Navigating Our Brains: A Journey with Billy Martin Sponsored by SimVS

Our minds are intricate prediction machines, but how do they really work? Today, we journey into the captivating world of neuroscience with Billy Martin. With an extraordinary background that spans from ski patrol, EMT, and paramedic to helicopter pilot, Billy's experiences are as vast as they are thrilling. He even shares insights from his upcoming adventure of climbing Mount Kenya.

As Billy guides us through the fascinating intersections of medicine and the electric utility business, he introduces us to the profound concept of experiential blindness. This idea, that our brains create circuits based on our experiences, is profoundly shaping our ability to face new challenges. As we delve into the simulation world, we discover how this tool can help us prepare better for real-life situations by predicting various outcomes. We also investigate a major roadblock in our conversations - the 3Ds: defensiveness, divisiveness, and dismissiveness. By embracing clean language and the power of rituals, we can reshape our beliefs and behaviors.

Finally, we turn to the psychological impact of our experiences. Hearing from a paramedic about the stress management challenges faced by linemen in the utility industry highlights the dire consequences of unpreparedness. We unravel the importance of simulation training in priming the brain for high-pressure scenarios and the need to be open to different perspectives. Join us as we call for a cultural shift in how we approach and prepare for stressful events. This episode promises a mind-expanding journey through neuroscience, human behavior, stress management, and much more. Come along with us and Billy Martin for an episode you won't want to miss!

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Transcript

Disclaimer/ Sim VS Ad / Intro: 0:00

The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or positions of anyone at Innovative Sim Solutions or our sponsors. Thanks to Sim VS for sponsoring this week's episode. Simulation helps develop the mindset of patient safety by allowing learners to practice and fail in a safe environment. Simvs designs tools that contribute to the development of this mindset. We are excited to release our new 4-pump simulator practice prime's proficiency. To learn more, visit www. simvs. com. Welcome to The Sim Cafe, a podcast produced by the team at Innovative Sim Solutions, Edited by Shelly Houser. Join our host, Deb Tauber, as she sits down with subject matter experts from across the globe to reimagine clinical education and the use of simulation. So pour yourself a cup of relaxation, sit back, tune in and learn something new from The Sim Cafe.

DebTauber: 1:21

Welcome to another episode of The Sim Cafe. Thank you very much for joining us and welcome Jerrod. And today our guest is Billy Martin. Billy is a fascinating person, Billy. Why don't you tell our listeners a little bit about yourself?

Billy Martin: 1:40

Sure Deb. I'm just thrilled for the opportunity, Thank you, thanks for being here. So I've got kind of a mixed bag of a background, but I did simultaneous careers in medicine and in the electric utility business so it's kind of hard to explain. But I started as a in the electric utility you know, janitor, all that kind of stuff up to 20 years as a lineman. And while I was a lineman I became a ski patrol and then realized that I didn't get enough experience. So I became an EMT and then a paramedic and then as a lineman I actually rolled onto a double log truck, tip over onto two cars that was the first one to seen. So I ended up managing the scene and called in three helicopters and then when I contacted the helicopter company they sent me an application. So I started flying and then I had a flying 23 years on a helicopter while I was in the electric utility business.

Billy Martin: 2:30

So my interest in medicine and now the outdoors also led me to a diploma in mountain medicine. I'm a ski patrol instructor, trainer, and it just keeps going on from there. So somehow I have these simultaneous things going on, which has evolved into a different way of thinking because I'm involved in a lot of high intensity adventures you know like. For example, I'm climbing Mount Kenya in Africa February 5th. It's a thousand foot rock climb to 17,000 feet will be my third time, wow, but my first time at 67 years old.

Jerrod Jeffries: 3:03

It's just all in the mentality and there's already in that sentence, Billy, which is just so much personal curiosity Where's your favorite place to?

Billy Martin: 3:10

So I'm a ski patrol at Whitefix Mountain. My favorite favorite place to ski is in the woods in the back country. I do a lot I do. I'm ice climber and also a back country adventurer and I really had a really good time. I've skied back country in Idaho. Just right when, just before COVID hit, I was stayed at the Opus hut between your Colorado and Silverton. It's situated 11, 6. You skin in three miles to get there and you climb. You ski, skin the peaks around and ski. That was unbelievable. I think I would like to do that again.

Jerrod Jeffries: 3:41

Yeah Well, your third time doing elevation that most people have not ever experienced as well, you know, outside an airplane. But we are going to take this podcast in a little different direction and make it a little more laissez-faire. So I'd love to just unpack a lot, because we both find you, as well as many of our listeners, so fascinating, and actually I want to lead off with a question of what are you reading, if anything, and what would you recommend to read?

Billy Martin: 4:06

That's a really good question. I got hooked on Audible a number of years ago, so I don't even know if I know how to read anymore, Jerrod, I just listen. But what I've been reading is a lot of neuroscience, the interesting thing. So I'm in the utility business and I do a lot of speaking on safety and I've also been in medicine. I just I spoke in San Diego just in November in the Citizen CPR Challenge Status Co-Conference and I also spoke in San Diego for the Incident Prevention Conference. So I also write for and do podcasts for, and was really there were two weeks apart in the same hotel, which was kind of interesting.

