How stressful situations affect our brain.

A few years back, I managed to gain entry into my own residence. Upon my arrival home after a drive, it was approximately midnight during the freezing winter of Montreal. Prior to that, I had been spending time with my friend, Mark, who lived on the other side of town. The temperature outside was incredibly frigid, as indicated by the thermometer on my front porch, which displayed minus 40 degrees. And just to clarify, it doesn't matter whether we're talking Celsius or Fahrenheit because both scales coincide at minus 40. To put it simply, it was extremely cold. Standing on the front porch, I rummaged through my pockets and realized that I didn't have my keys with me. To my frustration, I spotted them through the window, resting on the dining room table where I had absentmindedly left them.

After rapidly searching, I attempted to access all the alternate entrances, but they were securely locked. Considering the situation, I contemplated contacting a locksmith. However, I was aware that it might take a considerable amount of time for them to arrive, especially considering it was already midnight. Furthermore, the weather was cold, which added to the urgency of the situation. Since I had an early flight to Europe the following morning, I needed to retrieve my passport and suitcase and therefore couldn't go back to my friend Mark’s house for the night.

In a state of desperation and extreme cold, I discovered a substantial rock and forcefully shattered the basement window. I carefully removed the broken pieces of glass and managed to crawl through the opening. To temporarily cover the exposed area, I located a section of cardboard and secured it with tape. My plan was to contact my contractor the following morning before heading to the airport, in hopes that they could repair the window. While this repair would likely be costly, I rationalized that it would be comparable to the expenses associated with hiring a locksmith in the middle of the night. Thus, considering the circumstances, I believed I was breaking even.

As a trained neuroscientist, I possess knowledge regarding the brain's response to stress. In such situations, cortisol is released, resulting in increased heart rate, modulation of adrenaline levels, and impaired cognitive function. The following morning, I woke up after inadequate sleep, plagued by concerns about the window hole, a reminder to contact my contractor, freezing temperatures, and upcoming meetings in Europe. Due to the abundance of cortisol in my brain, my thinking was compromised, although I was not consciously aware of it.

Upon reaching the check-in counter at the airport, I suddenly realized that my passport was missing. Prompted by this realization, I hurried back home through the snowy and icy conditions, completing the round trip in approximately 40 minutes. Once I retrieved my passport, I raced back to the airport in order to catch my flight just in time. However, to my dismay, my seat had been given away to another passenger. Consequently, I found myself confined to a seat at the rear of the plane, positioned uncomfortably close to the bathrooms. Adding to my discomfort, the seat in question was unable to recline, making the eight-hour flight even more arduous. Throughout this lengthy journey, I had ample time for introspection, despite the absence of sleep.

I pondered if there might be certain measures I could take that would prevent awful events from occurring, or if one did, perhaps reduce its impact to a minimum; however, it wasn't until a month had passed by that my ideas became more tangible.

I was sharing that story with my colleague about how I had broken my window and forgotten my passport. He explained to me that he had adopted something called prospective hindsight, which was created by psychologist Gary Klein and was also known as the pre-mortem. This process is the opposite of the postmortem, where a team of experts analyse a disaster to figure out what went wrong. Through the pre-mortem, you can look ahead to anticipate potential problems and plan ways to prevent or minimize the damage. To carry out a pre-mortem, some concepts are obvious while some are not. To begin with, designating a place for small personal items is especially useful.

It sounds like common sense, and it is, but scientific research backs up the fact that our spatial memory works in a certain way. In our brain there is a structure called the hippocampus, which has evolved over thousands of years to keep track of important places - wells, where to find food, fruit trees, and the locations of friendly and enemy tribes. Research has shown that this part of the brain can become enlarged, such as in London cab drivers. It even allows squirrels to find their nuts, regardless of smell. To make sure you don't lose things like car keys, glasses and passports, designate a specific spot for each one of these items - such as a hook by the door for keys, or a drawer for your passport. This should act as an insurance policy. For travelling, take a picture of your credit cards, license and passport and send it to yourself online. Also, remember that under stress and when your brain releases cortisol, your thinking can become confused - so make sure to have systems in place to help you keep track of your essentials.

Being confronted with a medical decision can be an incredibly stressful experience, one that each and every one of us will face at some point. It can be an extremely daunting task to make a sound decision that will influence the medical care of ourselves or a loved one. Let's consider a real-world scenario: You visit your doctor and they tell you that your cholesterol levels are high-- which increases your risk of cardiovascular disease, stroke, and heart attack-- and suggest that you take a statin. Statins are some of the most widely prescribed drugs, and many people take them regularly. There is, however, one statistic you should ask for before making a decision: the number needed to treat. doctors often avoid discussing this and pharmaceutical companies tend to steer clear of it, but it's an important factor in understanding your medical decision.

Have you heard of the Number Needed to Treat, or NNT? It's a statistic that shows how many people need to take a drug, have a surgery, or go through any medical procedure before one person is helped. It may seem strange that the number isn't just one, but medical practice actually doesn't always work like that. According to a study from GlaxoSmithKline, 90 percent of drugs are only effective for 30 to 50 percent of the people taking them. That means for the most commonly prescribed statin, 300 people have to take it for one year before one of them experiences a reduction in heart attack, stroke, or other adverse effects. Furthermore, five percent of these 300 individuals experience side effects which may include debilitating muscle and joint pain and gastrointestinal distress. This means that you are 15 times more likely to be harmed by the drug than you are to be helped by it. Before deciding to take the drug or not, it's important to think it through ahead of time and be informed about the NNT.