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Welcome, welcome, welcome to armchair expert I'm Dan Shepard. I'm joined by miniature Mad Man. Hi. Today we have Dan Heath. Dan, he is a best selling author, speaker and fellow at Duke University's Case Center. And he's written several amazing books. His newest book, Upstream The Quest to Solve Problems Before They Happen, is so in our wheelhouse. We love this topic of trying to figure out how to fix things before they happen. Prevention's worth a pound of cure.


That's what they say, an ounce of prevention.


So please listen to Dan Heath. He is very fascinating and his message is one we should all embrace.


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He's not charged. Dan, I am so excited to be talking to you guys. I feel like now I am like one degree of separation from Idiocracy, like I have like a personal connection with all of that great comedies of all time. I mean, did you sort of know at the time that this was going to be a thing? No, look, this script was the funniest script I had ever read. And I had turned down a really great movie to be in that movie.


I wanted to work with Mike Judge and we got there and everything went seemingly well and then we wrapped. And then months and months just kept going by and it was becoming apparent Fox was not going to release it, but they contractually had to put it on some amount of screens. And all this adding up to us, finally finding out that the movie tested terribly. Right. Like, really? Really. Yes, really terribly. Oh, wow.


This is a very on topic because obviously Fox is a system, right? There's all these mechanisms and levers. And one of them rightly, globally speaking, is that you don't throw 30 million dollars marketing a movie that's testing at 30. It's just going to be a bad bet for you.


But I will say the one thing that a very smart person pointed out, has it not occurred to the studio that the people that go see a free movie that they know nothing about or the people being made fun of by the movie. So you should expect these very low scores. So there was no slot in this system to kind of comprehend that that might be the issue. Does that make sense? Right. Yeah. So no, I thought, oh, no, we did this movie.


No one saw it. It didn't even make a million dollars. And I'm like, oh, you're kidding me, no. And I thought, oh, this is just disappeared into the ether. And I feel terrible for Mike because it was a great movie. And then through the course of time, it turns out maybe more people have seen that movie than other movies I've been in that had done great initially. So it's been a great for me, a great life lesson of, like, you don't know, the outcome of really anything until the time horizon is such that you can evaluate it.


Does time horizon correctly? Probably not. I'm in for it. But it also tells you, like I mean, I think money correlates a little bit with quality, but not very much. It's a good reminder. Yeah. You know, I would love because you study all kinds of things and you study systems and you study data and we look for outcomes in Hollywood is one of the weirdest business models out there because you're weakly introducing a new concept or a new IP or a new idea.


Write your first book, Made to Stick, Why some ideas die and others stick. So you come across any kind of Hollywood stuff and you're researching that book.


The one thing we came across is is kind of a model of a sticky idea is is the high concept pitch. And you'll have to tell me whether this is still a thing or if this is all, you know, thing of the past. But the way movies would get pitched as Jaws on a spaceship was the alien high concept pitch and die hard on a bus was speed. And there's just what's so beautiful about those from a communications perspective is there's just so much meaning packed into those very short phrases.


You know, when you hear Die Hard on a bus, it tells you a lot of the foundational elements of the whole thing. You know, you already have an intuition about who the stars are going to be. And you already have an intuition that this is probably a summer release, not a winter release. And and so the high concept pitch is kind of a model of how to communicate a lot with a little.


And the problem is, is your example is is a one in a million perfect execution of something. So you're basically promising to things that are once a decade collapsed together.


Right. And yet it does enact some some kind of emotion that makes people want to buy it. But I mean, the odds of you executing Jaws and Star Trek in one picture, you know what, a high bar. But it's aspirational. I mean, that's the point is, is you want to get people thinking about the best case scenario. And I think what's even more powerful about it is just how much exposition is packed into that. Like, you can do the same thing with businesses.


Like if you if you went back in time to when Netflix was first being pitched as a thing and remember, the first iteration of Netflix was like DVDs being sent in the mail. Yeah, it must have seemed like a very weird idea at the time. And so to think about having to explain this new model and the shipping and you could just condense that down and say, well, Netflix, it's our new idea. It's kind of like Blockbuster Video with no late fees, which is in fact something they came up with.


And it kind of gets you in the right mental space in two seconds.