Billy Martin: 4:39

But I like to tell people that you know, if I want to spin the news, I can spin Fox News or CNN, or if I want to spin safety, there's a lot of really good safety gurus out there. But if you start learning about how our human works, that's not spin. That's based on studies. So, for example, andy Clark wrote the book the Experience Machine how Our Mines Predict and Shape Reality in May 2023. So this is pretty current study he's talking about and he refers a lot to Lisa Feldman Barrett who wrote seven and a half lessons of the brain 2020. And both of them talk about how our brain is a prediction machine. He calls it the experience machine. And then Andy M Paul wrote the Extended Mind the Power of Thinking Outside the Brain. That was 2021.

Billy Martin: 5:21

Interestingly, Andy Clark also wrote a paper in 1997, where Does the Mind Stop and the World Begin, which is really kind of an interesting paper, because back then they were thinking you know where is the mind and the brain encompassed in the same space? And they started doing studies where, like elementary kids, if they're doing math, if they sit on their hands, they can't do math because as they move their hands and fingers around, their mind is now in their hands and fingers to calculate math. And in 2007, they kind of proved that your mind goes wherever your focus is when the iPhone came into market. Because now that everyone has an iPhone, if you lose your iPhone Jared, you lose your mind.

DebTauber: 6:00

Yeah, very true.

Jerrod Jeffries: 6:02

Very true. But just to summarize that, though most of what you're reading is around neuropsychology or some form of mind matter, environment, society Is that fair to say?

Billy Martin: 6:17

Yes, yes, so it's a cross between behavioral neuroscience, neuroscience and cognitive psychology. Daniel Kahneman of course, the thinking fastest flow from 2011 was groundbreaking work and he got a Nobel Prize in economics actually for that. But where he refers to the brain as a metaphor of system one or system two thinking and system one's really fast and system two's more accurate, but you have to slow down. Tan Lee wrote the book Neurogeneration in 2020. She did studies on high school kids with EEG headsets and she found high school kids don't like to make eye contact, but when they do, their brain waves synchronized. And when you're engaged, like we're engaged right now, our brain waves start to synchronize, which now we're talking about things like neurosynchrony and social enhanced cognition or collective intelligence, which means we have to connect.

Billy Martin: 7:08

I like to say that every generation has a higher IQ than the one before it. But the IQ doesn't matter, because one neuron in your head screaming alone in a football field doesn't really do much. But when these really brilliant neurons connect with other people and we create that connection, we operate it in higher ground. Oh, I love that.

Billy Martin: 7:25

I love that Tan Lee Sherrod wrote the Optimism Bias which we'll be talking about today, a tour of the irrationally positive brain. He also wrote the Influential Mind, which is what our brain reveals about our power to change others. I'm involved with a study right now with John Barge and Gary Latham. John Barge is out of Yale. He's retiring this month. Actually, he wrote, before you Know it, the Unconscious Reasons we Do what we Do, and there's more, but I don't want to do the whole thing on books. But honestly, these books are all interconnect at some point where they all are, how we actually run our human. So, Jerrod, I don't know if I've talked to you about this. Before we get into what this model is that I've been working on, I kind of have to diffuse something. Is that all right?

Jerrod Jeffries: 8:09

Yeah, please. And also I think we should list the books that you just mentioned so we can include in the show notes too.

Billy Martin: 8:13

But yeah, yeah, so I've got a slide with 12 books. I'll send it to you, Please do so. I'm a baby boomer and I speak a lot now and almost everybody's younger than me, so I often start by apologizing for being a baby boomer and I also apologize to the baby boomers in the room first.

Billy Martin: 8:29

You see, look, I don't want you to, you know, please don't, you know, be judgmental of this. I'm not trying to call anybody out, but my generation, which was command and control, is really good at modeling defensiveness, divisiveness and dismissiveness. And when we do that, we hold the people we're operating with to a lower cognitive level. Because as soon as I make put you into defense, you're now moving into justification and rationalization and that's a ripple into the past. Right, but what we want to be? Because you guys are brilliant and, like I said, every generation has a higher IQ than one before, it's on the dumbest guy in the room, right, you don't have to defend anything, you just have to be curious and interested. You know why someone might have a different idea. That's a better model, because that unlocks reason, logic and intuition.

Billy Martin: 9:13

But you can't be justifying and rationalizing and move forward at the same time, right. And then, if you've read any Eckhart Tolle or Tolle Harvey von Braunz's last name, the power of now, really the only chance we have to change the future is right now. Whoops, that's gone. I mean right now, right. So when we're pushed into the past and we only have a certain amount of cognitive load available, it stunts our ability to operate at higher levels. So what I'm going to ask is I'm going to introduce some new things today and it's going to make some people feel uncomfortable because either haven't heard it or it's going to twist their brain a little bit. I'm just going to ask that you know if you've watched the Matrix take the red pill just for this podcast. Perfect there you go.

