetics benefits are nice too.

2. Active Release Therapy - this broke up scar tissue that I had, may not be applicable to you.

3. Fish Oil Supplements - acts as a natural anti-inflammatory

4. Vitamin D/sunshine - Not sure if it's just because the sun & vitamin D makes me feel better overall, but I feel like it makes a small difference.

Edited to clean up paragraphs

Gaining strength / muscle mass and losing fat can help for many kinds of pain. My father had back pain for something like 20 years. He worked an office job and was 20-30 lbs overweight. After he started working out again, jogging on his lunch breaks, and lost the weight his back pain went away.

Word. I got hit by a car while biking 7 years ago and had all sorts of back problems afterwards. It wasn't like a sharp pain, but my back was always very tense and ache-y.

What has really helped me is doing handstand-pushups. You do a handstand against a wall, and then do a push up, lowering your head towards the floor. It really engages all the muscles in the shoulders/back. You'll probably start off by just doing a handstand and then go from there slowly. Once you are a bit more confident you can also arch your back away from the wall engaging muscles lower in your back.

Just like with any exercise, don't push yourself too much and make sure to keep proper form.

> Active Release Therapy - this broke up scar tissue that I had, may not be applicable to you

If this is comparable to the Graston technique, I think it works well, but it is far from comfortable. I had this after surgery for my Achilles rupture and it felt someone was carving my achilles out with a dull butter knife.

Yes, that's roughly what it feels like. Bruised the hell out of me. That said, it's reduced my neuropathy and pain by at least 90% - I had tennis elbow badly enough it was starting to affect sensation in my hands.

I highly recommend active release therapy to treat muscle and joint pain.

what a load of balls...

the average man should be light and active enough to do a few chin ups with ease and run for a while

i have deadlifted over 350. it did nothing for my chronic neck pain and in fact only made it worse by over developing my traps.

neckbeard lifting gurus are so full of shit

You responded to:

  | This worked for me, I'm going to tell you
  | because it might help you too.

  | what a load of balls...

  | neckbeard lifting gurus are so full of shit
Way to keep it classy.

This is really a case of 'your mileage may vary'. Some people's problems will be fixed by a bit of exercise, some won't. This is true whether or not you can pull 350 or 530, and/or do chins. As an old man by gym standards, I have both been broken and fixed by lifting weights, in different places.

The most treacherous thing about this is that lifting weights (with a good warmup) often makes pain go away in a temporary fashion (while you're doing it), only to return big-time when your joints aren't all nicely lubed up.

Aside from the troll content here, you do have to be careful if you have e.g. spinal issues. Nerve damage can make even light exercise excruciating. I had to build back up carefully, never hyperextending, always keeping good posture, using light or (usually) no weight, focusing on weakened muscle groups, and never going to exhaustion, all of which is rather boring but was completely necessary. I do find that regular exercise helps with my neck and back pain, but it is certainly not a cure-all, and I worked out regularly before the pain started and definitely cannot do that type of workout any more. I've put back on about 15 pounds of muscle mass, but it's taken over a year of diligent work. On the plus side, my muscle tone is much better than it ever was from previous workout routines.

Hi, do you mind crawling back under this rock I'm holding up for you? It's at least 350lbs so is getting kind of heavy.

Do you even lift?

It does not even have to go that far: I was 26 when I was having a silly argument with my SO, and I tripped over while putting trousers on and fell forward. I had the bad reflex of putting my hands in front of me, but not fast enough so that my hands folded backwards, damaging wrist ligaments and cartilage.

Immediately examined by a doctor and a number of x-ray shots done, one of my left arm bone was slightly fractured which I was told will heal jsut fine, but cartilage had suffered permanent damage, that will only get worse with time. I had the habit to do regular Aikibudo wrist exercising (it helps prevent RSI), and this helps a lot in maintaining a status quo by strengthening ligaments and muscles, thus protecting the joint itself.

While I'm usually not in pain, I happen to be at seemingly random times, and I know what is the cause and that it will only get worse with time (it already does and I'm only 0x20)

You think that's bad? My sister broke her forearm in half, both bones, by tripping over her own leg (while getting ready to do a floor exercise at a gymnastics competition, that's the ironic part).

Seriously though, you should never fall straight on your arms. They're just there as a quick cushion before you do a roll over your shoulders. Learned that viable lesson spending my teenage years racing bikes down hills in the forest.

Has saved me multiple times, once in a head-on collision with a motorcycle. (I was on a mountain bike)

I have never had a broken bone in my life.

Sounds like a herniated disc in your neck. Given the time frame it seems stable -- but the only way to fix it is probably years of difficult physiotherapy or surgery (and then physiotherapy).

My theory when I started seeing a spinal surgeon was a herniated disc at the C8 root. But an MRI ( http://demoseen.com/mri/ if you'd like to see the imagery) didn't show anything of the sort. At this point, it's looking likely to be either Thoracic Outlet Syndrome or another injury to the nerves there.

I fell on my tailbone delivering papers in the icy winters of Canada when I was about 10 years old. My tailbone still occasionally acts up 17 years later.

I suspect whiplash from the fall caused trigger points in your neck and shoulders. I've had similar issues caused by RSI and stress. I highly recommend giving this book a try:


I will assume you tried chiropractor, acupuncture, and perhaps even yoga?

And pixie dust and sugar pills and wishes.

Do not dismiss other techniques so easily. The human body is a very complex mechanism and we still don't know exactly how it works. Modern medicine has been based only on the knowledge that we have: which is thus quite limited.

I'm not saying that they will work. But acupuncture and yoga are not the same as pixie dust, dung pills or what have you.

To give an example of what I mean: the waters of the Ganges were said to have "magical powers that cured disease"[0]. It was later found that the waters contained bacteriophages that killed bacteria. Could anyone have guessed this?


>But acupuncture and yoga are not the same as pixie dust, dung pills or what have you.

Okay, so why don't they show any efficacy above pixie dust in double-blinded studies?

Don't forget that pixie dust (or a saline injection) can actually be fairly effective. https://en.wikipedia.org/wiki/Placebo_effect#Pain

Do you have a cite for this? And efficacy in what? They are not medicines, they are lifestyles (just like lifting or diet as another commenter mentioned)

Unfortunately, double blind studies of acupuncture are impossible (the person doing it must know if they're putting needles in), and single blind studies are almost impossible (the patient can feel the needles, and tell how far in they are). The only thing than can be tested is the traditional Chinese medicine chi flow idea, and even assuming there's no chi flow along meridians, that doesn't mean the special locations it tries to explain aren't valid for some other reason. But it can't be tested.

It's all deeply frustrating. I tried acupuncture a few years ago (at a doctor's recommendation) and did a lot of reading. It didn't work for me, unsurprisingly - about the only thing it's been shown to have any effect for is some types of lower back pain, and my pain was (is) mostly in my hands.

The theory of acupuncture places rules and requirements on how the needles are placed. You can of course stick needles in wherever you want but that is not acupuncture in the same way that cracking my own neck is not chiropracy and cutting myself with a knife is not surgery. Any study that just says random needle sticking might work (in addition to being flawed due to the issues you've laid out) is not really any more compelling than a study that concludes "cracking your neck feels good".