Are all of Blockbuster in your mailbox? Exactly right. I just punched up their PC like time. I think Netflix would have really worked out that they. Did you slow down what is what is your history? I know that you throughout your career have worked a lot with your brother and chip. Right. And now your new book, Upstream, is a solo project. You've left the Beatles. I'm curious immediately before we talk about upstream, because I have an older brother who's older and who's younger.


He's older, he's 10 years older.


So he's 56. I'm 46. I mean, he was off to college by the time I was eight years old. So we don't have a lot of memories together, really growing up. Like we kind of developed our relationship as adults. I mean, it's kind of like a senior partner, junior partner thing, which is totally legitimate. I mean, he's he's a lot older. He has a lot more experience. And he's sort of the, you know, the wise elder in the family.


And he teaches at Stanford. He does. He's in the business school. He actually just retired from Stanford Business School. So he's doing other stuff now. But he was there for many years.


Yeah. Yeah. Because I was I was thinking maybe the gap would be so big that he might have looked on to you lovingly at times and thought, I'm going to help him.


I often hear from people I can imagine working with my brother on a book. And I think it's because, you know, most brotherly relationships, you know, there's that sense of competition and you're always trying to one up each other. And it would have been pretty pointless for him to engage in any sort of competition with me, you know, with ten years age difference he pretty much could have done for me at anything. Yeah. And so I think that takes a lot of the the ego out of our relationship is is I don't think we've ever really felt competitive with each other like, you know, we have to compete for attention or whatever.


I think it's just a really healthy, healthy place to start.


But you certainly have had to share accolades and praise in that. Yeah. The meagre quantities we've gotten.


Yes. We we we divide those up. When we first started working together on made to Stick, I mean, first of all, it was no picnic at first because we're very different people and we had never worked on something as as big as this. And I I'm sort of like the student who in college would have started a major paper at like 3:00 a.m. in the morning, like fueled by NoDoz and then just blaze through it. And he's the student who would have turned it in like a week early just to make sure it was done and kind of off of his desk.


And so you can imagine some of the the the tensions that we had during this first process. But he and and later, my wife, I think, over a period of about ten years, have slowly almost beaten the procrastination out of me, which I am eternally grateful for.


Oh, my gosh. Please share their their method, their methodology.


It's kind of slow attrition. You know, it's just like over a period of years, relentless work. You can eventually be healed. So all you procrastinators out there, all you have to do is get a sibling and a spouse that will collaborate against you.


And at the ripe age of 40, are you 47, 46? Forty six, you'll finally not procrastinate. Jagajaga nearing retirement. That's right.


Now made the stick is and I hope you take this as a compliment because he's my all time favorite. It's Gladwell. Yeah, it's a little Malcolm Gladwell. I do take that as a compliment. He's one of my all time favorites and really like kind of someone who blazed the trail for for all of these kinds of books that are now everywhere. If I had to describe the cottage industry, it's like it starts with these kind of social science theories or social science data, and it's got some overarching kind of hypothesis.


The genius of it is, is then you just keep derailing into these personal stories or company stories. There's so much storytelling in it, which ironically is part of made to stick. One of the elements that you're looking to have, right, is something that can be passed on orally.


What we were chasing with made to stick was was just a very simple question. Why is it that some ideas that you hear stick with you, change your life, change your behavior and others just kind of pass in one ear and out the other? And my brother had done a lot of research actually on urban legends.


Yes, that's one of my most favorite topics is urban legends. So so literally, the first story in the book Made to Stick is classic urban legend. It starts with I shouldn't get. I just gave away the punch lines. An urban legend.


Forgive me for that. So a friend of a friend of mine. It's a big business traveler. He's always, you know, flying around for work. And he had some extra time in the airport on the way home from a trip recently. And he stopped into the airport bar. And before he could even order a drink, this attractive woman walks up to him and asks if she could buy him a drink. And this isn't something that happens to this guy very often.


So he said, well, sure, I'll have one. So she walks up to the bar, she orders two drinks, one for her, one for him. They have a cheers moment and he's thinking, this is the best day of my life. And he takes a big chunk and then blacks out and some unknown amount of time later, he wakes up in a strange hotel bathtub full of ice. Sure.