Jerrod Jeffries: 9:57

So I don't know where you want to go from here. I love that you want to make people feel uncomfortable, because I think you grow when you're out of your comfort zone and I think that we most, by default, homo sapiens, will always default back to that comfort zone of this is safe, it's secure and we don't ever want to get out of that circle or out of that comfort zone. So I think conversations like this are what push society forward. And then when you get there and you're creating the synchronicity among humans or community and pushing those industries forward, pushing those boundaries forward, I think is beautiful, so we're so happy to have you there's a video if you want to.

Billy Martin: 10:34

It's apples. It was 1997, called the crazy ones, IBM ThinkPad. It just hit the market and it was controlling the market for computers. So Bill Gates comes on with this Apple commercial that doesn't show any computers. It shows Einstein and Amelia, Earhart and the Muppets. I mean all these things. And then the catchphrase at the end is the people who are crazy enough to think they can change the world are the ones that do.

DebTauber: 10:59

I remember that commercial yeah.

Billy Martin: 11:02

And it's just proof that the most successful people in businesses don't tell you how smart they are and what they're going to tell you. They tell you what they believe.

DebTauber: 11:09

So yeah.

Billy Martin: 11:11

I'm sorry, so go ahead. Dave, you're just going to say something.

DebTauber: 11:16

No, I'm just interested in the things that you're doing now. What are your new? You have some forward thoughts.

Billy Martin: 11:23

So I mean, you guys are in simulation and I started this journey doing mental rehearsals and mental simulations with Lyon to prepare for the worst case scenarios, and it's evolved, based on this research, to a formula. And actually I'm speaking in incident prevention in Orlando in May and it's going to be a pre-conference workshop. I spoke on it in San Diego a little bit and most of the comments I got were we need more time, can you talk longer about this? So now I'm going to do a pre-conference workshop and, oddly enough, I'm also partnered with a company up here now that is modeling this theory and rolling it out to their workforce, and the CEO and this lead safety person is going to come and speak.

Billy Martin: 12:06

I'm going to reveal the formula which I'm going to do here as an early reveal, and they're going to talk about the model. So anybody want to know how to deploy it. They're going to talk about how they're deploying it. So I think it's a logical progression. So when I'm about to tell you so I did five years with Greg Greg from CVS just did the pump simulations, fusion pumps, and that infusion pumps is a chance to experience using pumps before you use them.

Billy Martin: 12:36

It's okay to fail safely in a simulation, which is why simulations are so good because it is a simulation. Well, the same thing occurs with the way your mind works.

Billy Martin: 12:45

So there has been studies where, if you sit quietly and envision something like a golf swing, your golf swing improves almost as much as it is. You swing it 15 minutes in the morning and an afternoon is one group's swung or clubs, and another group sat in a chair 15 minutes in the morning and afternoon. When they finally did the evaluation, the people who swung the clubs were 23% better. People who sat there and envisioned it were 21% better. So when we create an experience for our mind, our mind you've heard neurons that fire together, wire together. Have you heard that before? Right, so our mind creates a circuit.

Billy Martin: 13:20

So, for example, when you first touched a hot pan as a kid and you burned your finger, you had never had the experience. So let's say you were experientially blind to that possibility. So your brain's prediction wasn't that you would burn yourself. It had a predictive processing error and you burned your finger. And as soon as you do, it creates a circuit that to prevent you from ever doing that again. Well, it turns out you don't need to burn your finger to make that circuit. That's what the model's about. It's a tally share with the book Optimism Bias, and optimism is a really good thing. Optimists do much better than pessimists, but we all have this optimism bias where we don't think it's ever going to happen to us. If we don't believe a thing will happen, then our brain doesn't create an experience for it, for us to predict the right outcome.

Billy Martin: 14:04

So what you guys have been doing, in simulation is actually creating an experience for the brain to see what's going to happen, but I think we're not using it to the level of the availability. So when I went around with Greg with high fidelity mannequins, that was really cool because the mannequin was really cool and we could have all kinds of cool scenarios. But the relationship between the people that are doing the simulation and the experience is just as important as the high fidelity. And I don't know if we weigh that. What do you think? No-transcript.

Billy Martin: 14:33

Yeah, so let me ask you this what if we did a simulation of a nurse making a medical error? The whole simulation wasn't, it isn't just if an error happened. The whole simulation is based on all right you're giving, you have one of a simulated pump and you just set it to the wrong setting and now you're overdosing whatever drug you can choose right To your patient and you notice it's the beta blockers, say, and their eyes are rolling back in their head and they're going unconscious. Go. And now what you need to do is you need to process. What do I need to do medically to help this patient? What kind of reporting system do I have that I? Who do I report to? What kind of remediation does our system have? I don't know. If you guys are in medicine, you can almost feel the pressure. Do you feel that?

DebTauber: 15:15

Yeah. Yeah you just feel the pressure that creates that circuit.

Billy Martin: 15:19

So once you create a subconscious circuit, you won't know if that changes your behavior, because it's subconscious. So I'm an optimistic nurse. I'm never gonna make a medical error. So I'm just, I'm multitasking. The bells are going off. All these things are going on. I have all this distraction. I set the pump.

DebTauber: 15:34

But now that I've done this simulation.