Therefore single-blind studies of acupuncture are trivial; just find people who don't know where the needles are supposed to go. A double-blind study could be possible, if you trained two sets of people to perform the procedure (one incorrectly).

Yes, the locations can be and have been tested. The needle action itself is what can't be properly tested, though there have been plenty of attempts with various types of sham needle, etc. I'm not trying to claim it doesn't or can't work (since I don't know), just that it's frustratingly difficult to research important bits of it.

You can compare to to deeper (in safe) or shallower insertions, and not tell the patient which is official acupuncture. You can apply anesthetic s first. These give clues.

> Unfortunately, double blind studies of acupuncture are impossible

It doesn't seem completely impossible. You could have someone put the same needles in randomly, instead of in whatever location acupuncture claims they should be put in.

That would be single blind (edit: actually, now I see what you mean, double WRT location), but yes, the locations can be tested - and they have been. The needle action itself is what can't be properly tested.

No it has been tested. It's only placebo.

Yeah I actually agree with that in theory because the needles would be mimicking the same side effect, the sensation of needle in skin, to a good effect.

There are double-blind studies on acupuncture, by using "trick-needles" that don't penetrate the skin but look like they do.

This study introduces them and shows that acupuncturists can't well distinguish both types: https://www.biomedcentral.com/1472-6882/7/31

This study uses them to check for differences in pain-relief (there are no differences): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2765771/

Yoga, perhaps, but it's on par with other low impact physical activity and stretching. The other two are just pseudoscience.

Have you had acupuncture and/or chiropractor? They at minimum can give relief.

Stooge: "Thanks 'Dr' that feels slightly better."

Chiropractor: "Great! Now let's just get you scheduled for three appointments a week for the rest of your life."

Yes, you have to deal with the underlying problems - if there are any that can be dealt with, to get your alignment back in place, etc..

Chiropractic is often very effective for manipulating bones and muscles into a correct alignment.

While there is a part of chiropractic that is, imo, alchemy, don't disregard the rest.

I've actually been to a chiropractor, as a sort of desperate measure once when I had really horrible back pain, could barely stand straight etc—exactly the sort of thing you'd think chiropractic would be perfectly suited for. I was skeptical about chiropractors, given their reputation, but I figured it couldn't hurt to try (er, probably... :).

The chiropractor I went to was in a fairly wealthy neighborhood, had a nice office, and seemed "respectable." However, once he actually started, it very quickly became clear he hadn't the faintest clue what he was doing, didn't care much, and was just going through some very simplistic motions. He not only failed to have any effect on my problem, but he was singularly ineffective in even trying to track down the issue. It was a very different experience from a normal doctor: almost every real doctor, even when completely confused and out of his depth, at least has clear techniques for probing and trying to figure out what's up or at least figure out the next step to take or who to ask—and they will very freely refer you to someone else if that's called for. This chiropractor: nothing. Zero. Nada.

After 30 minutes of painfully obvious hand waving, he then said "ok, well I guess you'd better schedule another appointment." I then went out into his waiting room, and heard another patient chatting with the secretary, and it became clear this patient was a "regular."

It seemed fairly obvious that the whole scam was to get patients on the appointment treadmill, offering promises, but no relief, continually dangling in front of them the hope that "next time" things would get better...

Maybe not every chiropractor is this way, but my experience perfectly matched their generally poor reputation, so I suspect it's more common than not.

[I didn't schedule another appointment... :]

Hunh. I've been to a variety of chiropractors. In general, they have usually yanked my body into position. Usually they have a mechanism of analysis and then cracking the body based on that. There are hokums out there, that is for sure. I hope that next time your back is tweaked you can find a competent one.

There's also a very significant risk of injury involved with chiropractic procedures, especially when spinal injuries are involved.

No, it's not. Reasearch shows chiropratic is, at best, approximately equal to physical therapy for your back but with a much higher risk of injury. Your spine doesn't get out of alignment as they claim.

My mom, a registered nurse, performed acupuncture on my dad for pain relief for a while when I was younger. It seemed to work fine.

Sugar pills can seem to work as well. Hell, dancing around while shaking a bag full of broken glass, pretty rocks, and bottle caps while chanting the names of you ancestors can seem to work fine.

If the placebo effect is stimulated, then its stimulated. Why knock the stimulant?

> dancing around while shaking a bag full of broken glass

Depends what happens next.

do you have any case studies / articles to back this up? i had fairly bad scoliosis when i was younger which was corrected by chiropractic, and i got back every few months for a bit of preventative maintenance. i'd honestly like to see if it's justified or if i'm just waisting my 20 dollars...

You could skip a month and see what happens.

After a snowboarding accident I was left with a knee that I couldn't run on. I saw physios for 2 years and saw no improvement. 2 months of osteopathy(twice a week) and yoga(3 classes + 20 minutes at home on the other days per week) and I was good to go, running, snowboarding, the works. I find I still need to do some yoga every now and again(maybe once or twice a month) but apart from that it's forgotten.

In the derivatives world, there's a saying for trying to bet against highly unlikely events with catastrophic risk for small gains: "picking up nickels in front of a steamroller." The issue is when you pick up enough nickels and watch for the steamrollers vigilantly first few times, you grow complacent and think that you are the master of nickel pickers and steamrollers are slow mofo's. You try to pick more nickels and linger longer in front of incoming steamrollers.

See debacle of Long Term Capital Management. Options trader take profit/loss as soon as a humble target is hit. It's as in life, the biggest loss is the complete loss of your physical capital which takes you out permanently of the game. Gamblers focus on the potential profits and get high on how their luck evaded fate in one nick of time, traders focus on preservation of capital.

I think LTCM's problem was more that they picked up all the nickels in front of steamrollers.

But it looked like there were some more nickels out in the middle of an 8-lane freeway...

Gutfreund to John Merriweather (LTCM's founder) "One hand, one million dollars, no tears."

To which Merriweather replied "if we’re going to play for those kind of numbers, I’d rather play for real money. Ten million dollars. No tears."

Gutfreund declined. In fact, he smiled his own brand of forced smile and said, “You’re crazy.”

No, thought Meriwether, just very, very good."


The CDC has keeps statistics on how people in the USA die http://www.cdc.gov/nchs/fastats/lcod.htm

Looking at the 2011 prelims "Accidents (unintentional injuries)" comes in at #5 with 122,777 deaths and Intentional self-harm (suicide) is at #10 with 38,285. Assault (homicide) is no longer in the top 15.

Also, Assault (homicide) by discharge of firearms is 11,101 with all other Assault (homicide) totaling 4,852. To give some context to the Assault (homicide) numbers, "Accidental poisoning and exposure to noxious substances" totals 33,554 deaths or about 3x the Assault (homicide) firearm number or 2x the total.

Looking at the stats and what kills us, we spend a lot of time looking at the stuff that is actually going down versus the stuff that is increasing.

It's important to remember that causes of death are often also activities which carry utility and even outright life-saving capability.

Accidental poisoning, for example, is often due to exposure to cleaning chemicals and drugs which have massively reduced illnesses and deaths. Spending more to make them less accessible may actually be self-defeating, in that it could well cause more deaths than it prevents, by making it harder to get and use those things for their intended purpose.