And there's. There's a sign on the wall of the tub that says, don't move. Call nine one one and there's a there's a phone right by the tub and he calls 911 one and he describes the situation. And the operator says, sir, can you reach behind you in the tub and see if there's a tube sticking out of your back? And so the guy like A are kind of numb and clumsy from the ice and reaches behind him and he feels a tube and now he's freaking out even more.


What's happened to me, I don't understand. And the operator says, sir, there's a ring of organ thieves in the area. They've taken one of your kidneys. This is known as the kidney thieves.


Urban legend, by the way, I just before we unpack all the mysteries, the one that just jumped out at me, too, because I've heard it a million times. I don't think it's ever crossed my mind until just now. But what ethical harvesters of organs that they left the second kidney like they've abducted someone, they drug them.


There's kidnapping charges, they're harvested. You're going to prison for all this. It's also so unethical. But you know what? Fucking don't take his second kidney because that's just that's just crossing the line.


That's amoral. What an interesting detail of that. But, yes, continue.


So the amazing thing about urban legends like this and by the way, for those of you listening, if you've never heard that story before, let me tell you something. Ten years from now, that's what you're going to remember from this podcast. Like everything else, you can just flushed down the memory hole. But that's what's going to stick with you. And the reason is if you start thinking about the anatomy of this idea and what makes it so sticky is it embeds itself in your brain as a kind of filmstrip.


You know, like if you're going to retell the story next week, you're not going to try to remember, like, the language, the words that I used. It's not like you're you're reciting from a mental transcript. You're just playing that movie because you can see it. Right. And you're narrating to the movie. And that makes it so much easier for an idea to travel when when we have those visuals that we can recollect so easily, which is a far cry from from most kinds of communication we encounter in the world that are loaded with data and bullet points and analytical arguments.


But a story like this that you can see that has emotion, that has storytelling, that has surprise, those are the engines of sticky ideas. And and the point of the book was, you know, none of us are in the business of trying to circulate urban legends, but there's things that we can learn from ideas that are naturally sticky and we can apply them to our own.


One of the things that immediately captures my interest is, oh, this is too good to be true. So there's like this kind of baked in fable language. I think we all at this point have deeply embedded in our culture that we inherited. And it's like, yeah, an attractive woman comes and buys you a drink and immediately I go, well, that doesn't happen.


So, you know, this is drink. I need an answer. I need an explanation because this shouldn't happen, be it. But it's too good to be true. Let's find out if it is, you know, just from the first sentence, I need to find out if this panned out or if it's, as I suspect, too good to be true. Yeah. And I think that that on the flip side, what makes it so powerful is, is the concreteness.


You know, notice these amazing details, like, has there ever been like a more visceral detail? Then you wake up in a bathtub full of ice? You know what I mean? It's is for me, really pops out as memorable as the two is. Well, yeah, yeah.


Finding a tube sticking out of your back. And that's the thing about these stories is when you hear them in their various versions and there's a hundred different versions of this, you know, I've asked people all over the world if they've heard it and their answer is yes, but but the details are different. But some details never vary, like there's always a bathtub full of ice. That's the stickiest detail in a sticky story, you know. Yeah, I'm just going with the one that made the rounds when I was in high school, and we're nearly the same age.


So I wonder if it hit yours, too. It was around spring break time. And the the legend was that a gal or guy? It can go either way. Went down to Cancun on spring break, met this amazing girl, kind of like fell in love and five days in and they had sex. And when when he left, she gave him a present. And she says, don't open it until you're on the airplane. It's just special and I want you to take it in.


So he he gets on the airplane and he opens up this box and there's a miniature coffin inside. And when he opens it, there's a piece of paper that says, Welcome to the wonderful world of AIDS. Oh.


Oh, my. You know, I, I have heard other versions of that one, but yours is way better.


I love the miniature coffin in the box. That's amazing. She's like a woodworker or he's a miniature, a dollhouse woodworker somewhere there's like Ballhaus furniture being made for this.


I feel like the through line between all of these, I was going to bring up the one that everyone thinks someone from their high school got a hot dog stuck in their vagina.


Yeah, yeah, yeah. And and they were drugged in the hot dog got shoved up there. Yeah. Everyone has that story, but everyone has a story, so it's not true, but I feel like fear is the through line between all of these legends and the stickiness. Is this like visceral fear that you feel like you could get taken advantage of or susceptibility or something?