Billy Martin: 15:36

I've actually made a medical error in simulation, so my brain knows that's possible. So I'm no longer optimism biased, I'm no longer experientially blind, so my subconscious can create a different prediction into the outcome. Our whole we seem to be focused on preventing the error and controlling the risk of medicine, not in predicting a different on different predictions.

Jerrod Jeffries: 15:59

And also, if you're not prepared, then you don't believe it'll happen. And so the flat tire analogy is that if you don't think the plane's gonna take off or the drive is gonna happen, then you're never gonna fully be able to fully execute as well as you would. So if you don't have your suitcase because you don't think you're actually gonna go well, then you're not gonna be prepared for the trip on hand.

Jerrod Jeffries: 16:21

You know the same thing to be practiced in healthcare, where if you're not prepared via simulation, then you're not really gonna actually execute as well within the actual patient.

Billy Martin: 16:31

So that's. I appreciate that that was excellent. And what you're talking about, the way you're speaking about this, is conscious, but what you're really doing is priming your subconscious, because in the prediction machine and in Lisa Feldman-Beret also has a TED Talk, a really good TED Talk about emotions. We don't have a circuit for emotions, they're created by our brain, right? So? And she talks about experiential blindness. If you haven't experienced something, you're blind. Like when you look at those pictures that are two variations of the same picture. Your eyes see the same thing, but all of a sudden you see both pictures, like the old lady, the young lady, right those? Have you seen those pictures? There's a bunch of those. So your eyes are seeing the same thing, but your brain changes the prediction. So because your brain? So this is kind of the thing is your brain.

Billy Martin: 17:17

You know you guys aren't seeing me right You're only seeing as reflection of light, that's on cones and rods in the back of your eyes. Your brain is interpreting those lights through electrical and chemical images. And then you're also not hearing me.

Billy Martin: 17:31

I'm vibrating the air to my speaker, which is sending a signal a wavelength which is vibrating the air in your eardrum, which is now being interpreted by your brain. So your brain is an interpreter, it's an experience and interpretation machine. It doesn't see anything, so it bases everything based on experience and there's turns out, there's four times the circuitry to get you moving forward. Then there is coming in for the stimulus that you're experiencing and the stimulus is really to fine tune what your brain has already decided. You know that the old tape was that they would dissect brains and determine routes. You know where they go and where the signal goes. But the new scientists say dead brains don't talk, they're using FMRI and EEG. So this is pretty new. Well, it's a little uncomfortable. There's another piece to it that I haven't gotten to and I know I'm talking a lot. I hope I'm, you know no, but I love this One.

Jerrod Jeffries: 18:22

it is heavy, but I love that. It is because it makes you a little uncomfortable, and this is what I so you did preface it. I'm just really enjoying listening to you.

Billy Martin: 18:31

So Victor Frankel, who?

Jerrod Jeffries: 18:33

Man searcher meaning yeah.

Billy Martin: 18:34

And he lived through four Holocaust camps. Right, and he said this is his quote he said there's this space between stimulus and response and in that space is our power to respond and in that response is our growth and our freedom. So Victor Frankel had to separate himself from his emotion in order to survive four Holocaust camps. In doing that we now realize there really isn't a space between symbols and response.

Billy Martin: 18:57

We have to create the space or, better yet, we have to be aware that there is a space, and so I'll ask you this Jerrod, are you aware of the voice in your head? I am yes, so you are aware of the voices. So are you aware that that voice in your head is not you? I'm not no. Right now you are hearing, we're interacting and you're aware that you're interacting. Correct, Now, when you're speaking in your head, you're the only one that's interacting with your head, right?

Jerrod Jeffries: 19:21

Aside from my imaginary friends.

Billy Martin: 19:23

But yeah, so, so, yes, you are actually the person or the observer that's aware of the voice in your head. You're not the voice in your head, you're not your mind, you're not your brain. You are aware of the voice in your head. So that creates a space between you and your emotion and we seem to have an entire population. As soon as you make a mistake, you're embarrassing it, but that's not even us. That's a biological reaction and make the law, hijack if you will. But if we start to realize that we are not the voice in our head, we're not even our emotion, we are the person that's aware of it. We can create a space and then be curious and interested why I'm having that emotion. And the psychologist say if we call the emotion out and I'm feeling intimidated or I'm feeling anxious, our subconscious goes to work to bypass it. But if we are our emotion, we will react, and you guys have. I've done it and I still am not great at it. But as soon as you react, and then you feel a little bit bad about what you said because it wasn't you, it was a reaction, right.

Billy Martin: 20:19

Well, when we start realizing that we are optimistic and we might be experientially blind to this and the prediction, the error we made was just a predictive processing error and what I need to do is get my brain to experience that thing so it can prepare me to not to make that error again. We start looking at simulation like, well, what experiences do we need to prepare for? And it turns out because of optimism bias, we don't prepare for worst case scenarios. I'll give you an example. I asked this recently and there's a bunch of people that I was at a CPR event and I was going to write this citizen CPR and I was explaining optimism bias and I said anybody here a CPR instructor? They said well, yeah, sure. I said well, can I trigger you a little bit emotionally? And I said it's gonna make you uncomfortable and I have to prepare the audience for this because if I just jump in on them, they may they're defensive, yeah and beat me up or something.