Further, many of the more prominent killers in society have already been the subject of safety campaigns. Cars are massively safer today than they were in the 70s and earlier, as a direct result of safety research and societal effort. As returns on such efforts have been diminishing for some time, the next dollar of safety research or societal effort is quite likely to impact more net lives when directed at a "lesser" killer that hasn't been the subject of as much study.

One must keep those two considerations in mind, when making judgements about whether we're spending an undue amount of time and money on a given threat.

Simply looking at a stack-rank of 'killers' isn't enough.

Simply look at one line of data on anything isn't enough, but it isn't a bad place to start looking at what our actual risks are to see what the numbers on that risk are. Using that as a guide for the first things you should be concerned with helps quite a lot.

Looking at the auto stats http://en.wikipedia.org/wiki/List_of_motor_vehicle_deaths_in... I am not sure I would say massive.

But today, we are surrounded by "incident news" without looking at the trend lines. "Incident news" does not look at daily problems as its just noise and not headline friendly. It doesn't have a story narrative.

Risk vs reward is always going to matter. We watch TV and see "gun control" as the story. The long term trend lines for guns are more now than ever, more concealed carry, and less deaths.

From 25 per 100,000 to 10 per 100,000 is not a massive change? Or, using the more appropriate rate -- fatalities per hundred million vehicle miles traveled -- dropping from ~7 in the 1950s to ~1 today?

Again, the stack rank isn't a bad place to start if you have no other context. But we do. We're well past that point. We all know the NTSB, Auto Companies, Insurance Companies, et al have been hammering on car safety for decades now, have been advancing auto safety about as fast as society will allow and are always conducting newer/better research.

So it remains ill-advised to use that rate (or similar well-studied risks) as some sort of reference point when considering whether a smaller risk is getting outsize attention.

> "The long term trend lines for guns are more now than ever, more concealed carry, and less deaths."

In the 70s, when it became an issue (due in large part to media crusading and 'incident news'), the long-term trends for auto fatalities were also on a downward slope from the highs of the 40s and 50s. Yet, as it turns out, we could still actually do better by allowing research into the issue and taking common-sense precautions.

Similarly with the long term trends around smoking rates, when we finally deigned to allow smoking/cancer/cessation research.

Similarly was Airplane travel, even with a bump from terrorism, the safest way to get from A to B. Yet it remains a good thing that we studied the terrorism 'problem', despite its low risk, and changed air crew procedure and hardened cockpit doors.

And the TSA stuff is nonsense, but it was and remains nonsense precisely because it's not being studied and considered in a sober cost/benefit analysis.

What remains notable about the gun debate in the US, is that we're not arguing about "what to do" so much as arguing about whether to study the problem.

Look at how the trial balloon for the "whether we should study the problem" effort only has some sliver of a chance to succeed, because it's being first aimed at a scapegoat (violent video games). It's not even a direct study of the self-evident real problem (gang violence) or its equally-obvious underlying cause (the war on some people's use of some drugs).

I was looking at fatalities per miles traveled (given that is the measure of how much we use cars). It seems the trend line was dropping pretty nicely before the 70's, so I am not sure how much all the safety requirements have actually changed things. Seat belts and air bags might account for the delta from the 70's, but I am not sure it isn't the same reasons we see a reduction from the 30s. Looking at what happened after a change is good, but it needs to be in the context of what was happening before.

> What remains notable about the gun debate in the US, is that we're not arguing about "what to do" so much as arguing about whether to study the problem.

You must be watching some other debate, I consider new legislation being introduced "what to do".

> "I am not sure how much all the safety requirements have actually changed things"

Well, absent digging into details that neither of us have, that's going to come down to a philosophical position: do you think that trends will continue indefinitely in the absence of any additional efforts to sustain them?

> "You must be watching some other debate, I consider new legislation being introduced "what to do"."

I'm watching the debate where practical political reality says every legislative proposal, other than "study the problem", is trivially DOA due the lobbying power of the NRA and Congress' makeup and existing obstructionist strategy.

This thread is how I wish all discussions were on this site. Disagreement that is just polite enough, tons of facts on both sides, both sides with reasonable opinions founded in reality. Thanks roc and protomyth.

sorry for the late response

> Well, absent digging into details that neither of us have, that's going to come down to a philosophical position: do you think that trends will continue indefinitely in the absence of any additional efforts to sustain them?

I would expect continued downward trend, but it cannot go down indefinitely (limit on flukes). I expect a upswing in the first couple of years of automated vehicles just because new realities tend to make for bad times (see the 1930's) then another sharp downward trend.

> I'm watching the debate where practical political reality says every legislative proposal, other than "study the problem", is trivially DOA due the lobbying power of the NRA and Congress' makeup and existing obstructionist strategy.

Just as I hope the EFF and ACLU will be obstructionist in defending some of the other amendments. The NRA is not powerful by itself. It is powerful because of the number of members. I dearly wish we had an NRA for the 5th amendment, but it seems we are getting beat there very badly. I would say the Senate has been more obstructionist due to their failure at passing a budget. They should remember which house is supposed to be preeminent in that regard.

In 2010 most deaths by firearm were suicides [19,392]. There were 11,000+ homicides by firearm. And 412 deaths from legal intervention by any means.

In other words, the person you are most likely to kill with a gun is yourself.

I imagine, also, that if one intends to kill oneself, having a gun or not is not a serious impediment to suicide.

Research suggests that more guns = more suicides.

"The preponderance of current evidence indicates that gun availability is a risk factor for youth suicide in the United States. The evidence that gun availability increases the suicide rates of adults is credible, but is currently less compelling."


I might try to get my hands on that study, as we had some trainers in the past using previous studies by the same group that didn't correspond to state stats at the time, but I'd like to point out two things about their studies:

1) Their gun in self defense studies http://www.hsph.harvard.edu/hicrc/firearms-research/gun-thre... have stats that do not match the US Dept of Justice

2) I would love to get ahold of the full study for #13 "The public does not understand the importance of method availability." because it would explain their base beliefs on a lot of the rest of the page.

I can't read the study, but lots of cultures in the US attach stigma to suicide(weakness) and to gun accidents(stupidity). Families in these cultures sometimes feel that they share the blame for not properly securing the firearm or not effectively mitigating the suicidal ideations of a depressed family member.

Consider a family with a youth who accidentally shot themselves. Rather than state that it was an accident, the family tells authorities that it was a "suicide".

Consider a family with an adult that chooses to commit suicide. Rather than state that it was a suicide, the family tells the authorities that it was an "accident".

Suicides misreported as accidents; accidents misreported as suicides. If both happen equally often, they'll cancel each other out.

Is there a good reason to believe that one of these effects is stronger than the other?

>>>Is there a good reason to believe that one of these effects is stronger than the other?

That's a great statistical question! If the data skew was proportionally equal in both directions, the two skews would cancel each other out, right?

Unfortunately, we don't know if the data skews towards accidents, or skews towards suicides, or skews towards them both equally. Here is the snarky one-liner answer to your question:

>>>Is there a good reason to believe that one of these effects is not stronger than the other?

> Looking at the stats and what kills us, we spend a lot of time looking at the stuff that is actually going down versus the stuff that is increasing.

We need to be careful: maybe things that are going down are going down because of how much time we have spent looking at them.

Possible in some things. They do make a special not on HIV in the paper that should not be ignored.