What you're on to something important here, which is which is the fuel for virtually all stagey ideas, whether they're true or not or urban legends are not, is emotion and urban legends, you're right. Tend to have a couple of different bases of emotion. Fear is a very common one, as with the kidney thieves, as with the casket in the box. But disgust is another all time classic. You know, you've probably heard the stories of like the Kentucky Fried Rat or, you know, you find an eyeball in your Coca-Cola.


You know, there's just some beautiful ones from that genre. And in fact, hilariously, Chip, at one point did some academic research where he varied the disgustingness of different, you know, versions of urban legends to see if it associated with memorability. And of course, it did. The more disgusting the better, basically. Yeah, but, you know, to be fair, there's a flip side to all this. And this is what got us so excited about the book is if it was just kind of trashy, sleazy, terrifying ideas that were sticky, this would be a pretty short conversation.


Yeah, but if you think about something like Proverbs, Proverbs are another example of a class of ideas that stick naturally and yet they contain moral truths, you know, not not sleezy, false ideas. Something like a bird in hand is worth two in the bush. And if you notice, you know, the similarities, for instance, the the concreteness is one of the things we talk about in the book is a quality of a sticky idea. And, you know, the bathtub full of ice is a very concrete sensory detail.


Notice the proverb is talked about in this visual language. A bird in hand is worth two in the bush, right? No, it's it's not it's not some abstract moral lesson. It's it's something you can see, you know, back to that idea of a filmstrip that embeds itself in your head. And so many proverbs have have that kind of quality. And so in the book, what we were doing is kind of comparing all these ideas that stuck really well, proverbs, conspiracy theories, urban legends, great lessons in school marketing campaigns.


And we're trying to figure out what all these things have in common, like what's what's the engine of their stickiness and can we learn some of those principles to make our own ideas stickier?


OK, now we're going to talk about upstream. So you're just lab designed for me and my own pet peeves at the top of this.


Yes. My number one most hated thing in the whole world, more than getting my kidneys removed without my permission, is being a part of a bad plan, like when someone comes out and they launch the plan. And then I have a role in this plan, but I can see that it's just a very flawed plan. Right.


Or were were were addressing something so downstream that I'm like we're going in circles. We need to back up now. So this is my number one thing that gets me irrationally angry at things. So I'm so delighted about upstream. Too little concepts that we need right out of the gates. Right. Is just what is this system? You know, how does this system differ from a person? I think those would be some relevant groundwork.


Yeah, well, and maybe even one step further as well. Just because I know the language upstream may be unfamiliar to some people. Like I discovered this this term in this concept when I heard a parable a while back, that's that's well known in public health, but not so much outside there. And it goes like this. You and a friend are having a picnic by the side of a river. And, you know, you've just spread out your picnic blanket.


You're getting ready to sit down and eat, and then you hear a shout from the direction of the river and you look back, there's a child thrashing in the river, apparently drowning. So you jump in, you save the child, you come back to shore and you're kind of just as your adrenaline is starting to recede a bit, you hear a second child, you look back, there's another child drowning. And so back in you go, you fish them out.


Then there's two more children and back and forth and back and forth you go. And it's exhausting all this life saving work. And then you see your friend swimming to shore, steps out and starts walking away as though to leave you alone. And you go, Hey, where are you going? I can't do this by myself. And your friend says, I'm going upstream to tackle the guy who's throwing all these kids in the river. Right. And that, in a nutshell, is what this book is about, this this kind of trap that we get into so often in life, in our personal lives and at work, where we're always reacting to things, the putting out fires and we're dealing with the emergency of the day.


But we never make our way upstream to deal with things at a systems level that that could have potentially prevented us from needing to be in the river, fishing out, drowning kids. And to your point, the question you asked about systems, probably my number one favorite quote that I learned in researching this book is, is this one from Paul Batard in a health care expert. System is perfectly designed to get the results it gets. I wrote that down, I bet is so fantastic.


Every system is perfectly designed to get the results. It's getting this kind of quote that just sticks in your mind and it changes the way you see the world. You know, there's stories in the book about substance abuse and homelessness and dropping out of high school. And one of the stories is about Chicago Public School District. At one point, CPS, Chicago Public Schools, they were graduating. Only about 52 percent of the students, like people, had a coin flip out chance.


