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The views and opinions expressed in this
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program are those of the speakers and
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do not necessarily reflect the opinions
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or positions of anyone at
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Innovative Sim Solutions or our
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sponsors . Thanks
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to Sim VS for sponsoring this week's
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episode . Simulation helps develop
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the mindset of patient safety by
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allowing learners to practice and fail
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in a safe environment . Simvs
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designs tools that contribute
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to the development of this mindset . We
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are excited to release our new 4-pump
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simulator practice prime's proficiency
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. To learn more , visit www
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. simvs . com . Welcome
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to The Sim Cafe , a
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podcast produced by the team at
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Innovative Sim Solutions , Edited
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by Shelly Houser . Join
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our host , Deb Tauber , as
0:59
she sits down with subject matter experts
1:01
from across the globe to reimagine
1:04
clinical education and the use
1:06
of simulation . So
1:08
pour yourself a cup of relaxation
1:10
, sit back , tune
1:12
in and learn something new from
1:15
The Sim Cafe .
1:21
Welcome to another episode of The Sim Cafe . Thank
1:24
you very much for joining us and welcome
1:26
Jerrod . And today
1:29
our guest is Billy
1:31
Martin . Billy is a
1:34
fascinating person , Billy
1:37
. Why don't you tell our listeners a little bit about yourself
1:39
?
1:40
Sure Deb . I'm just thrilled
1:42
for the opportunity , Thank you , thanks for being
1:44
here . So I've got kind of a mixed
1:47
bag of a background , but I did simultaneous
1:49
careers in medicine and in
1:52
the electric utility business so
1:55
it's kind of hard to explain . But I started
1:57
as a in the electric utility you know , janitor
1:59
, all that kind of stuff up to 20 years as a lineman
2:01
. And while I was a lineman I became a ski patrol
2:03
and then realized that
2:06
I didn't get enough experience . So I became an EMT and
2:08
then a paramedic and then
2:10
as a lineman I actually rolled onto a double
2:12
log truck , tip over onto two cars
2:14
that was the first one to seen . So I
2:16
ended up managing the scene and called
2:19
in three helicopters and
2:21
then when I contacted the helicopter company they
2:23
sent me an application . So I started flying
2:25
and then I had a flying 23 years on a helicopter
2:27
while I was in the electric utility business . So
2:30
my interest in medicine and now the outdoors
2:33
also led me to a diploma in mountain medicine
2:35
. I'm a ski patrol instructor , trainer
2:37
, and it just keeps going on from there . So
2:39
somehow I have these simultaneous things
2:41
going on , which has evolved
2:44
into a different way of thinking because I'm
2:46
involved in a lot of high intensity
2:48
adventures you know like . For
2:50
example , I'm climbing Mount Kenya in Africa February
2:53
5th . It's a thousand foot rock
2:55
climb to 17,000 feet will be my third time
2:57
, wow , but my first
2:59
time at 67 years old .
3:03
It's just all in the mentality and there's already
3:05
in that sentence , Billy , which is just so much
3:07
personal curiosity Where's your favorite place to
3:09
?
3:10
So I'm a ski patrol at Whitefix Mountain . My
3:12
favorite favorite place to ski is in the woods in
3:15
the back country . I do a lot I
3:18
do . I'm ice climber and also a back country adventurer
3:20
and I really had a really good
3:23
time . I've skied back country in Idaho . Just
3:25
right when , just before COVID hit , I was stayed
3:27
at the Opus hut between your
3:29
Colorado and Silverton . It's situated
3:32
11 , 6 . You skin in three
3:34
miles to get there and you climb . You
3:36
ski , skin the peaks around and ski
3:38
. That was unbelievable . I think I would like to
3:40
do that again .
3:41
Yeah Well , your third time
3:44
doing elevation that most people have not
3:46
ever experienced as well , you know , outside
3:48
an airplane . But we are going to take
3:50
this podcast in a little different direction
3:52
and make it a little more laissez-faire . So
3:55
I'd love to just unpack a lot , because
3:57
we both find you , as well as many of
3:59
our listeners , so fascinating , and actually
4:01
I want to lead off with a question of what are
4:03
you reading , if anything , and what would you recommend
4:05
to read ?
4:06
That's a really good question . I got hooked on Audible
4:09
a number of years ago , so I don't even know
4:11
if I know how to read anymore , Jerrod , I
4:14
just listen . But what I've been reading
4:16
is a lot of neuroscience , the
4:18
interesting thing . So I'm in the utility business and
4:20
I do a lot of speaking on safety and I've also been
4:22
in medicine . I just I spoke in San Diego
4:25
just in November in the Citizen
4:27
CPR Challenge Status Co-Conference
4:29
and I also spoke in San Diego for the
4:31
Incident Prevention Conference . So I also write for and
4:33
do podcasts for , and was really
4:36
there were two weeks apart in the same hotel , which was kind of
4:38
interesting . But I like to tell people that
4:40
you know , if I want to spin the news , I can spin Fox News
4:42
or CNN , or if I want to spin safety , there's
4:44
a lot of really good safety gurus out there . But
4:47
if you start learning about how our human works
4:49
, that's not spin . That's
4:51
based on studies . So , for example , andy
4:53
Clark wrote the book the Experience Machine how Our
4:55
Mines Predict and Shape Reality in May
4:57
2023 . So this is pretty current study
5:00
he's talking about and he refers a lot to Lisa Feldman
5:02
Barrett who wrote seven and a half
5:05
lessons of the brain 2020 . And
5:08
both of them talk about how our brain is a prediction machine
5:10
. He calls it the experience machine
5:12
. And then Andy
5:15
M Paul wrote the Extended
5:17
Mind the Power of Thinking Outside the Brain . That
5:19
was 2021 . Interestingly
5:21
, Andy Clark also wrote a paper in 1997
5:25
, where Does the Mind Stop and the World Begin
5:27
, which is really kind of an interesting
5:30
paper , because back then they
5:32
were thinking you know where is the mind and the brain encompassed
5:34
in the same space ? And they started
5:36
doing studies where , like
5:38
elementary kids , if they're doing math , if they
5:40
sit on their hands , they can't do math because as they move their
5:42
hands and fingers around , their mind is now in
5:45
their hands and fingers to calculate
5:47
math . And in 2007
5:49
, they kind of proved that your mind goes wherever
5:51
your focus is when
5:53
the iPhone came into market
5:55
. Because now that everyone has an iPhone
5:57
, if you lose your iPhone Jared , you lose your mind .