On guns, we have more than we had before, so the liberalization (old school meaning) of gun laws has not increased any gun related violence. On the other hand, we spend a lot on educating the public on proper eating. I get the feeling our approach isn't correct given the changes, but I would have to look up some study data.

I don't deny for a moment that Americans (and indeed, people everywhere) worry about the wrong things. We are biased in a number of ways to pay more attention to risks based more on the availability heuristic than any realistic assessment of what is more likely to happen.

It’s also important to remember that the total rate of death is constant at 1 death/person. Some death types going down will automatically result in others going up, so an increase or decrease in one type might not necessarily mean that the risk has changed.

I guess the goal is to reduce the deaths we can do something about.

Or weight the stats by age or health death. Old people dying of cancer is better than young people dying in car crashes.

Strangely not mentioned at all, so I'll put it here: Jared Diamond is the author of Guns, Germs and Steel, his most famous work. It addresses the question of how and why European societies were able to advance themselves so much farther ahead of all other civilizations. There is also an excellent four-part series streaming on Netflix.

Guns, Germs, and Steel was most certainly not about "how and why European societies were able to advance themselves so much farther ahead of all other civilizations". The concept of "advanced", or being "ahead of" is inapplicable. It's a book about sociocultural evolution.

Additionally, Diamond is pretty ambivalent about the "winners". Diamond wrote an essay on the subject of agriculture called "The Worst Mistake in the History of the Human Race". He closes the essay with "As our second midnight approaches, will the plight of famine-stricken peasants gradually spread to engulf us all? Or will we somehow achieve those seductive blessings that we imagine behind agriculture's glittering facade, and that have so far eluded us?"


No. I'm pretty sure it was about why and how European civilizations were able to conquer technology and the world, and specifically why many of the developments critical to the rise of European supremacy are not found in other societies. Yes, the judgments made in the book tend to be more fact-based and objective, e.g., a gun is more effective than a spear.

It is not a screed extolling the virtues of European civilization, nor a litany of the failings of other people. Sorry if that's how you understood my brief.

Gotta love HN-contrarianism. Oh have you also heard of Jared Diamond and would now like that knowledge recognized by pedantically contradicting me?

EDIT: actually let me update this. It is about sociocultural evolution. However if I had said "he wrote a book about sociocultural evolution," nobody would have understood the primary emphasis of his work. That book is specifically and primarily about identifying the key developments in Europe which allowed that civilization to rise in power. He has spent many years living among primitive societies around the world to explore his hypotheses. As much as possible, concepts like "primitive" and "advanced" are objective qualifiers and not value judgments.

When I say it that way, people understand what it's about and want to read the book.

In my opinion, the book is about 1) How geographical location and natural factors (accidental agriculture etc.) resulted in some part of the humanity accumulate certain knowledge that helped accelerate them over others 2) Advancement of certain civilization is not a necessary indication they are better, smarter, more hard working, but an indication of accumulated knowledge resulting from #1 over a long period of time 3) #2 culminated in Europeans dominating the world over the better part of last 500 years

I've read the book and feel your brief is more accurate, but less useful. The shorter one is close enough and many more people will read and grok a short one.

> When I say it that way, people understand what it's about and want to read the book.

Exactly. All pedants do is push people to hedge, equivocate, and employ dense jargon to throw them off the scent, and where's the help to the rest of us in that?

>hedge, equivocate, and employ dense jargon


Having a vocabulary that includes the word "equivocate" is distinct from using jargon (specific to a technical field, e.g. chemistry)

Come on - when used with hedge and employ, it's dense jargon. And now you're being pedantic.

Its not jargon, he gave you the definition.

Haven't read Guns, Germs and Steel myself, but "why and how European civilizations were able to conquer technology and the world, and specifically why many of the developments critical to the rise of European supremacy are not found in other societies" sounds like a description of "Civilisation" by Niall Ferguson.


(Niall Ferguson is pretty outspoken politically too, e.g. http://www.theatlantic.com/business/archive/2012/08/a-full-f...


Ferguson is someone whose contemporary political writings have really pissed me off, but his longer-view historical works (I've read The Ascent of Money but not yet Civilisation) are fairly insightful.

Yeah I've read The Ascent of Money too, it was great. You'll enjoy Civilisation.

Although after learning of his political views(I don't live in the US), I couldn't help but wonder how much it influenced his views in Civilisation. It comes off as a bit overly biased in favour of Europeans (read: the white man) when seen in this new light. For example, he tries to argue that church attendance being down is a sign that European influence/culture is declining.

It's been a while since I read it, but it think it would be more about why one "tribe" developed guns and the other didn't. (Minor nitpicking by someone who also heard of Jared Diamond).

I'm in the middle of the book right now, the author goes to great pains to point out that there is no value judgment being passed on what is better, who is more advanced (in the moral, judgmental sense), or who is right.

But at the end of the day, it is a study of how some parts of the world - particularly Europe - came to technologically, and subsequently politically/economically dominate everyone else. I don't think this is an unfair thing to say, and it implies no Euro- or Amero-centrism.

I didn't disagree with that. I just wanted to point out that his reasoning is much more subtle than just "they had guns and the others only spears". That is exactly the point of the book, because the usual explanation people come up with is "they were too stupid to invent guns". The book explains how intelligence had nothing to do with it.

Yes, I think I could have placed more emphasis on the fact that his primary hypothesis is that the conditions sufficient for technological advancement were present in Europe and the Middle East. But absolutely not that there were innate deficiencies in the people who did not benefit from those conditions. He's showing that most of history has been the result of a geographical lottery.

Jared Diamond is a very sensitive and empathetic man, and that really comes through if you watch the TV series by the same name. His work is not at all promoting Euro-centric supremacy as a race or culture, merely explaining a set of historical circumstances.

Yeah it was more about why native Americans didn't invade Europe in 1492.

I think Collapse is better than Guns, Germs and Steel. It is about the end of isolated settlements, and the path which lead them to their demise.

And I think it should be mentioned that Guns, Germs and Steel is rather extreme in suggesting an 'geological determinism.' [1] While his arguments are generally quite good, there is simply quite a bit more happening. A nice book to balance this is Ian Morris, Why the West Rules--For Now.

[1] Jarred Diamond actually warns of this determinism fallacy, but the book certainly left me with the impression that such a determinism exists.

GGS is the kind of book that makes academics despair [1]. I remember a Geography lecturer once relating how Diamond had been given honorary membership of some geographical society or other, and was giving an acceptance talk. It was a cause of supreme embarrassment for most of the people in the room; Diamond didn't seem to realise that he was addressing many senior academics who had spent most of their careers exploring why his ideas are unsound.

[1] http://onlinelibrary.wiley.com/doi/10.1111/j.1475-4959.2008.... (paywall)

Do you have any specific criticisms in mind? That abstract implies that the paper doesn't actually argue with anything in GGS itself. Rather, "environmental determinism" sounds like it's a dirty word in their niche of academia, and they need to yell at GGS because it might be contaminated.

One way to phrase the distinction is that no one really expects huge empires in Antarctica, so everyone admits there's some role to the environment. GGS talks about more complicated effects that the environment has, without saying anything about the outcome being deterministic. It argues that the odds were somewhat higher of Europe invading North America than vice-versa, and doesn't even try to quantify by how much.

