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Humans Are Bad at Risk Assessment, and Other Stories

I grew up tempting fate.

When I was about 12, we moved into a subdivision that was still under construction. Our house was in a cul-de-sac near the front of the development and the surrounding streets had dozens of houses that were in various stages of construction. I quickly met some other boys around my age and those houses became our playgrounds.

One summer day, three of us went to a neighbor's house across the street from mine and went up to the second floor and climbed out onto the roof above the front porch. We sat there for a while, talking about nothing I can remember. When we decided it was time to go, my two friends, Tony and Chris, climbed back through the window and went down the stairs. I stood up and looked at the pile of red clay below the roof in the front yard--our neighbors were doing some landscaping--and decided to take the express route. I jumped and landed on my knees, dusted myself off and then walked down the side of the dirt pile to where my friends were standing in the driveway.

My friend Tony pointed at my leg and started shaking his head. I looked down and saw a non-trivial chunk of bluestone sticking out of my knee. Without really thinking, I pulled the rock out of my knee and then watched as a waterfall of blood covered my shin and flooded my Adidas Sambas. I have a vague memory of Tony and Chris walking me up the lawn to my house and ringing the doorbell, which seems dumb since we all lived in each other’s houses. My mom came out, looked at my knee, and then went inside and got her purse and drove me to the hospital where they put about 15 stitches in my knee. (I later took the stitches out myself.)

“What were you thinking?” my mom asked on the way home.

I don’t remember what I actually said, but it was probably some version of, I wasn’t. It just seemed fun. I hadn’t thought about the risks.

About 20 years later I was running my second Boston Marathon. I had recently been diagnosed with a really fun form of rheumatoid arthritis called ankylosing spondylitis and was on some pretty potent anti-inflammatories. They were keeping my symptoms in check and I was in good shape and planning to run somewhere around 3:20 that day. But one thing about anti-inflammatories is they tend to dehydrate you. That day was weirdly warm for Boston in April, in the high 70s, and I knew that it would be tough, so I took it relatively easy for the first eight to 10 miles. I was hydrating, but by about the halfway mark I started getting the kind of leg cramps you get at night that make you want to scream. I knew I was in real trouble, but I kept running. No matter how much water or Gatorade I took in, it didn’t matter. The cramps got worse.

"The lesson, in the broadest sense, is that humans are bad at assessing risk. Even, or maybe especially, when it comes to our own lives."

I eventually found a medical station around the 15 mile mark and the EMT noticed I wasn’t sweating at all. You need to drop out, she said. I asked if she was going to force me to stop. She said that wasn’t her job. I kept going. Spoiler alert: Things got much, much worse. To the point that I had to ask a spectator to borrow his phone to call my wife and let her know I’d be an hour or so later than she expected. I made it to the finish, in about 4:40, and drank a bottle of water and immediately threw it up. An EMT standing nearby told me I needed to go to the ER immediately. My kidneys had shut down, he said. I’m sure I heard him, but instead of going to one of 10 hospitals in Boston, I got in my father-in-law’s car and we drove back to Plymouth, an hour away. I remember telling him to just take me home and I’d be fine after a nap. He kept saying sure, and drove me right to the hospital in our town.

Not surprisingly, the ER doctor (who I knew slightly) did some tests and confirmed that my kidneys weren’t working so well. Or at all. They gave me several (4?) bags of IV fluids in a few hours and I felt great! I was ready to go home, I told the doc. Sure, he said. In about two days. Turns out, had I actually gone home after the race and gone to sleep, as I wanted to, I wouldn’t have woken up. My stupid kidneys went on strike somewhere in the middle of the race and hadn’t processed anything in quite a long time. I was in the ER for three days, wearing my finisher medal the entire time, like an idiot. When I was finally released, one of the ER nurses tapped the medal and said, Was it worth it? I nodded. In the years since, I’ve seen that nurse around town at restaurants and stores and she will always smile and shake her head at me. Again, I hadn't really considered the risks of what I was doing.

What did I learn from these incidents? Hard to say. Probably not much back then. Between the two incidents described above, I tore my knee to shreds in a high school soccer game but kept playing because we were undefeated and I was the captain and was going to play in college the next year. That turned out poorly, as you might imagine.

The lesson, in the broadest sense, is that humans are bad at assessing risk. Even, or maybe especially, when it comes to our own lives. We see a thing we want or a thing we want to do and go toward that, consequences be damned. This is the basic trait that attackers exploit in various ways--phishing, social engineering, etc. Identifying risks and determining what the consequences of any given action might be is not easy, so a lot of us just look at the benefits and ignore the risks. And that impulse is the most difficult thing to defend against because it requires amending human nature.

That’s a fool’s errand, of course, but if you find a way to do it, let me know. I’ll be sitting on the roof.