6:00
Yeah , very true
6:02
.
6:02
Very true . But just to summarize
6:05
that , though most of what you're reading is around
6:08
neuropsychology or
6:10
some form of mind
6:12
matter , environment , society
6:15
Is that fair to say ?
6:17
Yes , yes , so it's a cross between
6:19
behavioral neuroscience , neuroscience and cognitive
6:21
psychology . Daniel Kahneman of course
6:23
, the thinking fastest flow from 2011
6:26
was groundbreaking work and he got a Nobel
6:28
Prize in economics actually
6:30
for that . But where
6:32
he refers to the brain as a metaphor of system
6:35
one or system two thinking and system one's really fast
6:37
and system two's more accurate
6:39
, but you have to slow down . Tan
6:41
Lee wrote the book Neurogeneration in 2020
6:43
. She did studies on high
6:45
school kids with EEG headsets and she found high
6:49
school kids don't like to make eye contact , but when they do
6:51
, their brain waves synchronized . And
6:53
when you're engaged , like we're engaged right now , our
6:55
brain waves start to synchronize , which
6:58
now we're talking about things like neurosynchrony
7:00
and social enhanced cognition or
7:03
collective intelligence , which
7:06
means we have to connect . I
7:08
like to say that every generation has a higher IQ
7:10
than the one before it . But the IQ doesn't
7:12
matter , because one neuron in your head screaming
7:14
alone in a football field doesn't really do much . But
7:17
when these really brilliant neurons connect
7:19
with other people and we create that connection
7:21
, we operate it in higher ground . Oh
7:24
, I love that . I love that Tan
7:26
Lee Sherrod wrote the Optimism Bias which we'll be talking
7:28
about today , a tour of the irrationally
7:31
positive brain . He also wrote the Influential
7:33
Mind , which is what our brain
7:36
reveals about our power to change others . I'm
7:38
involved with a study right now with John Barge and Gary
7:40
Latham . John Barge is out of Yale . He's
7:43
retiring this month . Actually , he wrote
7:45
, before you Know it , the Unconscious Reasons we Do what we
7:47
Do , and there's more , but I don't want to do
7:50
the whole thing on books . But honestly , these
7:52
books are all interconnect
7:54
at some point where they
7:56
all are , how we actually
7:58
run our human . So , Jerrod , I don't
8:01
know if I've talked to you about this . Before
8:03
we get into what this model is that I've been working
8:05
on , I kind of have to diffuse something
8:08
. Is that all right ?
8:09
Yeah , please . And also I think we should
8:11
list the books that you just mentioned so we can include in the show notes too .
8:13
But yeah , yeah , so I've
8:15
got a slide with 12 books . I'll send it to you
8:17
, Please do so . I'm a
8:19
baby boomer and I speak a lot
8:21
now and almost everybody's younger than me , so
8:24
I often start by apologizing for being a baby
8:26
boomer and I also apologize to the baby boomers in the room
8:28
first . You see , look , I
8:30
don't want you to , you know , please don't , you know
8:32
, be judgmental of this . I'm not trying to call anybody out
8:34
, but my generation , which was
8:36
command and control , is really good at modeling
8:39
defensiveness , divisiveness and dismissiveness
8:41
. And when we do that
8:44
, we hold the people we're operating with
8:46
to a lower cognitive level . Because as soon as
8:48
I make put you into defense , you're
8:50
now moving into justification and rationalization
8:53
and that's a ripple into
8:55
the past . Right , but
8:57
what we want to be ? Because you guys
8:59
are brilliant and , like I said , every generation has a higher IQ
9:01
than one before , it's on the dumbest guy in the room , right
9:04
, you don't have to defend anything , you just have to be
9:06
curious and interested . You know why someone
9:08
might have a different idea . That's
9:10
a better model , because that unlocks reason , logic
9:12
and intuition . But you can't be justifying
9:15
and rationalizing and move forward at
9:17
the same time , right . And
9:19
then , if you've read any Eckhart Tolle or Tolle Harvey
9:21
von Braunz's last name , the power
9:23
of now , really the only chance
9:26
we have to change the future is right now . Whoops , that's
9:28
gone . I mean right now , right
9:32
. So when we're pushed into the past and
9:35
we only have a certain amount of cognitive load available
9:38
, it stunts our ability to
9:40
operate at higher levels . So what I'm going to
9:42
ask is I'm going to introduce some new things
9:44
today and it's going to make some people feel uncomfortable
9:46
because either haven't heard it or it's going to twist
9:48
their brain a little bit . I'm just going to ask that you
9:51
know if you've watched the Matrix take the red pill just for this
9:53
podcast . Perfect there
9:55
you go .
9:57
So I don't know where you want to go from here . I
9:59
love that you want to make people feel uncomfortable , because
10:01
I think you grow when you're out of your comfort
10:03
zone and I think that we most
10:06
, by default , homo sapiens , will always
10:08
default back to that comfort zone of this
10:10
is safe , it's secure and we don't ever
10:12
want to get out of that circle or out of
10:14
that comfort zone . So I think conversations
10:16
like this are what push society
10:19
forward . And then when you get there and you're
10:21
creating the synchronicity
10:23
among humans or community and
10:26
pushing those industries forward , pushing
10:28
those boundaries forward , I think is
10:30
beautiful , so we're so happy to have you there's
10:32
a video if you want to .
10:34
It's apples . It was 1997
10:36
, called the crazy ones , IBM
10:39
ThinkPad . It just hit the market and it was
10:41
controlling the market for computers . So
10:43
Bill Gates comes on with this Apple commercial
10:46
that doesn't show any computers . It shows Einstein
10:49
and Amelia , Earhart and
10:51
the Muppets . I mean all these things . And
10:53
then the catchphrase at the end is the people who are
10:56
crazy enough to think they can change the world are
10:58
the ones that do .
10:59
I remember that commercial yeah
11:01
.
11:02
And it's just proof that the most
11:04
successful people in businesses don't
11:06
tell you how smart they are and what they're going to tell you
11:08
. They tell you what they believe .
11:09
So yeah .
11:11
I'm sorry , so
11:13
go ahead . Dave , you're just going to say something .