DebTauber: 21:12

What no, I was gonna say. Why don't you tell our listeners about the 3Ds? I think that's really important to remember when you're having conversations, especially when something could trigger someone.

Billy Martin: 21:27

So you know, our tap room investigations are about the five whys. I just wrote an article it's still in draft right now on pattern disruption. Don't ask why, because as soon as I ask you why, that puts you in defense right, your next move is defense. If I say why you're gonna defend your position Really the words how and what, or clean language, that's something you can look up. It's a way to ask unbiased questions like what's that for or what would you like to have happen? Those are not why. So when I talk about the 3Ds, my generation is modeling defensiveness, divisiveness and dismissiveness right. And as soon as we do that, it puts you in defense. Because if you're accusatory or I dismiss you now, you need to defend your position. But because we don't ever need to defend our position, we believe what we believe. We're welcome to believe whatever we want to believe in this country, which is so far anyway, which is pretty awesome.

Disclaimer/ Sim VS Ad / Intro: 22:25

But I like to say a.

Billy Martin: 22:26

Muslim, a Jew, a Buddhist, an atheist and a Catholic can build a house together with the same tools, Because the house and the tools live in physical reality and they don't care what we believe or what we think Right. So when we start to realize that our brain is a structure, and as we change that structure to be more curious and interested, we will learn more things. It doesn't matter what we believe. We can believe anything we want. It doesn't affect any of that. That changes physical reality of our conversation. I don't know if that makes any sense. This is pretty heavy, too dear, but I often hand out a corn seed.

Jerrod Jeffries: 23:02

Well, it does make sense and I think I would interpret it as based off where you're born, is the beliefs, customs, norms that you acquire, and based off that environment from society, community, family, etc. I mean religious practices probably be one of the most prominent. Is then that leaves you to believe X over time and your, your heuristics and mnemonics and other types of ways of looking at life, very well studied and researched, I think really applies to a lot of areas, obviously in the physical, mental, spiritual world, but also resonates deeply within healthcare too, because you're able to say you know, I love the analogy of all the different religious practices building a house is you have interprofessional education of. Even though you have different backgrounds and you have different mental frequencies or you know substances internally, you can still practice towards the common goal and create this shared outcome.

Billy Martin: 24:08

Yeah, so that's the world I want to live in, right? So what we do is we hold on to ritual, right? That's kind of what you're talking about debates on whatever heuristics where we are, so we develop this. So the taproot is a ritual, the five Y's and then the hierarchy of controls was a ritual started around 1950,. Right, we need to control hazards. This model is based more on prediction than control, because if we change our prediction, the thing never happens.

Billy Martin: 24:37

And there are I mean you can link to this as a short story where there are no parades for things that don't happen. So, for example, I can give you an example. I just spoke in Long Island and I was moving from Island Park to some other part of the island, to another fossil fuel plant for the next day, and the directors just oh, by the way, when you come in, if you come in from the North, there's a really steep hill with a lot of traffic and there's a 90 degree driveway at the bottom. You got to turn in and it's horrendous. So if you can come in from the South, that would be better. I've never been there. I have no idea what he's talking about. So I get up in the morning and I punch up my deep grass and there's a 35 minute route and a 45 minute route and normally I just pick the shortest route right. But I know that all of a sudden it plugged into my head when he said that shortest route comes down and then there's a left turn. So I said well, that must be what he's talking about. I'll take the other route. So I changed the prediction of my trip to that thing based on his input, because he raised a concern.

Billy Martin: 25:28

So this is the other thing I'm doing with this is that round this should happen in medicine. When we're doing a nurse's shuttle, whatever, or they're doing it already, a tool of Guwani's checklist manifesto, they're doing it in operating rooms, right. If they get in a circle, they say what's your role, what concern do you have? You realize, somebody expressing a concern is not somebody writing down a concern. They're calling it up, and when I call up a concern, it triggers you. If I say finger licking, you might see that we're good at a chicken, right?

DebTauber: 25:57

Right.

Billy Martin: 25:57

I don't say finger licking, you see nothing. So he raised his concern, and a concern is a prediction of an outcome you don't want. So if we could practice every day in a hospital setting, okay, everybody gets to speak up. That's practicing speaking up. The likelihood of somebody speaking up at the moment they need to is slim. But if you practice the violin, you get pretty good at it. And if you don't, you don't. But if you practice speaking up in this little huddle, what's your role? What concern do you have?

Billy Martin: 26:22

I'm doing it with the electric utility and they love it. Even after they do their job brief, they get in a circle and they're all type A's, they're competitive and they're like oh man, I got to have the best concern. Today they're all looking around for the best concern before they get to that part of the job brief now, and that raises a number of predictions. And then, once you play out, well, what's going to happen if that happens? It changes your experience in your brain, which changes the outcome. That director changed the outcome for me going that day because he gave me a prediction of that hill and the funny thing was when I got there I said this is exactly what I'm talking about.

Jerrod Jeffries: 26:54

He said yeah, you know that's the shortest route for me. I'm beginning to wonder if I should be going that way and I laughed.