With the disclaimer that I've watched the documentary and haven't read the book, the reasoning seemed faulty and unsound to me. It was definitely too deterministic and did not really go into non-environmental factors. For example, it boiled down the state of development of Papua New Guinea civilizations to the primary source of starch being palm trees vs grains, or something to that effect. It feels like picking one contributing factor and focusing on it at the expense of everything else.

I didn't see the documentary, but the book does build a single case, but it's mostly saying "please consider the many, many complex effects of the environment" rather than "don't consider other things."

I thought Diamond's comparison of Europe and China was especially weak. He wrote it off as that China had an emperor, and thus a single point of failure. He didn't do enough to explain why Europe did not become an empire, or to explain why China's immense bureaucracy did not avoid such a single point of failure.

I remembered he did explain why Europe failed to become a united empire - geography.

According to the book, the reason China has a large stable empire was because of China's geography, which was mostly flat and well-connected by the Yangtze and the Yellow river. With few geographical segments, this led to the people being less likely to form 'tribes' and more likely to be united culturally.

This is in contrast to Europe, which has a large impassible mountain range in the middle, and lots of peninsulas and small rivers, forming natural boundaries. This led to Europe being more diverse culturally.

But Europe has at one point been a united empire. Doesn't that imply that pure geography is not the cause?

Geography is the reason why Europe did not remain united long.

I think the reason Diamond's books are so popular and influencial is because academics do a poor job of relating to the public the consequences of their discoveries. By building on the latest scientific findings and filling in some gaps with speculative theories Diamond is able to astound readers with insights that the general public rarely hears. Even if the theories aren't the most accepted by academics the fact that the ideas are being discussed in a publicly digestible way is beneficial.

Btw, I noticed that Diamond has another book out, for all of you who are interested in his work.

Yep. This is why every dollar spent on the TSA would be better spent on preventing car accidents, heart attacks, and falls in the shower.


But I like the OP's more practical point: personal attention to normal activities that are actually risky, based on a realistic view of those risks.

Especially since the TSA actually accomplishes almost nothing in preventing deaths. All a terrorist about to be discovered at the airport security gate would have to do to complete his deadly mission would be to detonate his bomb right then and there. It would cause people to fear airports and security gates and mess up the whole system. Terrorism is all about sowing fear that the government can't protect you. The TSA just shifts some of the risk from the airplane to the airport. You can't security check everything in life. Better to figure out why people want to detonate bombs in the first place and solve that problem. But symbolic solutions are so much easier.

Worse than that, the TSA nonsense encourages a non-trivial population to drive when they would have flown. Driving being far less safe, it's probable that Security Theatre has a body count.

The body count has been tallied quite a number of times over the last several years. Here's a search I just ran that gives a couple: https://www.google.com/search?q=tsa+drive+rather+than+fly+de...

Ironically, the fact that there haven't been any big successful airline-related terrorist attacks in the US for a long time is evidence that the TSA is useless, because of what you point out, despite the tendency for certain groups of clueless people to claim the opposite.

There are a couple of more parts to that story that help to make it more persuasive.

1) Zero succesful airline attacks

2) Zero convictions for attempted terrorism of anyone detained by the TSA

3) Zero civilians killed in any form of (islamic extremist) terrorist attack on US soil in the last decade or so (all the way back to 9/12 if you don't count the borderline case of John Malvo).

The point being that not only is the TSA not stopping attacks on airplanes, it is also not doing such a good job that it would redirect those attacks to other targets.

Well, the obvious "other target" would be the security lines, so I think it already makes that point. But of course more point-making is better.

Of course people interested in increasing government control over the population love security checks and any excuse to increase them.

I am a little skeptical of this idea. We should spend no money fighting one threat until all greater threats (as measure by deaths/year) have been eliminated? I think rather we should spend money proportionally.

And I do not think that we should completely ignore the fears of irrational people. If our citizens are unhappy because they fear something, it is worth some expense to set them at ease. Though perhaps a careful placebo would be most fitting

Well it's a little more complicated: you should always spend money where the most deaths prevented per dollar are achievable. So if you can save 1 life per $20 spent on thing A, and 1 life per $100 spent on thing B, you shouldn't spend any money on thing B. That's because each life saved via thing B means five people died from not having thing A (net loss of 4 lives).

while that is good in theory, the reality is that the $100 spent on thing B is much more visible. The action from money spent saving thing A could be less visible, lower profile and generally more pedestrian, so politicians who makes these decisions go for the more flashy option and therefore garner more votes or credit.

The goal has never been to save more lives - which is the root cause of the TSA's problem.

>> Though perhaps a careful placebo would be most fitting

...which is exactly what the TSA is.

A very expensive and inconvenient placebo.

Speaking specifically about fall risk in older people: if you want to ensure a high quality of life when you're older, maintain strong muscles through exercise. This may seem like a no brainer, and yet almost nobody actually does it.

Balance and strength are highly dependent on exercise. Even fairly old people can maintain very good balance and strength if they don't let their muscles deteriorate through inactivity.

Being frail in old age is not inevitable. A sedentary person after age 50 loses something like 5% of muscle mass annually. But that same person can boost their muscle mass 20% in a single year if they just get serious about strength training, and then slow the deterioration to 1 or 2% thereafter. Run the numbers, it makes a dramatic difference in outcomes.

Just as important bone density and minimizing bone loss through resistance training. Stressing the bones forces them to become stronger.

Yes! Not to mention it makes you much more resilient even if you do fall.

Mortality Data on Falls from the CDC shows the increase in risk as Americans age - and that is the direction of our demographics:

  Cause of death (based on ICD-10, 2004)        Falls (W00-W19)
  All ages                                      26,009
  Under 1 year                                  10
  1-4 years                                     24
  5-14 years                                    28
  15-24 years                                   211
  25-34 years                                   299
  35-44 years                                   493
  45-54 years                                   1,283
  55-64 years                                   2,011
  65-74 years                                   2,988
  75-84 years                                   7,249
  85 years and over                             11,412    
  Not stated                                    1

The takeaway for programmers: every time you write a statement, the odds that you're introducing a bug are quite small, but you do this a lot, so the odds guarantee you will introduce a bug. The guys at NASA who came to TX/RX in Houston used to treat soldering defects as a statistical certainty. You empirically determine your solder failure rate, count the solder joins in the project, then look for your predicted number of failures. When they told me this, a light went off in my head. Why don't all programmers do this?

Think of it like this: if someone paid you $100 to take 2 steps balancing on a rail, you're certain to be able to do it. How about going 100 times as far for $10,000 over a 1000 foot drop? As they say: Quantity has a quality all its own.

"They" in this instance was one Joseph Stalin.

Oh yeah! I've been watching too many WWII documentaries. Linus Torvalds also once said that there's a point after which a quantitative difference becomes a qualitative one. ( Back when the grumps were complaining that the world didn't need his stupid git thing.)

Stalin worked at TX/RX?

No, there's a different dictator there.

>>>Stalin worked at TX/RX?

You have conflated the two uses of the word "they" in the gpp. And you are maddeningly close to having your pedantry card revoked pending discovery that you are in fact a native english speaker: so consider yourself on notice, [as they say](they refers to Steven Coldbear). Let's begin.