11:16
No , I'm just interested in
11:18
the things that you're doing now . What are
11:20
your new ? You have some forward thoughts
11:22
.
11:23
So I mean , you guys are in simulation and
11:25
I started this journey doing
11:27
mental rehearsals and mental simulations
11:30
with Lyon to prepare for the worst case
11:32
scenarios , and it's evolved
11:34
, based on this research
11:36
, to a formula . And actually
11:38
I'm speaking in incident prevention
11:41
in Orlando in May and it's going to be
11:43
a pre-conference workshop . I
11:45
spoke on it in San Diego a little bit and most of the comments
11:47
I got were we need more time , can
11:50
you talk longer about this ? So now I'm going to do a
11:52
pre-conference workshop and
11:55
, oddly enough , I'm also partnered with a company
11:57
up here now that is modeling this theory
12:00
and rolling it out to their workforce
12:02
, and the CEO and this lead safety
12:04
person is going to come and speak . I'm going
12:06
to reveal the formula which I'm going to do here
12:08
as an early reveal , and
12:11
they're going to talk about the model . So anybody want to know
12:13
how to deploy it . They're going to talk about how
12:15
they're deploying it . So
12:17
I think it's a logical progression
12:19
. So when I'm about to tell you so
12:21
I did five years with Greg Greg
12:24
from CVS just did the
12:26
pump simulations , fusion pumps
12:29
, and
12:31
that infusion pumps is a chance to experience
12:33
using pumps before
12:35
you use them . It's okay to fail safely
12:37
in a simulation , which is why simulations are
12:39
so good because it is a simulation
12:41
. Well , the same thing occurs with the
12:43
way your mind works . So
12:46
there has been studies where , if
12:48
you sit quietly and envision something like a
12:50
golf swing , your golf swing improves
12:52
almost as much as it is . You swing it 15
12:55
minutes in the morning and an afternoon is one group's swung
12:57
or clubs , and another group sat in a chair 15
12:59
minutes in the morning and afternoon . When they
13:01
finally did the evaluation , the
13:03
people who swung the clubs were 23% better
13:05
. People who sat there and envisioned it were 21%
13:08
better . So when we create an experience
13:10
for our mind , our mind
13:12
you've heard neurons that fire together , wire together
13:14
. Have you heard that before ? Right
13:17
, so our mind creates a
13:19
circuit . So , for example , when you first
13:21
touched a hot pan as a kid and you
13:23
burned your finger , you had never had
13:25
the experience . So let's say you were
13:27
experientially blind to
13:29
that possibility . So your brain's prediction
13:31
wasn't that you would burn yourself . It had
13:34
a predictive processing error and you burned your
13:36
finger . And as soon as you do , it
13:38
creates a circuit that to prevent you from ever doing that
13:40
again . Well , it turns out you don't need to burn your finger
13:42
to make that circuit . That's what the model's about
13:44
. It's a tally share with the book Optimism
13:47
Bias , and optimism is a really
13:49
good thing . Optimists do much better than
13:51
pessimists , but we all have this optimism
13:53
bias where we don't think it's ever going to happen to us
13:55
. If we don't believe a thing will happen
13:57
, then our brain doesn't create an experience
14:00
for it , for us to predict the
14:02
right outcome . So what
14:04
you guys have been doing , in simulation is
14:06
actually creating an experience for
14:09
the brain to see what's
14:11
going to happen , but I think we're not using it to the
14:13
level of the availability . So
14:16
when I went around with Greg with high fidelity mannequins , that
14:18
was really cool because the mannequin was really cool and
14:20
we could have all kinds of cool scenarios . But
14:22
the relationship between the people that are doing the
14:24
simulation and the experience is
14:27
just as important as the high fidelity . And
14:30
I don't know if we weigh that . What do you think ? No-transcript
14:34
. Yeah , so let me ask you this what if we
14:36
did a simulation of a nurse
14:38
making a medical error ? The
14:40
whole simulation wasn't , it isn't just if an error
14:42
happened . The whole simulation is based on all
14:45
right you're giving , you have one of a
14:47
simulated pump and you just set it to the wrong
14:49
setting and now you're overdosing whatever drug
14:51
you can choose right To your patient
14:53
and you notice it's the beta blockers
14:55
, say , and their eyes are rolling back in their head and
14:58
they're going unconscious . Go
15:00
. And now what you need to do is you need
15:02
to process . What do I need to do medically
15:04
to help this patient ? What kind
15:06
of reporting system do I have that I ? Who do I report
15:09
to ? What kind of remediation does our
15:11
system have ? I don't know . If you guys are in medicine
15:13
, you can almost feel the pressure . Do you feel that ?
15:15
Yeah . Yeah you just feel the pressure that
15:17
creates that circuit .
15:19
So once you create a subconscious circuit
15:21
, you won't know if that changes
15:24
your behavior , because it's subconscious . So
15:26
I'm an optimistic nurse . I'm never gonna make a
15:28
medical error . So I'm just , I'm multitasking
15:30
. The bells are going off . All these things are going on . I have
15:32
all this distraction . I set the pump .
15:34
But now that I've done this simulation .
15:36
I've actually made a medical error in simulation
15:39
, so my brain knows that's possible
15:41
. So I'm no longer optimism biased , I'm no longer
15:43
experientially blind , so my subconscious
15:46
can create a different prediction into
15:48
the outcome . Our whole we seem
15:50
to be focused on preventing the error and controlling
15:52
the risk of medicine , not
15:55
in predicting a different on
15:58
different predictions .
15:59
And also , if you're not prepared , then you don't believe
16:01
it'll happen . And so the flat tire analogy
16:04
is that if you don't think the plane's gonna take
16:06
off or the drive is gonna happen , then
16:09
you're never gonna fully be able to fully
16:11
execute as well as
16:13
you would . So if you don't have your suitcase
16:16
because you don't think you're actually gonna go well
16:18
, then you're not gonna be prepared for the trip on hand . You
16:21
know the same thing to be practiced in healthcare , where
16:23
if you're not prepared via
16:25
simulation , then you're not really
16:27
gonna actually execute as well within
16:30
the actual patient .