Billy Martin: 27:00

I said did you hear yourself? I said you already answered your question, right? Right, you had enough concern to tell me and you're still driving that way. That's a higher level thought. And we get caught up in those rituals, right?

Billy Martin: 27:13

The Swiss cheese model, James Reason, I don't feel familiar with that. That was around 2000. And I love James Reason's work and I've read it. But the Swiss, the model itself, the depiction of a bunch of slices of cheese and the holes lining up, is not a good model because it's a model of an anomaly. And when that all if nothing happens linearly and if everything, all the holes line up, that's a pretty rare event. And then what we do is we try to add layers and layers of control to prevent that thing from ever happening again. But really all we needed to do is do a small compass correction in the front. That thing would have never happened. But we're not aware that it didn't happen. Because we made the change. I think we are capable of improving our predictions and removing experiential blindness and that's why this model is starting to gain ground. I think because it's.

Billy Martin: 28:00

I did its test on LinkedIn. I wanted to see if the hierarchy controls was actually a religion and I knew, if I posted something about it, that you know where are the hierarchy controls, because it talked about a hierarchy of predictions. And I immediately got a repost with a whole negative post on it and people just beating the crap out of me, which I love. I guess it's a social experiment for me, like, and I don't get emotional about it, it's just fun, right? So one guy said our controls is perfect, we don't need to put a strawberry on top, and I loved that because it might be perfect, but that pretty much just confirmed You're so sold on it.

Billy Martin: 28:36

Now you're defending it, and I didn't say the post to defend it. I was curious about how much are we working on predictions, but what range of defense, and that's I take some responsibility for that. My generation has modeled that really well, you know yeah.

Billy Martin: 28:50

I even did a tiktok recently, just as it is. I do that I'm on tiktok because the younger generations are there and I want to see what they're learning. So I did one. I was riding the chairlift at whiteface and I just did a brief one on. I said I'm a baby woman, I'm sorry. And then I went through the whole defensive device of dismissive thing. It's a short tiktok and the guy got out there and he said with a comment he said hey, I'm a baby boomer. My millennial and gen X started to watch your video. But when they saw that you were on your ski vacation, they tuned up and I said and I said, geez, I love this. Thank you for confirming this. I said what I'm hearing is they immediately judged and dismissed me because I'm on a ski vacation. I said but what's interesting? I'm not. For 30 years I've been a volunteer ski patrol and and I started ski patrolling because I couldn't afford to ski. So you dismissed me based on a belief.

Jerrod Jeffries: 29:38

That's not true.

Billy Martin: 29:39

Hmm, I said, which means your children learned well. Wow, that's something. Yep, I mean, you see it. On Facebook and all these other social media, people go rate to defense. If somebody challenges their belief, they go read to defense, and I think the world we want to live in is we don't need to defend. We have we're pretty cognitively high level on this planet. We just need to be curious why somebody else has a different belief.

Jerrod Jeffries: 30:04

Yeah, to that point, which I completely agree with. They always try to shift the blame too, and I love what you're doing, billy is trying to learn and interact with younger generations, where most people try to blame younger generations or older. Oh yeah, I see a lot on on X. It's like we can't afford a house now because the boomers did this, and it's like what what that doesn't do with them, you know, and so there's always a shift in blame.

Jerrod Jeffries: 30:29

And to this one, it's like, to your point. There's always a shift in like okay, I have this preconceived notion of what I believe and there's not room for growth lack of better word Because they're not trying to learn and they're not trying to understand more of different situations, unique situations. Back to your Swiss cheese model. Is these anomalies like wait, now, you know, on 2023, December, skeen in the United States is expensive. You found a way? Hey, I want to volunteer, I'm gonna make sure this happens. Or Outside the US, right, if you get there somehow on a cheap airfare, or whatever. Most Europe or or even South America, is way cheaper because it's not almost a Monopoly or a small conglomerate that owns all the mount ranges, and so there's all these different ways, but it's it's easier to always say, oh, billy's scheme, I can't listen to him and it's just yeah.

Jerrod Jeffries: 31:21

It's just so unique that where you're coming from is a much more open, optimistic Learn. I will even go out of my comfort zone joining tick-tock I'm not even on tick-tock, so I love that but joining tick-tock to try to learn and be with, be with the youth and try to understand them more.

Billy Martin: 31:38

So I started a path and I don't want to go too long here for you, but the CPR thing and the CPR instructor thing I started as I got. I got a ping-pong and missed it. But so I asked the the, the CPR instructor. I said I'm gonna trigger you. I remember I started talking about that.

Disclaimer/ Sim VS Ad / Intro: 31:52

I said is it okay? I said yeah, so.

Billy Martin: 31:54

So I'm gonna explain optimism bias. So are you gonna CPR? Yeah, are you married.

Billy Martin: 31:59

Yeah, all right, let's just say You're washing dishes. I said it was a male. I said, which I know is not true and and your wife walks in and you look and all of a sudden you drop, did Go. What will she do? And she said well and Well, and it's a lot of them will look probably. I said well, probably. You know, those are those red flag words Probably, maybe, should be, might be means we don't know. But going, keep going. And you know, with simulation, I can't tell you what to do. I can only keep asking questions. So, she's well, so he'll call 911. Okay, does she know CPR? Well, yeah, okay, what she gonna do? Well, she's gonna start CPR and then what well, 911 is gonna tell you. It's 12 minutes. I said so what's she thinking about? And at the end we redo.

