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The Tragedy of Prevention: No One Knows When They Don’t Die

In a recent Vlogbrothers video and in his newsletter, Hank Green talked about how we don’t take enough notice of the things that quietly keep us alive, healthy, and safe.

The tragedy of prevention goes like this: The most effective way to save lives (prevention) is the least noticeable, which leads us to undervaluing it in our individual choices, in what we celebrate, and in public policy. That undervaluing of prevention leads to a great deal of needless death and suffering.

But there’s a second tragedy here, which is that we spend way less time celebrating the accomplishments of humanity than I think we should. If every person who had their life saved by a vaccine, or an airbag, or a clean air regulation felt the same as a firefighter carrying an unconscious person out of a burning building, I think we’d feel a lot better about humanity, and maybe that would help us move forward more effectively.

This follows Green’s Bluesky post from early April:

A tricky thing about modern society is that no one has any idea when they don’t die.

Like, the number of lives saved by controlling air pollution in America is probably over 200,000 per year, but the number of people who think their life was saved by controlling air pollution is zero.

In the early days of the pandemic, I wrote about a related concept: The Paradox of Preparation.

Preparation, prevention, regulations, and safeguards prevent catastrophes all the time, but we seldom think or hear about it because “world continues to function” is not interesting news. We have to rely on statistical analysis and the expert opinions of planners and officials in order to evaluate both crucial next steps and the effectiveness of preparatory measures after the fact, and that can be challenging for us to pay attention to. So we tend to forget that preparation & prevention is necessary and discount it the next time around.

Comments  9

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Katie Mays

Jon Lovett from Pod Save America recently interviewed Michael Lewis about his book on public servants and their impact on society, and they discussed why people don't really attribute the good stuff that comes from the government as being from the government. Seems right in line with this! A story that stood out was Michael Lewis interviewing a guy that worked for NOAA or the Coast Guard or something, who developed an algorithm that utilized data on weather, ocean currents, and several other factors to locate people who fall overboard. The algorithm worked stunningly well, and one of the first times it was used was to save a guy that had fallen off a cruise ship in the middle of the night-- something that was thought to be nearly impossible to survive. The kicker? When they asked that guy what saved him, instead of recognizing that government-funded science and math and general expertise had been the key to his unlikely survival, he said that while he was floating in the middle of the ocean, he found Jesus, and this is what saved him.

Jo Ma
David Dunbar

Lewis’ own podcast — Against the Rules — is excellent, and he has an episode about that very story if I remember correctly.

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Drew McManus

Wow, this is really great. I’m going to be thinking about this for a long time.

David Dunbar

If it weren’t for air bags, I’d have been dead for 20 years. Three cheers for engineers and regulations!

Tim Bradshaw

Two great examples of this are the year-2000 problem and retail banks not collapsing in 2008. Still today I hear people say 'oh, Y2k, that was just an invented thing to give a lot of people work'. And it is likewise really common for people to say that the banks should have been just allowed to fail in 2008.

(Note 'keeping the banks afloat' and 'not punishing the people responsible for the problem' are not the same thing: only one should have been done, not both.)

Meg Hourihan

I feel like there's an opportunity for some really cool PSAs here, like "near death experiences" that show how this type of thing was avoided. IDK, someone w measles vaccine passing someone with active infection and some cool graphic overlay showing the body avoiding the infection. Or David's airbag: a timeline splits and we see both outcomes. Etc. Etc. Small nuggets shareable on social to help people literally see the outcomes and alternatives. Internet creatives, please get on it!

B Roseman

I am very clearly a product of air pollution reduction. I grew up in the San Fernando Valley in the 1960s and 70s. I was diagnosed with asthma at age 12 and wasn't really free of it until I moved away from LA at age 21. We have photographs from our backyard where you cannot see the mountain ranges that surround the Valley, and then after 10 years of stricter emissions controls, you suddenly can. It was pretty miraculous. Kids who grew up with that pollution will have it affect them for their lifetime. Kids who grew up without it have no idea how bad it was.

David Leppik

I keep thinking about a theory I heard long ago that history repeats itself on an 80-100 year cycle. I think I heard it around 2000 and it was specific to economic crashes, essentially saying we were due for another Great Depression.

The theory was essentially that after a big enough disaster, there’s enough motivation to create new institutions and regulations to keep the disaster from ever happening again. Then when the last generation that remembers the disaster dies, the impassioned watchdogs die with it.

I think about the world wars from the last century. WW I was caused in part, they say, because people believed Europe had become too integrated/civilized for a major war and did too little to avoid it. Until a decade ago, Nazis were considered so obviously evil that expressing a hint of a rumor of sympathy was political suicide.

The minute the WW II generation left us, fascism returned.

The last polio survivors in Congress are retiring, just in time for vaccine skepticism to take over.

We need to learn how to have longer memories.

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