16:31
So that's . I appreciate that that was excellent . And
16:33
what you're talking about , the way you're speaking about
16:35
this , is conscious , but what you're
16:37
really doing is priming your subconscious , because in
16:40
the prediction machine and in Lisa Feldman-Beret
16:42
also has a TED Talk , a really
16:44
good TED Talk about emotions . We
16:47
don't have a circuit for emotions , they're
16:49
created by our brain , right ? So ? And
16:51
she talks about experiential blindness . If
16:54
you haven't experienced something , you're blind . Like when
16:56
you look at those pictures that are two variations
16:58
of the same picture . Your eyes see
17:00
the same thing , but all of a sudden you see both
17:02
pictures , like the old lady , the young lady
17:05
, right those ? Have you seen those pictures
17:07
? There's
17:09
a bunch of those . So your eyes are seeing the same
17:11
thing , but your brain changes the prediction
17:13
. So because your brain ? So this is kind of the
17:16
thing is your brain . You know you guys aren't seeing me
17:18
right You're only seeing as reflection of light , that's
17:20
on cones and rods in the back of your eyes . Your
17:23
brain is interpreting those lights
17:25
through electrical and chemical images
17:29
. And then you're also not hearing me . I'm
17:31
vibrating the air to my speaker , which is
17:33
sending a signal a wavelength which is
17:35
vibrating the air in your eardrum , which
17:38
is now being interpreted by your brain
17:40
. So your brain is an interpreter
17:42
, it's an experience and interpretation machine
17:44
. It doesn't see anything , so it
17:46
bases everything based on experience and
17:49
there's turns out , there's four times the circuitry
17:51
to get you moving forward . Then there
17:53
is coming in for the stimulus
17:55
that you're experiencing and the
17:57
stimulus is really to fine tune what your brain has already
18:00
decided . You know that the old
18:02
tape was that they would dissect
18:04
brains and determine routes . You know where they
18:06
go and where the signal goes . But the
18:08
new scientists say dead brains don't talk , they're
18:10
using FMRI and EEG . So
18:13
this is pretty new . Well , it's a little
18:15
uncomfortable . There's
18:18
another piece to it that I haven't gotten to and I know I'm talking
18:20
a lot . I hope I'm , you know no , but I love this
18:22
One .
18:22
it is heavy , but I love that . It is
18:24
because it makes you a little uncomfortable , and this
18:26
is what I so you did preface it . I'm
18:29
just really enjoying listening to you .
18:31
So Victor Frankel , who ?
18:33
Man searcher meaning yeah .
18:34
And he lived through four Holocaust camps . Right
18:36
, and he said this is his quote
18:38
he said there's this space between
18:40
stimulus and response and in
18:42
that space is our power to respond and in that response
18:45
is our growth and our freedom . So
18:47
Victor Frankel had to separate himself from
18:50
his emotion in order to survive four Holocaust
18:52
camps . In doing that we
18:54
now realize there really isn't a space between symbols
18:56
and response . We have to create the space or
18:58
, better yet , we have to be aware that there is a space , and
19:00
so I'll ask you this Jerrod
19:03
, are you aware of the voice in your head ? I
19:05
am yes , so you are aware
19:07
of the voices . So are you aware that that voice in your
19:09
head is not you ? I'm not no
19:11
. Right now you are hearing
19:13
, we're interacting and you're aware that you're
19:15
interacting . Correct , Now , when
19:17
you're speaking in your head , you're the only one that's interacting
19:20
with your head , right ?
19:21
Aside from my imaginary friends .
19:23
But yeah , so , so , yes , you
19:25
are actually the person or
19:27
the observer that's aware of the voice
19:29
in your head . You're
19:32
not the voice in your head , you're not your mind , you're not your brain
19:34
. You are aware of the
19:36
voice in your head . So that creates
19:38
a space between you and your emotion
19:40
and we seem to have an entire population . As
19:42
soon as you make a mistake , you're embarrassing it , but
19:44
that's not even us . That's a biological
19:47
reaction and make the law , hijack if you
19:49
will . But if we start to realize
19:51
that we are not the voice in our head , we're not
19:53
even our emotion , we are the person that's aware
19:55
of it . We can create a space
19:57
and then be curious and interested why
20:00
I'm having that emotion . And the psychologist
20:02
say if we call the emotion out and I'm feeling intimidated
20:04
or I'm feeling anxious , our subconscious
20:07
goes to work to bypass it . But if
20:09
we are our emotion , we will react , and you guys
20:11
have . I've done it and I still am not great at it . But
20:13
as soon as you react , and then you feel a little bit bad about
20:15
what you said because it wasn't you , it was a reaction
20:18
, right . Well , when
20:20
we start realizing that we are
20:22
optimistic and we might be experientially
20:24
blind to this and the prediction , the
20:27
error we made was just a predictive processing error
20:29
and what I need to do is get my brain to experience
20:31
that thing so it can prepare
20:33
me to not to make that error
20:35
again . We start looking at
20:38
simulation like , well , what experiences
20:40
do we need to prepare for ? And it turns out because
20:42
of optimism bias , we don't prepare
20:45
for worst case scenarios . I'll give you an example
20:47
. I asked this recently and
20:50
there's a bunch of people that I was at a CPR
20:52
event and I was going to write this citizen CPR
20:54
and I was explaining optimism bias
20:56
and I said anybody here a CPR instructor ? They said well , yeah
20:58
, sure . I said well , can I trigger you a little
21:00
bit emotionally ? And I said it's gonna make you uncomfortable and
21:03
I have to prepare the audience for this because
21:05
if I just jump in on them , they may they're
21:07
defensive , yeah and beat me up
21:09
or something .
21:12
What no , I was gonna say . Why don't you
21:14
tell our listeners about the 3Ds
21:16
? I think that's
21:18
really important to remember
21:21
when you're having conversations
21:23
, especially when something could trigger
21:26
someone .
21:27
So you know , our tap room investigations are about
21:29
the five whys . I
21:31
just wrote an article it's still in draft
21:33
right now on pattern
21:35
disruption . Don't ask why , because
21:38
as soon as I ask you why , that puts you in
21:40
defense right , your
21:43
next move is defense . If I say why you're
21:45
gonna defend your position Really the words
21:48
how and what , or
21:50
clean language , that's something you can look
21:52
up . It's a way to ask unbiased
21:54
questions like what's that for
21:57
or what would you like to have happen ? Those
21:59
are not why . So when
22:01
I talk about the 3Ds , my
22:04
generation is modeling defensiveness , divisiveness
22:06
and dismissiveness right . And as soon as
22:08
we do that , it puts you in
22:10
defense . Because if you're accusatory
22:12
or I dismiss you now
22:14
, you need to defend your position . But because
22:16
we don't ever need to defend our position , we believe
22:19
what we believe . We're welcome to believe whatever
22:21
we want to believe in this country , which is so far anyway
22:23
, which is pretty awesome .