>>>As they say: Quantity has a quality all its own.

The word "they" occurred twice in the gpp. The first time was in reference to "The guys at NASA who came to TX/RX". The second occurrence of the word "they" occurred in the phrase "As they say" which is an idiom, or a turn of phrase [as they say](they refers to "people who use idioms"). Therefore it clearly was not referring to the only other use of the word "they".

A native english speaker would know this...but maybe you aren't a native english speaker! Watch your posts friend, maybe spice them up with some "ethnic" flair. Also, do not get into a land war in Asia, [as they say](they refers to the writers of The Princess Bride, as they wish).

Nothing against New Guineans, but the notion of attributing not sleeping under a dead tree to their specific culture is funny. It's basic risk management of anyone who camps frequently in the backcountry. In fact many learn the 4 W's of concern when picking a campsite- Wind/Weather, Water, Wildlife, and Widowmakers (i.e. a falling tree branch)

I think you missed his point. He wasn't trying to establish that New Guineans somehow "invented" the idea of not sleeping under a dead tree, merely that the author wasn't personally tuned to the risks of being under trees until he spent time with the people there. That's all.

The point is not lost, but the author does attribute it to a specific culture:

>"I first became aware of the New Guineans’ attitude toward risk on a trip into a forest..."

>"I now think of New Guineans’ hypervigilant attitude..."

>"Traditional New Guineans have to think clearly about dangers....In contrast, Americans’ thinking about dangers is confused."

The truth is it's a common, learned attitude of anyone who spends a lot of time sporting in the outdoors - no matter where you live. The author himself points out the American/European pilot and raft guide, for example.

None of those statements imply that it is unique to the New Guinea culture though.

It's just another example of the "magical natives, so in tune with the natural world" bullshit myth.

No it's simply an example of people who live in a particular environment being well aware of the risks associated with it.

For example, before I worked in the Peruvian rain forest I would not have guessed that being hit by a brazil nut was one of the commonest reasons for accidental fatalities in the forest.

Good grief, do you have to wear a helmet any time you're in the forest?

No, but the rule of thumb was never to go into the forest when there was a storm with decent winds.

Or maybe it's just where the author happened to learn this. He could have cited the boy scouts if he'd learned it there.

I was about to respond to the GP with "Jared Diamond uses New Guineans in many of his examples because he spends an extraordinary amount of time with them. He's not trying to say they are unique."

But you're right, he's a native fetishist.

I read it as an example of natural selection. The natives who attune themselves to a particular risk, are much less like to die, and more likely to pass along, this particular idea.

Or.. humans in general have evolved the ability to gauge risk and modify their behavior accordingly, long before any humans stepped foot in Papua New Guinea. That this particular culture is more vigilant than others (if in fact that's the case, which I highly doubt) has nothing to do with natural selection. It has to do with culture.

Heaven forbid an author write from his experience, and use a vivid illustration, instead of consulting the Compendium Of Facts Of What Every Person Knows and choosing the blandest and most local example.

I see someone on a motorcycle, and I think "idiot". I've known 7 people in my life who have had motorcycle accidents. One has had 2. He broke his neck in one of them. A couple spilled their bike on uneven pavement. A guy I met in college was like doctor House (dead bone in his leg causing great pain). Another guy was thrown 60 feet when he was rear-ended by a truck. And the last 2 are a father and son. The father has brain damage that destroyed his marriage. Go ahead and have your midlife crisis. I'll be in my car. I might die in a horrific accident someday, but a fender bender won't turn into road-rash and a concussion.

Author doesn't understand how statistics/probabilities work and it ruins the article.

If you roll a dice six times, you have no guarantee to get a six. Each time you roll the dice, you have 1/6th chance of getting a six and this doesn't change no matter how many times you roll.

If you roll a dice six times, you have around 66,51% (1-(5/6)^6) chance of getting six at least once.

For the same reason, if you have 1/1000th chance of dying under the shower, and you take 5,000 showers, you won't die 5 times...

You will have 1-(999/1000)^5000 chance of dying, that 99,32%. That's not 1. So you won't die 5 times.

You're apparently the one who doesn't understand how statistics/probability works. You're correct about his chance of dying once, but there's also a chance of dying twice, a chance of dying 3 times, etc. The expected value of the number of times he would die is 5000(1/1000), or 5.

If you replaced "deaths" in your post with "coin flips", this becomes obvious. I'll repeat your post with some different numbers so you can see how absurd your argument is.

    If you have a 1/2 chance of flipping heads and you flip 10 coins, you won't get 5 heads.

    You will have 1-(1/2)^10 of flipping heads, that [sic] 99.902%. That's not 1. So you won't get 5 heads.
See how that doesn't make sense?

Now, obviously a real person can't die more than once, but if you think he was mistaken about that then his supposed error has more to do with biology than statistics. Any reasonable reader would understand that it was just his rhetorical way of describing a large number of independent statistical events. If it helps, think of it as a population of 5000 equally-careless people taking 1 shower each, not a single person taking 5000.

Sorry, I understand what you're trying to say, but I don't think your example serves your point.

I don't think I mixed up expected value and probability of occurrence, if I did please point out where.

You don't care too much about expected value because once the event occurs (death), you can't play anymore...

If you were playing money, on the other hand, expected value would be much more interesting.

I think probability is interesting because if you say "I'll take the shower 2,500 times instead of 5,000" you drop the probability of death to 91.8 % (from 99.9%)...

If you say I'll die on average only 2.5 times you say nothing interesting.

He actually says "I’d die or become crippled about five times before reaching my life expectancy." Being crippled does not necessarily preclude you from taking a shower. Therefore, if you look at his expected value of "having a significant fall in the shower" instead of "dying in the shower", it doesn't have the same problem of being impossible. Obviously all 5 can't be fatal events.

That's a relief, I prefer only dying once. Pedantic silliness aside, it was clearly an illustration of how frequency can amplify small probabilities to near-certainties, evidenced by the repetitive use of the one-in-a-thousand statistic.

Just another name for Murphy's Law :)

I'm willing to bet that Jared Diamond understands statistics. He just understands that most of the people reading his article don't. The inaccuracy doesn't affect the article so it's better to be more clear than completely inaccurate.

The thing is, it's not even an inaccuracy. He's entirely correct (statistically speaking). He's describing the concept of Expected Value* without explicitly using the term.

The only thing he could be said to "wrong" about is the idea that a person can die more than once, but everybody understands that that's not actually true. It certainly doesn't "ruin the article" like this poor fellow seems to think.

* http://en.wikipedia.org/wiki/Expected_value

The other key thing is that the risk he mentioned was not specifically of dying, but of either death or being crippled. Both of those are very frightening prospects, and he simplifies it as "dying five times" when he does the calculation.

Expected value gives you the "If I look at 5000 shower-takings with a 1/1000 probability of a shower-taking resulting in death, I expect to see 5 deaths on average". Of course when applying it to a single lifetime, the correct thing to consider is "If I take showers until I have taken 5000 showers or died, what is the expected number of shower-deaths I will incur", which is .9972.

> Life expectancy for a healthy American man of my age is about 90. (That’s not to be confused with American male life expectancy at birth, only about 78.)