That number seemed impossible when I read that. So what year was this?


That was 1998, 52 percent, 52 percent. And also, it's a humongous public school system. What did you say? Six billion dollars and six billion dollar budget, which is about the same as the city of Seattle, is 300000 students. I mean, this is a massive, massive system. And the point of that quote in this context is, if you think about it, you're not failing half your students because people aren't trying hard enough or because they're not showing enough enthusiasm.


You know, you're not going to hire a motivational speaker to come in and get people jazzed up and then, you know, graduate 80 percent. This, in essence, is a system that has been designed to fail half its students. And so if you want different results, you have to figure out how to reconfigure and redesign that system.


Yeah. And again, back to that quote you just said, it is designed not intentionally, but if the results are what they are, 52 percent, then regardless of the intentions, this is what the system is producing and will likely produce forever unless intervened. Yeah, yeah. That's a really big example of a system that's broken. But but it also applies to smaller things like, you know, I have two young girls. I know you do, too.


I see some artwork behind your head that screams young girl. Yeah, yes, yes, yes.


That's that's mama as a giant.


And if you find the same thing happening, whatever it is, meltdown's at bedtime happening, you know, every night. I mean, what you got to ask yourself is this is a system perfectly designed to get the results it gets. And any time you see consistently bad results, you got to be thinking something's wrong with the system. What do we change with the system? It's not a matter of like just rejiggering our attitudes in the moment. It's something about this process that we have to tweak.


Boy, that is so true, right. In the simple examples are like, OK, great. So when we give them sugar at six p.m. or so. Right. He's pretty predictable outcome at seven thirty pm. Exactly right. These things just become kind of self-perpetuating. And that was true in Chicago public schools, by the way, like one example of what they found when they started thinking about this as a system was discipline policies. So this was the era, you know, 1998 of, you know, being tough on discipline, zero tolerance, that kind of thing.


And so I talked to this one woman, Sarah Duncan, who had a big role in the change. And she said during that era, two week suspensions were doled out like candy, like a couple of kids would shove each other in the hallway and they both be slapped with a two week suspension. But what we know now from the research is if you take a kid who's kind of on the border, you kick them out of school for two weeks, they come back, they're lost and they can't catch up.


They end up failing classes. Failed classes are a heavy predictor of dropping out of school. And and so it's like these unexplored trails of causation where the assistant principal who slapped them with that suspension, never in a million years would it have occurred to that person, hey, this may be the reason they don't graduate from high school, you know, and so it's things become opaque and kind of hard to hard to trace inside systems.


But but once we flip around the lens and think, how could we rewire this for for better outcomes, you know, often we can change them. But really quick, just so so as we move forward, I want everyone to have a really good concept of system. Yeah. Yeah. I would just think of a system and this is a loose definition, obviously, but in terms of, you know, the the participants involved. And so your family is those are the collaborators involved in that system, if you will, and then your habits, your routines.


So your bedtime process is a routine of some kind. And the example you gave of, well, you know, we've just gotten in the habit of giving him chocolate milk 15 minutes before bedtime, like, aha. Maybe that has something to do with these results. We're seeing, you know, these things that that we often do unconsciously can lock in and become part of the habitual recipe for the bad results that we don't like. By the way, one of the funniest things I've ever heard on your show is I don't remember which episode this was.


But you were talking about, you know, you're a little bit of an older father like I am, and and just how old the father is. I think there's a lot of advantages to that. But but we're also a lot lazier.


Oh, I'm so relieved to hear you relate. And I laughed when I heard that because I find that. I spend a lot of energy like coming up with low energy games for my daughters, you know, like when I'm one of my greatest triumphs is is what I call theater in the sky, which involves my my four year old. And I will just lay down on the ground. That's the laziness part of it. Yeah, well, hold up like dolls or little figurines or whatever.


Inevitably it's on an Elsah, to be honest. OK, so I think to be truthful, it's also continue. Yeah, she's Elsah. I'm on a right, of course, you know, because she has the magic powers, naturally. And, you know, we'll just have like some kind of little story that happens.