Disclaimer/ Sim VS Ad / Intro: 32:38

I said when's the last time

Billy Martin: 32:39

you visited that sequence in your mind Never? When's the last time a nurse, dead, has sequence going home doing CPR on their own husband? Right? It's not something you want to, it's not a norm, right? So because because we're out, because we don't think it will happen, although it happens, thousand out of hospital cardiac arrest a day, 700 are in the home. You know 70% are in the home but we don't think it was gonna happen.

Billy Martin: 33:02

So we practice for the skill of CPR but not for that stress response. And I gotta tell you as a paramedic, if you call me Jared and you have a broken leg, you're kind of hoping I have some experience in that thing. But we actually don't practice for worst-case scenarios and when we do, we're experientially blind to them. I work with the utility industry.

Billy Martin: 33:22

Heat stroke those guys don't know the difference between exhaustion and heat stroke. You don't realize they're gonna be soaking wet because they're they're working outside and they're sweating already a lot of these to be hot and dry. For heat stroke it's not, unless you're in a nursing home, right, or electrocution. You know there I investigated a number of the fatalities last year the utility industry and every time it appeared they were out at first. They're out of. The crew was out of sync and that response was so stressful for them that now they're PTSD Because we don't practice for that thing even in our mind. So I think Simulation needs to start doing some exercise for the brain, and by doing that we need to remove experiential blindness To things like nursing errors or.

Billy Martin: 34:05

You know, you're not just. You run a quote in ACLS. The coach should actually follow some natural sequence. No person has chest pain and then all of a sudden, and now they're grabbing their chest and now they're in v5. You know, now they're in v-tac. You know, now they're. Now we're shocking them and they're, they have a weak pulse and well, now they just lost the pulse again and that type of thing.

DebTauber: 34:25

Right, because you, those are the ones, real ones you've been on, yeah oh, yeah, yeah, compared to a CLS, when they're just putting different rhythms up and you have to randomness.

Billy Martin: 34:34

Right.

Billy Martin: 34:35

Yeah this didn't sound as scary to talk to you about as I thought it was going to you guys, but it's. We all have optimism bias. It creates experiential blindness because we don't our brain doesn't have the experience that we don't think it'll ever happen, which causes a predictive processing error so we can get better at predictions. Which removes the event all together. I think an example 9 11 Shouldn't have never happened and the odds of it happening before and after are the same, except now I have to be got my belt in my shoes To go fly right. We created all these layers to control the thing from ever happening again. But the thing with an anomaly there's so many combinations and permutations as to how things, outcomes, can occur. We can't control them all. But if we get in the front and start actually focusing on predictions, being prepared for that worst-case scenario and making it happen, so it actually does stress us a little bit I think it changes outcomes.

DebTauber: 35:30

And that's no. I think you're right. I think when I hear about your, what you're doing with the linemen and having them think differently before they start their work Right, and they're all challenged to come up with you know, one up each other and I think that that's a cultural shift. Well, that's the other part is we don't have to like each other.

Billy Martin: 35:50

We just have to be curious and interested why somebody as bright as you guys might think something different than me, and that's.

Billy Martin: 35:56

I think I mentioned the hamburger thing last time. I'm not sure, in case I didn't. So I asked people if they like hamburgers or not. They say you do eat hamburgers here, I do you ever have a really good hamburger? I have, and How'd you know it was good? I enjoy the taste of it, right, and that's what we think the reality is. The only reason you knew was good is because you've had a bad one, and as soon as you bite into it without cognitive load, you know this is really good. Not as good as Joe's, but ten times better than those other ones. And I remember I did this with dead last time. She likes McDonald's, right?

DebTauber: 36:28

So that's your hamburger bandwidth.

Billy Martin: 36:30

You don't base your good hamburgers only on the good ones, it's on all the hamburgers. It's the same with ideas. You don't base a good idea just on the ones you like. Your bandwidth is based on all of the ideas. So you wouldn't have to even like my idea or who I am or any of that. But you need to be interested why this idea might be something different and you should really add it to your bandwidth. You know I think it was Margaret Mead said Never underestimate the power of a small, dedicated group of individuals to change the world. It's the only thing that ever has.

Billy Martin: 37:00

True, so I appreciate to Si m V S setting this up. I wrote three one-page blurbs on optimism, bias, experiential blindness and predictive processing and Greg said he's going to put those up on his SimVS website. So if anybody wants to read a little bit more about it, I can give you the word my book list. The reality is, you guys are that population that Margaret Mead was talking about. This podcast has the potential to change the world. I changed the route I traveled because one guy told me something and I don't know what would have happened coming down that hill. Maybe nothing, but I can tell you, I can guarantee you, if I got hit in the rear end making that left turn.