22:25
But I like to say a .
22:26
Muslim , a Jew , a Buddhist , an atheist
22:28
and a Catholic can build a house together with
22:30
the same tools , Because the house
22:33
and the tools live in physical reality and
22:35
they don't care what we believe or what we think Right
22:38
. So when we start to realize that our
22:41
brain is a structure , and
22:43
as we change that structure to be
22:45
more curious and interested , we
22:47
will learn more things . It
22:50
doesn't matter what we believe . We can believe anything we want . It
22:52
doesn't affect any of that . That
22:54
changes physical reality of our conversation
22:57
. I don't know if that makes any sense . This
22:59
is pretty heavy , too dear , but I
23:01
often hand out a corn seed .
23:02
Well , it does make sense and I think I would
23:05
interpret it as based
23:07
off where you're born , is the beliefs , customs
23:09
, norms that you acquire , and
23:11
based off that environment
23:14
from society
23:16
, community , family , etc
23:18
. I mean religious practices
23:20
probably be one of the most prominent . Is
23:23
then that leaves you to believe X over
23:25
time and your , your
23:27
heuristics and mnemonics and other
23:29
types of ways of looking at
23:32
life , very well studied and researched
23:34
, I think really applies
23:36
to a lot of areas , obviously
23:39
in the physical , mental , spiritual world
23:41
, but also resonates
23:45
deeply within healthcare too , because
23:47
you're able to say you know , I
23:49
love the analogy of all the different religious
23:51
practices building a house is you
23:54
have interprofessional education of . Even though
23:56
you have different backgrounds and you have different
23:58
mental frequencies or
24:00
you know substances internally
24:03
, you can still practice towards the
24:05
common goal and create this shared outcome
24:07
.
24:08
Yeah , so that's the world I want to live in , right ? So
24:11
what we do is we hold on to ritual , right
24:13
? That's kind of what you're talking about debates
24:16
on whatever heuristics where we are
24:18
, so we develop this . So the
24:20
taproot is a ritual , the five Y's
24:22
and then the hierarchy of controls
24:24
was a ritual started around 1950,
24:26
. Right , we need to control hazards
24:28
. This model is based more on prediction
24:31
than control , because if
24:33
we change our prediction , the
24:35
thing never happens . And
24:37
there are I mean you can link to this as a short story
24:39
where there are no parades for things that don't happen . So
24:42
, for example , I can give you an example . I just spoke
24:44
in Long Island and I was
24:46
moving from Island Park to some
24:49
other part of the island , to another fossil fuel plant
24:51
for the next day , and the directors
24:53
just oh , by the way , when you come in , if you come in from the North , there's
24:55
a really steep hill with a lot of traffic and there's
24:57
a 90 degree driveway at the bottom . You got to turn in
24:59
and it's horrendous . So if you can come in
25:01
from the South , that would be better . I've never been there
25:03
. I have no idea what he's talking about . So I get
25:06
up in the morning and I punch up my deep grass and there's a 35
25:08
minute route and a 45 minute route and
25:10
normally I just pick the shortest route right
25:12
. But I know that all of a sudden it plugged into my
25:14
head when he said that shortest route comes
25:16
down and then there's a left turn . So
25:19
I said well , that must be what he's talking about . I'll take the other route
25:21
. So I changed the
25:23
prediction of my trip to that thing based
25:25
on his input , because he raised a concern
25:28
. So this is the other thing I'm doing
25:30
with this is that round this should happen
25:32
in medicine . When we're doing a
25:34
nurse's shuttle , whatever , or they're
25:36
doing it already , a tool of Guwani's checklist
25:38
manifesto , they're doing it in operating rooms , right . If
25:41
they get in a circle , they say what's your role , what
25:43
concern do you have ? You realize , somebody
25:45
expressing a concern is not somebody writing
25:48
down a concern . They're calling it up , and
25:51
when I call up a concern , it triggers you . If I say
25:53
finger licking , you might see that we're good at
25:55
a chicken , right ?
25:57
Right .
25:57
I don't say finger licking , you see nothing . So
26:00
he raised his concern , and a concern
26:02
is a prediction of an outcome you don't
26:04
want . So if we could
26:06
practice every day in a hospital setting
26:08
, okay , everybody gets to speak up . That's
26:10
practicing speaking up . The likelihood
26:12
of somebody speaking up at the moment they need to
26:14
is slim . But if you practice the violin , you
26:16
get pretty good at it . And if you don't , you don't
26:18
. But if you practice speaking up in this little huddle , what's
26:20
your role ? What concern do you have ? I'm doing
26:22
it with the electric utility and they love it . Even
26:24
after they do their job brief , they
26:26
get in a circle and they're all type A's , they're competitive
26:29
and they're like oh man , I got to have
26:31
the best concern . Today they're all looking around for
26:33
the best concern before they get to that part of the job brief
26:35
now , and that raises
26:37
a number of predictions . And
26:39
then , once you play out , well , what's going to happen if that happens
26:41
? It changes your experience in your brain
26:43
, which changes the outcome . That
26:46
director changed the outcome for me going that
26:48
day because he gave me a prediction of that hill
26:50
and the funny
26:52
thing was when I got there I said this is exactly what I'm talking
26:54
about .
26:54
He said yeah , you know that's the shortest route for me . I'm
26:56
beginning to wonder if I should be going that way and
26:59
I laughed .