And and the whole time I'm just getting to lay down on the floor. But she's loving it because it's a story. It's on an Elsah. So anyway, maybe I'll frame that as an upstream solution to to a child rearing problem. Yeah, OK.


So when wanting to look at systems and to go upstream to try to find the source of problems and to address those, there are some initial barriers according to you. So let's start with the first one is problem blindness. Problem blindness says we can't solve a problem when we don't see it. So this this thing happens where when we've been living with the evidence of problems for a long time, often we just kind of tune out, you know, when it's so ubiquitous, we just kind of lose sight of it.


And one of my favorite examples of this is there's a guy named Marcus Elliott who was hired as a trainer for the Patriots. And this was a time when the Patriots had been plagued by hamstring injuries. They had 22 hamstring injuries in one season. And, you know, some of their best skill players were laid out because of that. And at the time, and even to some extent now, I think people think of injuries in the NFL as just, well, that's just part of the deal, right?


It's a violent game as people colliding, of course, people are going to get hurt. That's just the price of admission. But Marcus Elliott comes in and he has a totally different perspective. Is thinking is most injuries are actually the result of inadequate or improper training. And so he comes in with this very different vision. At the time, he told me, you know, even in the NFL, weight rooms were kind of like high school weight rooms.


You know, it's all about bench pressing and squats. And it's like who can who can push more iron and who can get big and strong? And his point was, look, the demands of these positions are so different, you know, from being an offensive lineman to being a wide receiver, something that you really have to think carefully about what muscle groups you need developed for which positions and even player by player. It's quite different. Like Marcus Elliott said, a lot of times you see people get injured because of muscle imbalances, like maybe your left hamstring is stronger than your right hamstring, for instance.


And so he he starts doing these kind of one off training programs custom for each position. And he focused particularly on wide receivers because they're prone to to hamstring injuries. And anyway, bottom line, he reduced the number of hamstring injuries to three after eliminating his system. No shit. Can I ask a real quick question? Why did they even bring him in if they were just chalking it up to like that's part of this game? Well, I think they were ahead of the curve.


I think they they knew of his work and they were like, hey, when you got twenty two injuries, you start getting open to crazy ideas.


But the rest of the league wasn't there yet. Not today. It's very different story. I mean, people have gotten very sophisticated about this and individualized training programs. And in fact, Marcus Elliott, if you're interested in this, you should Google him. He works in a training shop now that does these very, very sophisticated analyses of NBA players like the NBA players will come to their facility and they'll like videotape them and in three dimensions and look at like the way they land after a rebound and they'll look at, like, talk.


I mean, it's just it's crazy. And it's just fascinating to think about this stuff. You know, you think about an injury like Kevin Durant, and it's just heartbreaking for the athlete and for the fans. And and you trace it back and you wonder how many of these career ending injuries could have actually been prevented with the right attention at the right time. And Marcus Elliott, by the way, they've scanned like more than half of the active NBA players.


So they know what they're talking about. No kidding. And he says, you know, certain kinds of pivots, especially in the knee they can detect with this fancy system, are highly associated with with knee injuries. And so it's like he can tell an athlete, look, the way you're landing right now, about 95 percent of the athletes that have had that same pattern have gone on to have a knee injury within two years. So we need to start working on this now.


Oh, wow.


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You give a great example of problem blindness as it pertains to homelessness, and specifically you looked at homelessness in Illinois. What was the city, Rockford. So now you say that, you know, one of the problems with homelessness is that people generally have a very strong opinion about it. This could not be more appropriate for Los Angeles.


As you know, the whole West Coast is in crisis, but everyone has a strong opinion about it.


Yet no one has been homeless. Right. So I don't have a huge opinion about Olympic diving because I don't know what the fuck goes into Olympics. You know, I wouldn't presume to have a strong opinion about timing, but I'll tell you, I got a lot of strong opinions about homelessness. And then also you point out no one's really even talked to a homeless person, which weirdly enough, just before covid, I told Monica, I'm going to interview 10 homeless folks to find out what is the experience?


Why are you there? Do you want to leave? What do you think of the things we're doing? What do you think of you know? And it just occurred to me I don't think I've heard a homeless person interviewed sincerely, you know, a real interview, not a clip on the news. It's a great idea. It's a little shelved at the moment. But, yeah, walk us through what happened there. Yes. A Rockford guy named Larry Morrissey was mayor.