It's interesting that Diamond literally describes the survival function[0], which is usually thought of as E[X|x>=a], but then conflates this with the expected value in the next breath.

I'm confident he understands the difference, but the notion of the survival function is so easy to understand without the underlying statistics (as he explains in two sentences), and provides a much more useful way of conceptualizing statistics. (Expected values of binomial distributions, on the other hand, are highly useful mathematically but difficult to conceptualize without the underlying statistics).


I guess to die 99,32% is not dying at all, so you actually die never. Taking a shower is perfectly save.

And surprisingly enough, if you add the many-worlds quantum theory[1] that is exactly what you get. Non-death.


For those equally concerned, there are "shower chairs" that you can get that greatly reduce the risk of falls. Since my SO had her amputation it was the only way she could take a shower. However I've found it to be pretty convenient as well.

One of the reasons falls are so fatal for old people is because elderly people in our society rarely stay active. Look at cultures like the Chinese, where you so elderly women up in the morning doing Taichi, or working out on those weird outdoor gym sets in the rest of the day. Maintaining strength and flexibility during old age helps mitigate damage from falls a lot.

Physical deterioration is often a self-fulfilling prophecy,

The real reason falls are so fatal for the elderly is because the victims become immobalized, causing them to become less active. After a fall, many elderly people are bed-ridden which causes a whole host of greater health problems which are the actual killers.

But then good health and daily activity are the best ways of preventing falls, (along with balance training and physiotherapy, especially after a surgery or stroke) so yes it is a cycle as you say.

I don't agree with it being primarily a cultural thing though. Daily exercise is an individual choice. There's a guy in my new building who I see all the time, he just walks to the end of the hall and back many times each day. Each lap probably takes him 10 minutes. But he chooses to stay active, even in very old age.

Daily exercise is an individual choice, but humans are social beings. An implicit societal framework for being physically active helps at the margins... and the margins are pretty large.

Just to point out that according to: http://en.wikipedia.org/wiki/List_of_countries_by_life_expec...

the life expectancy at birth for China in 2011 was 73.47 years (CIA World Factbook (2011 estimates)) compared with 78.37 for the U.S and 80.05 for the UK.

So one reason that all those old Chinese people may appear so mobile is that they aren't quite as old as you might expect.

There are a lot of killers between birth and elderly. Look at life expectancy at 65.

Angband(the roguelike) is an excellent teacher of the point made in the article.

The game is quite long and if you die you have to start over from the beginning. You can also be killed in one turn if you are unlucky and not careful. The only way to win is to lower the risk to die at each turn sufficiently that you can play through the 100 000 turns or so that it takes to win.

Playing it has really given me perspective on risks in a similar way to the author of the article. In real life you end up doing some things a lot of times and then the risk has to be damn low.

Seriously showering 365 times/year is, while normal in the US, really pretty bizarre and definitely decadent. Put on some deodorant, shower every other day and this guy could cut down his risk massively. And save colossal amounts of water!

Does he sweat regularly? Play sports? If not, in the winter, shower twice per week. Doing otherwise is really falling into one of the weirdest forms of American prissiness.

In general I shower when my wife tells me I need to. On average that means every 2-3 days. How strange and wasteful would it be if someone washed their car every single morning regardless of whether it was dirty or had even been moved from the garage that day! (I work from home so the analogy frequently works)

I know he's making a broader point about risk but if you want to get over some crazy warped American perceptions to improve your life and the world, obsessive showering is as good a one as getting over delusions of risk of terrorist attacks.

> Put on some deodorant, shower every other day and this guy could cut down his risk massively

Yeah, if by "massively" you mean he'll only be expected to have a possibly-fatal fall twice instead of five times.

Your post is extremely ignorant. It not only offensively and incorrectly ascribes daily showering to "prissiness" and "obsessiveness" (as if that's the reason I shower every day, instead of, you know, wanting to smell nice, look nice, and feel refreshed), it also claims that this is an American phenomenon (I'm Canadian, and many/most people I know shower daily. The ones I know who don't, smell). It also assumes all people are the same. Personally, I'd feel pretty sorry for your wife if you smell like I do after not showering that morning.

It's no more "bizarre" than the Japanese are bizarre for using those funky toilets with built-in bidets. Cultures may be different. Let them be different without judging, and without projecting.

Canadians are known to be one of the only cultures more prissy than Americans so you entire comment is invalid.

In general I shower when my wife tells me I need to.

I'm not here to judge you or your lifestyle, but if I were to rely on my significant other to tell me when I needed to shower, I would feel as though I was taking advantage of their good will. I want to take care of myself and be attractive for them, not use them as a smell-o-metre.

use your own heuristic but showering every day, when all you did was sit in front of the computer and walk your dog in 40 degree weather, is wasteful, pointless, and weird.

Huh. Funny. Your comment seems wasteful, pointless, and weird, but here we are.

This varies significantly from person to person. For me after 30-48 hours so I start getting itchy, my hair and face get obviously oily, and I start to smell. And that's assuming I'm not being very active.

Reminds me a lot of Nassim Taleb's focus on payoff/cost (expected outcomes) vs probability. If the possible costs are high enough, it makes a lot of sense to take precautions. Hardly rocket science - seat-belts, hand-rails, smoking etc.

I initially thought this was going to be about long-term health risks of showering every day. I've heard that long hot showers are bad for the skin and/or hair, is that true? Or might they be bad for the body in other ways?

(But good piece nonetheless, Jared Diamond is brilliant.)

It's common knowledge in Australia that you don't pitch your tent under a tree, alive or dead. I imagine that's because Eucalyptus trees have a habit of dropping large limbs without warning (it's an adaptation to survive droughts).

The other reason of course is because of the drop bears.

Eucalyptus are rather notoriously bad about that, moreso than many other trees. I've witnessed them make a widow, or widower, in this case.

> If I’m to achieve my statistical quota of 15 more years of life, that means about 15 times 365, or 5,475, more showers.

Or, take fewer showers. You don't need to shower every day in winter, do you?

> Or, take less showers.

Would that be showers taken with reduced water pressure? Or do you perhaps mean fewer showers?


Yes, I meant fewer. Corrected in the post above, thanks. (I'm not a native speaker but this is no excuse, I should have known that! ;-)

It's been my experience that non-native speakers do a better job of paying attention to issues of structure and coherence than native speakers. And I can't count the number of times I've met someone whose excellent English composition abilities were completely at odds with their place of birth.

Some might say that my going on about "less/fewer" and other similar grammatical arcana is unfair or irrelevant. There is some merit to that argument, but we're comfortable tearing people's computer code apart, and this is a similar activity -- except in an emotional sense. Most people who eagerly welcome computer code corrections bristle at grammatical corrections.

So thanks for taking my comment in good humor.

For a more detailed description of Jared Diamond's experience with the dead tree in New Guinea:


And if you're in London, consider adding yourself to the waiting list: http://www.thersa.org/events/our-events/the-world-until-yest...

Consider doing exercise that strains your bones and strengthens you in ways that will protect you when falling. Jiu-jitus is excellent at this. You will learn to structure your body, and creating frames with your limbs in many potitions, and you will fall to the ground multiple times. This prepares you.

The NYT headline is clearly link bait. If it had simply said "Some thoughts on everyday risks we underestimate" if would go nowhere.