DebTauber: 37:38

I would have been mad that I didn't listen to him so it's the same thing with my pool mitigation, the risk mitigation plan that we work through. We have the slide. We went ahead and created a sign. I put new things on the stairs, creating that awareness to a potential safety threat.

Billy Martin: 37:58

Absolutely and the easy way to start. So I'm going to add just the physical reality, and I mentioned this earlier. I handed out a corn seed. The only thing I handed out in Sim Prevention for the utility was a corn seed, and I had everybody hold in their hand and I said this corn seed, what is the potential? And they were like that can become a corn plant. I said right, and what is its potential? If you set it on your desk tomorrow and come back in, Will it be a plant? They said no, and I said what does it need? Well, it needs good soil, sunlight and water.

Billy Martin: 38:25

And your plant doesn't care what you think or believe. If you do the right thing with that seed, you can leave and it grows a plant. That's exactly how your subconscious works. You can plant an idea and I said so what on our planet starts with that genetic code? And they're like thinking I said well, let me change that. What on our planet doesn't start with that genetic code?

Billy Martin: 38:45

Everything starts just as genetically coded, like the seed, including us, right?

Billy Martin: 38:49

I mean your seed, Jerrod, started a week before your mother was born.

Billy Martin: 38:54

All of the ingredients to form your eggs of her million were there, right, and then you are whatever number of siblings you have in a million, not counting the odds of what that particular sperm fertilizing that egg. And then at some point you came into some level of consciousness, you came from a biological journey to a spiritual or conscious journey and to me that's a space, that's a room in space, and the door opened, you entered the room and you guys are in the room and we create whatever havoc we can create in this life and eventually we exit Because we wake up, having never been asleep, and we go to sleep never to wake up. But I firmly believe, and especially being in medicine, I've seen that space in that room be very small. A baby born, is born and dies, sometimes in a matter of minutes. But that space we come from, the space we go to, I have to believe, is the same space, regardless of our religion, right? And what we do, what we accomplish in that space.

Billy Martin: 39:49

I read the book also 4,000 weeks, but 4,000 weeks is a lifespan If you start looking at how many weeks you have left. Why do we want to spend any more of our weeks being defensive?

DebTauber: 40:00

Right. There's only a certain number left Right.

Billy Martin: 40:04

While we're in that space, before we hit that exit door, let's raise our consciousness to a higher level for the whole society and start realizing that the bomb that lands in Palestine or the bomb that lands in Israel is in physical reality. It doesn't care. Its job is to blow things up. The only difference between those two bombs is their justification for being there.

DebTauber: 40:22

And that's a social construct.

Billy Martin: 40:23

Right, right, but I talked to a lot, I know, and I bounced around a lot of things. I hope I didn't blow your mind too much, Jerrod.

Jerrod Jeffries: 40:31

No, this was excellent and my biggest takeaway is, if you optimize, your optimizing bias leads helping to remove that experiential blindness which then causes the predictive processing errors.

Jerrod Jeffries: 40:44

And I think that there's a lot that you've if I'm unpacking so much of I'm grasping here from all different areas, but one is it's your own perspective in a much larger world, where being more predictive or taking in outside variables to try to learn obviously learning is more powerful than anything but then using that to be more cautious I don't want to say cautious, but predictive in what you're pushing forward in your future.

Billy Martin: 41:15

So what we need are triggers. So the optimism bias actually causes experiential blindness, because if we don't think it's going to happen. We don't predict and experience where it happens. So if you don't think you're going to fall off the bridge today, you're not going to be worried walking across it, yeah, or wearing a light jacket, exactly.

Billy Martin: 41:34

So the optimism bias that's Tali Sherrick's book she wrote causes experiential blindness, which is in the YouTube video by Lisa Feldman-Barrick which is the easiest way to see that explanation. So it changes our predictions. We need triggers. So, for example, when that thought comes to your mind without your permission, we go to do a defense off suddenly like, oh, I don't need to worry about that or that's not going to happen. But really, if there's a high consequence to that thought that enters your brilliant mind without your permission, you need to just take a moment and switch to that system. Two condiment, more accurate thinking. Just weigh it. We can move ahead with a maybe, but not without switching out of your system one mind to your system two to really consider the consequence for that action which is what I did when I changed my route on Long Island last week.

Billy Martin: 42:22

And then you learn not to blow other people's ideas Because it didn't show up in your head doesn't mean it's wrong if it shows up in somebody else's head. It takes practice. I'm not great at it yet, but I'm working on it. I still have time.

DebTauber: 42:36

Great outlook.

Billy Martin: 42:38

Well, listen, I appreciate this and I think I probably talked too long. It's been almost an hour, no, but thank you.

DebTauber: 42:44

Yeah, thank you. We enjoyed listening to your unique perspectives and the things that you're trying to do. Thank you.

Billy Martin: 42:53

Well, thank you, guys. You're providing a platform to change the world, right? You are exactly what Margaret B talked about Small group of dedicated individuals with a desire to change the world. So thank you.

Jerrod Jeffries: 43:05

Certainly try the only the crazy ones do. That's right, all right, thanks guys.

DebTauber: 43:11

Thank you, happy simulating.

Disclaimer/ Sim VS Ad / Intro: 43:14

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