27:00
I said did you hear yourself ? I said you
27:03
already answered your question , right ? Right
27:05
, you had enough concern to tell
27:07
me and you're still driving that way . That's a higher
27:10
level thought . And we get caught up in those rituals
27:12
, right ? The Swiss
27:15
cheese model , James Reason , I don't feel familiar
27:17
with that . That was around
27:19
2000 . And I love James Reason's
27:21
work and I've read it . But the Swiss , the
27:23
model itself , the depiction of a bunch of slices
27:26
of cheese and the holes lining up , is
27:28
not a good model because it's a model of
27:30
an anomaly . And when
27:32
that all if nothing happens linearly and
27:34
if everything , all the holes line up , that's a pretty rare
27:36
event . And then what we do is we try to
27:38
add layers and layers of control to prevent that thing
27:40
from ever happening again . But
27:42
really all we needed to do is do a small compass correction
27:44
in the front . That thing would have never happened . But
27:47
we're not aware that it didn't happen . Because we made the
27:49
change . I think we are capable
27:51
of improving our predictions and
27:54
removing experiential blindness and that's why this
27:56
model is starting to gain ground
27:58
. I think because it's . I did its test on
28:00
LinkedIn . I wanted to see if the
28:03
hierarchy controls was actually a religion and
28:06
I knew , if I posted something about
28:08
it , that you know where are the hierarchy
28:10
controls , because it talked about a hierarchy of predictions
28:13
. And I immediately got
28:15
a repost with a whole negative post on it
28:17
and people just beating the crap out of me , which
28:19
I love . I guess it's a social experiment
28:21
for me , like , and I don't get emotional about it , it's
28:23
just fun , right ? So one guy
28:25
said our controls is perfect , we don't need
28:27
to put a strawberry on top , and I loved
28:29
that because it might
28:31
be perfect , but that
28:33
pretty much just confirmed You're so
28:36
sold on it . Now you're defending it , and
28:38
I didn't say the post to defend it . I was curious about
28:40
how much are we working on predictions , but
28:43
what range of defense , and that's I take
28:45
some responsibility for that . My generation has
28:47
modeled that really well , you know yeah
28:50
. I even did a tiktok recently , just
28:52
as it is . I do that I'm on tiktok because
28:54
the younger generations are there and I want to see what
28:56
they're learning . So I did one . I was
28:59
riding the chairlift at whiteface and I just did a brief
29:01
one on . I said I'm a baby woman
29:03
, I'm sorry . And then I went through the whole defensive device of dismissive
29:05
thing . It's a short tiktok and
29:08
the guy got out there and he said with a comment he
29:10
said hey , I'm a baby boomer . My millennial
29:12
and gen X started to watch your video . But when
29:14
they saw that you were on your ski vacation , they
29:16
tuned up and
29:18
I said and I said , geez , I love this . Thank
29:21
you for confirming this . I said what
29:23
I'm hearing is they immediately judged
29:25
and dismissed me because I'm on
29:27
a ski vacation . I said but what's
29:29
interesting ? I'm not . For 30 years I've been a volunteer
29:32
ski patrol and and I started
29:34
ski patrolling because I couldn't afford to ski . So
29:36
you dismissed me based on a belief .
29:38
That's not true .
29:39
Hmm , I said , which means your children
29:41
learned well . Wow
29:45
, that's something . Yep , I
29:47
mean , you see it . On Facebook and all these
29:49
other social media , people go rate to defense
29:51
. If somebody challenges their belief , they
29:53
go read to defense , and I think the world we want to live in is
29:56
we don't need to defend . We have we're pretty
29:58
cognitively high level on this planet . We
30:01
just need to be curious why somebody else has a different
30:03
belief .
30:04
Yeah , to that point , which I completely agree
30:06
with . They always try to shift
30:08
the blame too , and I
30:10
love what you're doing , billy is trying to learn
30:12
and interact with younger generations , where
30:15
most people try to blame younger generations or
30:17
older . Oh yeah , I see a lot
30:19
on on X . It's like we can't
30:21
afford a house now because the boomers did
30:23
this , and it's like what what that
30:25
doesn't do with them , you know , and so there's
30:27
always a shift in blame . And to this
30:29
one , it's like , to your point . There's always
30:31
a shift in like okay , I have this
30:34
preconceived notion of what I believe
30:36
and there's not room for
30:38
growth lack of better word Because
30:40
they're not trying to learn and they're not trying to understand
30:43
more of different situations , unique
30:45
situations . Back to your Swiss cheese model
30:47
. Is these anomalies like wait
30:49
, now , you know , on 2023 , December
30:52
, skeen in the United
30:54
States is expensive . You found
30:56
a way ? Hey , I want to volunteer , I'm gonna
30:58
make sure this happens . Or Outside
31:01
the US , right , if you get there somehow on
31:03
a cheap airfare , or whatever . Most
31:05
Europe or or even South America , is way cheaper
31:08
because it's not almost a Monopoly or
31:10
a small conglomerate that owns all the mount
31:12
ranges , and so there's all
31:14
these different ways , but it's it's easier to always say
31:16
, oh , billy's scheme
31:18
, I can't listen to him and it's just
31:20
yeah . It's just so unique that
31:22
where you're coming from is a much
31:25
more open , optimistic Learn
31:27
. I will even go out of my comfort zone joining tick-tock
31:29
I'm not even on tick-tock , so I love that but
31:32
joining tick-tock to try to learn and
31:34
be with , be with the youth and try to understand
31:36
them more .
31:38
So I started a path and I don't want to go too long
31:40
here for you , but the CPR thing and the CPR
31:42
instructor thing I started as I got . I got a ping-pong
31:45
and missed it . But so
31:47
I asked the the , the CPR instructor
31:49
. I said I'm gonna trigger you . I remember I started talking about
31:51
that .
31:52
I said is it okay ? I said yeah , so .
31:54
So I'm gonna explain optimism bias . So are you
31:56
gonna CPR ? Yeah , are
31:58
you married . Yeah , all right , let's
32:00
just say You're washing dishes
32:02
. I said it was a male . I said , which I know is
32:04
not true and and your wife walks in and you look
32:06
and all of a sudden you drop , did Go
32:09
. What will she do ? And she said well
32:11
and Well , and it's a lot of them
32:13
will look probably . I said well , probably . You
32:15
know , those are those red flag words Probably
32:17
, maybe , should be , might be means we don't know . But
32:19
going , keep going . And you know , with simulation , I can't
32:22
tell you what to do . I can only keep asking questions . So
32:24
, she's well , so he'll call 911 . Okay , does she know CPR
32:26
? Well , yeah , okay , what she
32:28
gonna do ? Well , she's gonna start CPR and then what well
32:31
, 911 is gonna tell you . It's 12 minutes . I
32:33
said so what's she thinking about ? And
32:36
at the end we redo .