He was in his third term. He said when he had started, he developed this 10 year plan for ending homelessness in Rockford. And in year nine, at best, he said, they just kind of treaded water and probably lost a little bit of ground. And so one of his colleagues comes to him in year nine with this idea to participate in this program called Built for Zero, which was a brand new model of working on homelessness. And he was pretty cynical about it.


I mean, the guy has been trying for nine years, gotten nowhere, like what's going to change. But he reluctantly agrees to be part of this. And then 10 months later, Rockford becomes the first city in the U.S. to end the problem of veteran and chronic homelessness, just a massive achievement. So the obvious question is, what the hell happened in those 10 months? And in several things. The first of which was homelessness, like a lot of complicated social issues, has so many constituents.


If you think about all the people who have some part of the puzzle of homelessness, well, it's it's the health system. It's homeless shelters. It's the VA, it's social service agencies. It's the police on and on and on. But they all have their little piece that they administer, but they rarely are all collaborating together. So they all were brought together into this kind of task force to work on homelessness. And then the second thing was, and this is what Larry Morrissey told me was critical, is they had actually brought together those people in the past periodically.


But usually they would just talk about the issue of homelessness. You know, they would kind of pontificate about it, what should be done. And Larry Morrissey said a lot of times it would just devolve into bitch sessions. Sure. And and what changed was they started taking a a real time census of the homeless population in Rockford, meaning that at any given moment they knew exactly how many people were on the street, what their names were, what their case histories were.


It's all in a Google doc. I, like looked over one on their shoulders when I visited there. And that changed everything, because now when they brought people together, they could go name by name on this list. And it wasn't about homeless policy anymore. It was about, hey, who's seen Larry last week? Well, right. Right. You know, I saw him.


He still got his tent under the bridge. And, you know, he's been coming into the shelter for lunch pretty regularly. And then, you know, the social services people can say, well, we actually just had a housing unit open up. We're ready to to ask Larry to take it who's in the best position to do the outreach. And it becomes this very tangible project, you know, with a human face in a way that defies a lot of work on uncomplicated issues like this.


And so person by person, name by name, they just start winning. They start getting people off the streets and into their own housing. And that's the strategy that has been rolled out nationally by this this group I'm talking about built for zero, that kind of retrained cities. How to think differently about homelessness. We interviewed Mayor Garcetti and he had brought up the amount it would cost to supplement rent, to prevent eviction versus the amount that you then spend to deal with anyone living on the street through medical costs and police and, you know, all the number of of expenses that come that are unavoidable.


It's pennies on the dollar. Exactly right. Isn't that always the biggest hurdle publicly? It's very hard to get people in this country to accept that there are cheaper ways to deal with problems, but that they're going to have to violate maybe one of the simple concepts about liberty or equality or one of these tenants. Right.


But so often I try to say, like, even if you're a fiscal conservative, forget about the social responsibility to help forget. That's not even my argument. The argument is let's work backwards. Are you going to turn people away at hospitals? Is that something you. I think we're going to do in the US and everyone agree now, we're never going to turn people away at hospitals, right? So we start with that fact and then you go, OK, someone's going to pay for all the people that don't get turned away.


And you recognize that's us, right? That's the taxpayer. Yes, OK, I recognize that.


OK, so you're going to pay for it whether you want to or not. So is it cheaper is it a better use of money to prevent it? You know, what is the total cost? And it just seems like a very hard thing to get Americans to buy into because maybe they feel like they're violating a principle that there shouldn't be handouts. And it's like, OK, well, that's that's a fine position to have. I wouldn't argue whether you think there should be handouts or not, but we all agree we're going to have to pay for the hospital admissions.


Then let's just try to reduce that. Right.


Completely agree. And I've talked to some of the leaders of this homelessness movement and they acknowledge your point, that part of their game plan is to do what they call housing first, which in the old model, homeless people would have to kind of earn their way into housing. So they would they would first try to get them in substance abuse treatment and then they would try to give them some kind of job skills. And then, you know, as the seventh hurdle, they could finally get into housing once they had proven themselves worthy.


