Know Your Goals when Dealing with Risky Situations

Whether you’re heading up Everest or placing a crown, there’s a certain amount of risk involved. Managing that risk, according to Scott Parazynski, M.D., who is also the only astronaut to have summited Everest, boils down to knowing what your goals are in advance. Those goals often involve everyone going home safely. To that end, doctors need to know when they’re out of their league.

Interview Transcript (Modified for Readability)

“Having a core set of goals for your practice, or for whatever your pursuit is, is paramount. In the setting of an expedition, the ultimate goal is for everyone to come back healthy and as friends. It’s a pretty low bar, if you keep that in mind. In a dental practice or a clinical environment, you’re worrying about patient comfort and clinical outcomes. I’m certain that there are many examples where the case becomes more challenging, you realize that perhaps this is something beyond your level of training, and you need to refer to another specialist.”

“Making critical decisions in life-or-death situations is very challenging even with lots and lots of experience and training. I think, first and foremost, you have to think about the ultimate goal, which is brining everyone back safely. It has to be the highest-level order for the team. When you have to make a decision whether to pursue a summit or a mission goal in a spacewalk, for example, versus getting everybody back in safely, it’s a pretty simple thing to do. You put all of your resources to crew safety. Most of the time, those decisions are kind of insidious. There’s one setback that happens after another, and the real challenge to a leader is identifying, ‘Things are starting to turn south here. I’m detecting a pattern. We need to stop and rethink or retreat.’

Thankfully, I’ve been trained and developed a lot of experience in a lot of different environments that have given me the sensitivity see some of those raising the hair on the back of the neck situations and making the decision to waive off early.

Recently, I went to Masaya Volcano in Nicaragua — the youngest lava lake in the world. It’s a very dynamic, eruptive environment. We were looking at magma from the inner parts of our planet and lots of eruptive activity taking place nearby. Making the call to notice the subtle differences in trends and pulling the team out early is just one example that comes to mind.”

RELATED: More Advice from Scott Parazynski, M.D.

· How to Think Critically about Risk

· Rethinking Risk in Extreme Environments

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