32:38
I said when's the last time
32:39
you visited that sequence in your mind Never
32:42
? When's the last time a nurse
32:44
, dead , has sequence going home
32:46
doing CPR on their own husband ? Right
32:49
? It's not something you want to , it's not a
32:51
norm , right ? So because because we're out , because
32:53
we don't think it will happen , although it happens , thousand
32:55
out of hospital cardiac arrest a day , 700
32:58
are in the home . You know 70% are in the home
33:00
but we don't think it was gonna happen . So
33:02
we practice for the skill of CPR
33:04
but not for that stress response
33:06
. And I gotta tell you as a paramedic , if you call me
33:08
Jared and you have a broken leg
33:10
, you're kind of hoping I have some experience in that thing . But
33:13
we actually don't practice
33:15
for worst-case scenarios and when we do , we're
33:17
experientially blind to them . I
33:19
work with the utility industry . Heat
33:22
stroke those guys don't know the difference between exhaustion
33:24
and heat stroke . You don't realize they're gonna be
33:26
soaking wet because they're they're working outside
33:28
and they're sweating already a lot
33:30
of these to be hot and dry . For heat stroke it's not
33:32
, unless you're in a nursing home , right
33:34
, or electrocution . You know there
33:37
I investigated a number of the fatalities last
33:39
year the utility industry and every
33:41
time it appeared they were out at first . They're out of . The
33:43
crew was out of sync and that response
33:46
was so stressful for them that
33:48
now they're PTSD Because
33:50
we don't practice for that thing even in our mind
33:52
. So I think Simulation
33:55
needs to start doing some exercise
33:57
for the brain , and by doing that we
33:59
need to remove experiential blindness
34:01
To things like nursing
34:03
errors or . You know , you're not just
34:05
. You run a quote in ACLS . The
34:08
coach should actually follow some natural
34:10
sequence . No person has chest pain
34:13
and then all of a sudden , and now they're grabbing their chest
34:15
and now they're in v5 . You know , now they're
34:17
in v-tac . You know , now they're . Now
34:19
we're shocking them and they're , they have a weak pulse and
34:22
well , now they just lost the pulse again and that type of
34:24
thing .
34:25
Right , because you , those are the ones , real ones you've been on , yeah oh
34:27
, yeah , yeah , compared to a CLS
34:29
, when they're just putting different rhythms
34:32
up and you have to randomness
34:34
.
34:34
Right . Yeah this didn't sound
34:37
as scary to talk to you about as I thought it was going to
34:39
you guys , but it's . We
34:41
all have optimism bias . It creates experiential
34:43
blindness because we don't our
34:45
brain doesn't have the experience that we don't think it'll
34:48
ever happen , which causes
34:50
a predictive processing error so we
34:52
can get better at predictions . Which
34:54
removes the event all together . I think an example
34:56
9 11 Shouldn't
34:59
have never happened and the odds of
35:01
it happening before and after are the same , except
35:03
now I have to be got my belt in my shoes To
35:06
go fly right . We created all these layers
35:08
to control the thing from ever happening again
35:10
. But the thing with an anomaly there's so many
35:12
combinations and permutations
35:15
as to how things , outcomes
35:17
, can occur . We can't control them
35:19
all . But if we get in the front and start
35:21
actually focusing on predictions , being
35:23
prepared for that worst-case scenario and
35:26
making it happen , so it actually does stress us a little bit
35:28
I think it changes outcomes .
35:30
And that's no . I think you're right . I think
35:32
when I hear about your , what you're doing with the linemen
35:35
and having them think differently before
35:37
they start their work Right
35:40
, and they're all challenged to come up
35:42
with you know , one up each other and
35:44
I think that that's a cultural shift . Well
35:47
, that's the other part is we don't have to like each other
35:49
.
35:50
We just have to be curious and interested why somebody
35:53
as bright as you guys might think something
35:55
different than me , and that's . I think I mentioned
35:57
the hamburger thing last
35:59
time . I'm not sure , in case
36:01
I didn't . So I asked people if they like
36:03
hamburgers or not . They say you do eat hamburgers
36:05
here , I do you ever have a really good
36:08
hamburger ? I have , and
36:10
How'd you know it was good ? I enjoy
36:12
the taste of it , right , and that's what we think
36:14
the reality is . The only reason you
36:16
knew was good is because you've had a bad one , and as
36:19
soon as you bite into it without cognitive load , you
36:21
know this is really good . Not as good as Joe's , but ten times
36:23
better than those other ones . And I remember I did this
36:25
with dead last time . She likes McDonald's , right ?
36:28
So that's your hamburger bandwidth .
36:30
You don't base your good hamburgers only on the good ones , it's
36:33
on all the hamburgers . It's the same with
36:35
ideas . You don't base a good idea just
36:38
on the ones you like . Your bandwidth
36:40
is based on all of the ideas . So you wouldn't have to
36:42
even like my idea or who I am or any of that . But
36:44
you need to be interested why this idea
36:47
might be something different and you should really add
36:49
it to your bandwidth . You know I think
36:51
it was Margaret Mead said Never
36:54
underestimate the power of a small , dedicated group
36:56
of individuals to change the world . It's
36:58
the only thing that ever has . True
37:01
, so I appreciate to
37:03
Si m V S setting this up . I wrote three
37:05
one-page blurbs on optimism
37:07
, bias , experiential blindness and predictive processing
37:09
and Greg said he's going to put those up on his
37:12
SimVS website . So if anybody wants
37:14
to read a little bit more about it , I
37:16
can give you the word my book list . The
37:19
reality is , you guys are that population
37:22
that Margaret Mead was talking about . This
37:24
podcast has the potential to change the world
37:26
. I changed the route I traveled
37:28
because one guy told me something
37:30
and I don't know what would
37:32
have happened coming down that hill . Maybe nothing , but
37:35
I can tell you , I can guarantee you , if I got hit in the rear end
37:37
making that left turn .
37:38
I would have been mad that I didn't listen to him so
37:41
it's the same thing with my pool mitigation
37:43
, the risk mitigation plan that we work through
37:45
. We have the slide . We went
37:47
ahead and created a sign . I
37:50
put new things on the stairs
37:52
, creating that awareness to
37:55
a potential safety threat .