That said there is a clear benefit and need to take a shower for many people as opposed to sleeping under a tree or crossing the street in the middle for which there is a work around.

What is nowadays called "link bait" used to be called "headlines" back in the days of paperboys and rotary presses. It's simply an old journalistic practice.

A good headline is pretty much 'link bait' by definition. If a feature writer mistakenly wrote a terrible headline like yours, I would expect the newspaper editor to fix it before going to press.

Some people have a more civilized education.

This stuff particularly applies to machinery: the horror stories about people getting hair and clothing caught in machinery or looking away for a second when using a bandsaw are always a reminder to be careful no matter how many times you've used the machine before.

The article ignores the fact that there is a variety of equipment available to further minimize the risk of falls in the elderly - and it's the elderly that really matter, because a fall, in their case, could very well turn out to be life threatening. There are shower mats to increase friction. There are bars in the shower to hold on to. There are even tub benches to sit on while showering. I don't really expect the sort of absurd headline grabbing articles like this from the NYTimes. I expect articles that responsibly describe the risks and ways to mitigate them.

I've always been shocked at how wealthy people fly around in small private planes. At least once a year, I hear of a tragedy involving such a person, often wiping out all or most of their family.

While large aircraft are extremely safe, small ones have a significant chance of catastrophic crashes, particularly in inclement weather. While I'll fly in small aircraft, I will never make a habit of it - eventually the number will catch up with you.

Same goes for motorcycles. How many motorcyclists have driven for 30 years without a serious accident? None I know.

Solution: a bathtub. I have some combination bathtub + shower so I sit down and wash myself -- it doesn't take longer and I can fall (since I am already at floor height.

I can easily think that climbing in and out of a bathtub is way more risky (wrt. falling) than merely stepping under a shower. I believe people don't fall when they stand in the shower. They fall when they step out of it on moist surface. Sorry if I ruined your day. :)

They actually make such tubs that allow one to walk in: http://www.luxuryhousingtrends.com/walk-in-tub-with-massage-...

I visited a friend in Slovenia and discovered this is the normal routine in Central Europe. In fact they have comfortable tubs which have a higher section for sitting on.

CBC.ca mentioned a study by Simon Fraser University in BC, Canada.

> "We show that the most common causes of falls are incorrect weight shifting and tripping, and the most common activities leading to falls are forward walking, standing quietly and sitting down,"


What else should we be vigilant about besides falling? I felt the article was a little incomplete w/o this information.

I've got one: * Lifting heavy things correctly.

I like how this article is written, with good english. This is refreshing. It might be that old people write better than we do. :)

Oddly, I'm not sure why one would not consider skipping the daily shower if you had these concerns. Though, I realize that is a highly personal decision. (Meaning that personal influences matter a lot. I've known folks who would go without a shower for upwards of a month with nobody noticing. Others, if a day was skipped it was obvious.)

That's why they build special showers (that are on floor level) for elderly people. No reason to sleep under a dead tree.

Not to mention hand rails, non-slip mats to stand on, chairs in the shower and other risk reduction strategies.

Amusingly, Lonely Island's latest music video, just posted 5 days ago, expresses pretty much this precise sentiment. It's called YOLO and is available at https://www.youtube.com/watch?v=z5Otla5157c.

When I here a statistic like, your chance of falling and getting an injury in the shower is 1 in 1000, I assume they mean over my lifetime, not each day. There is not way in hell it's 1 in 1000 per day. I don't buy it. That said, I get the point of the article.

I love it when people who don't understand the concept of expected value circle around it intuitively without quite getting there.

Shouldn't this problem be hugely mitigated by putting rubber or any non-slippery material on the shower floor?

You mean ... you people in the US don't all have rubber anti-slip mats in the showers ?

Boy, I love Jared Diamond's books. An absolute must read for any hacker.

"Cause of injury: Lack of adhesive ducks." - Sheldon

I'm not sure what the takeaway from this article is supposed to be. Always be conscious of your safety but not to the point of constant paranoia?

Isn't that basically -- dare I say it -- common sense?

Interesting post for senior citizens. Thanks.

Where can I get that snake-head shower-head?

Not discussed is how the author's hyper-vigilance impacts his life in the form of stress. Stress kills.

The author has already made it to age seventy-five. As he writes in the submitted article, "My hypervigilance doesn’t paralyze me or limit my life: I don’t skip my daily shower, I keep driving, and I keep going back to New Guinea. I enjoy all those dangerous things."

I think the author has actually made a very sound point, statistically speaking, that often incremental improvements in dealing with the little things has as much impact on health outcomes as heroic measures to deal with the big risks to health. All around the developed world, mortality from all causes is steadily declining at all ages,


and most of that decline in mortality (and consequent increase in life expectancy) has come about from incremental reductions in risk. Changing engineering standards for highway construction reduces risk of injury and of death from car crashes. Simple checklists can reduce the risk of surgical complications.



A girl with my daughter's birth year in the United States has a better than even chance to live to be 100 years old,



just from an accumulation of incremental improvements in health in the developed countries. The little things matter. We don't have to worry about the little things. Indeed, we can celebrate that so many little things are taken care of for us by societal changes.

I think hyper-vigilance is a poor choice of words. It's more a habit of thinking than a constant state of conscious alertness. When you become aware of a hazard, it takes conscious effort to avoid putting yourself in the way of that hazard.

To take the author's example of sleeping in the jungle under dead trees, when you first become aware of the hazard, you have to stop and look at your campsite before deciding whether or not to pitch a tent there. Eventually it just becomes part of your background processing when checking a spot, and you would pass up an otherwise nice spot without stopping to think why. If asked, it might take you a moment of looking the spot over before realizing that it's because of the dead tree sitting over it.

If you think about it, it's a lot like developing good practices in coding. What at first is something you have to think about quickly becomes second nature. For example: why do you (possibly hypothetically) use curly braces around a single line block following an if statement in a C-like language?

Several reasons if you think about it. First, so that you can't forget to add them in when you need to add another line. Second, because it makes it unambiguous which if or else if an else belongs to if you have a big nasty chain. You don't spend a lot of time thinking and stressing about those reasons every day, but having the habit protects you anyway.

> I think hyper-vigilance is a poor choice of words

Well, it's his choice of words. You seem to be trying to redefine the article to your liking.

You're right, rules like the curly braces one you mentioned eventually become second nature, such that you don't think about them. That's a "habit of thinking", as you say. That's clearly not what the author is talking about. The author uses words like: "hypervigilant", "obsess about the wrong things", "verging on paranoia", "constructive paranoia", "I remain alert", "I try to think constantly", "being attentive to hazards".

He's talking about an attitude which might very well bring about stress. It beign second nature to add a curly brace after an if statement doesn't.

Its possible to be careful and unstressed. I avoid caffeine. I don't even think about it any more; I just don't choose drinks containing caffeine.

Not so black and white though, caffeine may have health benefits, e.g.


Sure, but I get squirrly and my blood pressure goes up. So all the studies in the world don't mean more to me than my experience.

"I don't even think about it any more" means you're not being "hypervigilant". I'm using the author's word-choice here.

It remains to be shown that a hypervigilant attitude has any effect whatsoever on what you're being vigilant about, and in particular shower falls.

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