37:58
Absolutely and the easy way to start . So I'm going
38:00
to add just the physical reality , and
38:02
I mentioned this earlier . I handed
38:04
out a corn seed . The only thing I handed out in Sim Prevention
38:07
for the utility was a corn seed , and
38:09
I had everybody hold in their hand and I said this
38:12
corn seed , what is the potential ? And
38:14
they were like that can become a corn plant . I said right , and
38:17
what is its potential ? If you set it on your desk tomorrow
38:19
and come back in , Will it be a plant ? They said no
38:21
, and I said what does it need ? Well , it needs good
38:23
soil , sunlight and water . And your plant
38:25
doesn't care what you think or believe . If you
38:27
do the right thing with that seed , you can leave and it grows
38:30
a plant . That's exactly
38:32
how your subconscious works . You
38:34
can plant an idea and I said
38:36
so what on our planet starts
38:38
with that genetic code ? And
38:40
they're like thinking I said well , let me change that . What on
38:42
our planet doesn't start with that genetic code
38:44
? Everything starts just as genetically
38:47
coded , like the seed , including us , right ? I
38:49
mean your seed , Jerrod , started
38:51
a week before your mother was born . All
38:54
of the ingredients to form your eggs of her million were
38:57
there , right , and then you are
38:59
whatever number of siblings you have in a million , not
39:01
counting the odds of what that particular
39:04
sperm fertilizing that egg . And
39:06
then at some point you came into some
39:08
level of consciousness , you came from a biological
39:11
journey to a spiritual or conscious journey
39:13
and to me that's a space
39:15
, that's a room in space , and
39:17
the door opened , you entered the room and
39:20
you guys are in the room and we create whatever havoc
39:22
we can create in this life and eventually we
39:24
exit Because we wake up , having
39:27
never been asleep , and we go to sleep never
39:29
to wake up . But I firmly
39:31
believe , and especially being in medicine
39:33
, I've seen that space in that room be very small . A
39:35
baby born , is born and dies , sometimes in
39:37
a matter of minutes . But that
39:39
space we come from , the space we go to , I
39:41
have to believe , is the same space , regardless
39:44
of our religion , right ? And what we
39:46
do , what we accomplish in that space . I
39:49
read the book also 4,000 weeks , but
39:51
4,000 weeks is a lifespan If
39:54
you start looking at how many weeks you have left . Why
39:57
do we want to spend any more of our weeks being defensive
39:59
?
40:00
Right . There's only a certain number left Right
40:03
.
40:04
While we're in that space , before we hit that exit door , let's
40:06
raise our consciousness to
40:08
a higher level for the whole society and start
40:10
realizing that the bomb that lands in Palestine
40:13
or the bomb that lands in Israel is in physical
40:15
reality . It doesn't care . Its job
40:17
is to blow things up . The only difference between
40:19
those two bombs is their justification for being there
40:21
.
40:22
And that's a social construct .
40:23
Right , right , but
40:25
I talked to a lot , I know , and I bounced around
40:27
a lot of things . I hope I didn't blow your mind too much
40:30
, Jerrod .
40:31
No , this was excellent and my biggest
40:33
takeaway is , if you optimize , your
40:36
optimizing bias leads helping to remove
40:38
that experiential
40:40
blindness which then causes the predictive
40:42
processing errors . And I
40:44
think that there's a lot that you've if
40:47
I'm unpacking so
40:49
much of I'm grasping here from
40:51
all different areas , but
40:53
one is it's your own perspective in
40:55
a much larger world , where
40:58
being more predictive or taking
41:00
in outside variables
41:02
to try to learn obviously learning
41:04
is more powerful than anything but
41:07
then using that to be more
41:09
cautious I don't want to say cautious , but predictive
41:12
in what you're pushing forward in
41:14
your future .
41:15
So what we need are triggers . So the
41:18
optimism bias actually causes experiential
41:20
blindness , because if we don't think it's going to happen
41:22
. We don't predict and experience where
41:25
it happens . So if you don't think you're going to fall
41:27
off the bridge today , you're not going to be worried
41:29
walking across it , yeah , or wearing a light
41:31
jacket , exactly . So
41:34
the optimism bias that's Tali Sherrick's
41:36
book she wrote causes experiential blindness
41:38
, which is in the YouTube video by Lisa
41:41
Feldman-Barrick which is the easiest way to see
41:43
that explanation . So it changes our
41:45
predictions . We need triggers . So
41:47
, for example , when that thought comes to your mind
41:49
without your permission , we go to do a defense
41:51
off suddenly like , oh , I don't need to worry
41:53
about that or that's not going to happen . But
41:55
really , if there's a high consequence to
41:58
that thought that enters your brilliant
42:00
mind without your permission , you
42:02
need to just take a moment and switch to that system
42:04
. Two condiment , more accurate thinking
42:06
. Just weigh it . We can move
42:08
ahead with a maybe , but not without
42:10
switching out of your system one mind to your system two
42:13
to really consider the consequence
42:15
for that action which is what I did when
42:17
I changed my route on
42:19
Long Island last week . And
42:23
then you learn not to blow other people's ideas Because
42:25
it didn't show up in your head doesn't mean it's
42:27
wrong if it shows up in somebody else's head
42:29
. It takes practice . I'm
42:31
not great at it yet , but I'm working on it . I
42:34
still have time .
42:36
Great outlook .
42:38
Well , listen , I appreciate this and I
42:40
think I probably talked too long . It's been almost an hour
42:42
, no , but thank you .
42:44
Yeah , thank you . We enjoyed listening
42:46
to your unique perspectives
42:48
and the
42:51
things that you're trying to do . Thank you .
42:53
Well , thank you , guys . You're providing a platform to
42:56
change the world , right ? You are exactly
42:59
what Margaret B talked about Small
43:01
group of dedicated individuals with
43:04
a desire to change the world . So thank you .
43:05
Certainly try the only the crazy ones do . That's
43:08
right , all right , thanks guys .
43:11
Thank you , happy simulating
43:13
.
43:14
Thanks again to
43:16
SimVS for sponsoring this week's episode . Check
43:21
out simvs . com to
43:24
learn more about their new four-pump
43:26
simulator . Thanks
43:33
for joining us here at The Sim Cafe . We hope you
43:35
enjoyed . Visit
43:40
us at www . innovativesim solution . com and be
43:42
sure to hit that like and subscribe button so you
43:44
never miss an episode . Innovative
43:51
Sim Solutions is your one-stop shop for your simulation needs
43:53
. A
43:57
turnkey solution .
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