The new model called Housing First, basically says homeless people are first and foremost. People without houses like that is the presenting problem is they are a person without a house. Why are we delaying the obvious if they don't have a house, let's get them in a house, you know, and then we can we can work on the other problem subsequent to that. And and I think that makes a ton of sense from a public health perspective, from just a moral perspective.


But but I think a lot of people hear that and they're like, well, wait a second, you're just going to give free rent to this homeless person that's on the street. And meanwhile, there's people struggling to pay the bills. And I mean, there's there's some tension there.


Well, and legitimately, a lot of people are going, why would I have to work and no one else has to work? And then why would you take some of my money from the work I'm doing and give it to someone who doesn't want to work? So, yeah, that's a fine opinion to have. But you're going to pay for it or you're going to say we're the country that turns people away at the hospital. Exactly right. Yeah.


I mean, one way or the other, this is our problem as a community to deal with. And this is an area where I think the finances and the humanity are both aligned, where there's pretty good evidence that if you just get people into housing, you start saving money downstream on emergency room visits and and all the outreach that has to happen across agencies. And and so you get R y, but you also get, you know, the humane benefit of helping someone without a house get a house.


To your point, you're so right. The group of people we were exploring was called the kidney list people.


We wouldn't go like, well, how do you make your kidneys bad in the first? We're going to change your beverage intake habits exactly like we're going to make you prove that you won't destroy another kidney. And it's like, OK, well, we should probably do that, but that's probably not step one.


It's it's funny how blind we can be about these things where we're willing to pay 100 X downstream rather than just take a few steps upstream. And probably the best example of that is health care. You know, we spend three point five trillion dollars a year in this country on health care and in virtually every nickel of it is spent after the problem has happened. You know, it's it's a fee for service system. You know, it's triggered by somebody shows up with an ailment and we try to undo whatever is wrong with you.


You're so right. I mean, the expense of a yearly physical versus dealing with somebody that's got full blown heart disease. There's no comparison in those numbers. None at all. And in fact, I talked to this guy, Patrick Conway, who used to work as the senior administrator, Medicare, Medicaid, and he said it's kind of outrageous that we think nothing of paying forty thousand dollars a year for insulin, but we won't pay a thousand dollars for a program to keep people from getting diabetes wise and pound foolish.


One last thing on the whole thing. I happened to be shooting something. We had hired police to shut down a road. We're in between shots and bored. I start talking to the guy about it, ask him if he's in a motorcycle gang and shit. And then it came on to the topic of homelessness. So I said, you know, from your point of view, what's the experience? And he said, well, you know, here's one of the crazier things we deal with is that people are living on the side of the highway like no one in the five.


Very dangerous scenario. Right. A police could remove someone from that dangerous of a situation. The laws are such here in Los Angeles that they have to evict them. Right. So they have to serve them an eviction notice.


And then you have some period of time after being served that you can vacate. Right. So I want to say he said it was seventy two hours, so. Their job, think about what a fucking insane proposition this is, their job is driving around the highway, going and getting an eviction notice, then serving it to somebody, then tracking. Where was this person? Oh, they were at mile marker thirty two point two. So I can go in three days now and remove them from this very dangerous living situation.


And it's like I hadn't even heard that. I hadn't heard that either. I mean, that's a great example of a system that is just baked wrong. You know, it's like we're we're spending all this energy just treading water so the homeless person moves, what, one mile marker down and then and the whole process starts again. And and meanwhile, we could have found some for them to live.


Yes. Yes. Yeah. I just I can't imagine how a police officer doesn't just throw their hands in the air like I'm not going to serve this guy and then serve them four days later for being a mile down the road. Right.


OK, lack of ownership, lack of ownership is is something curious about. But upstream versus downstream works with downstream work. Usually it's pretty clear who's on the hook for something. If your house is on fire, it's a fire department's job to come and put out the fire. Right. It's it's very easy. But when you start thinking about upstream issues, it gets more complicated. Like if you were to ask whose job is it to keep your house from catching on fire?


There's probably at least a half dozen different parties you could point to, ranging from the homeowner themselves, of course, to the fire department, to the people who write the building codes, to the people who built your home and the materials they used and on and on. And and when authority is kind of diffuse in that way, a lot of times what happens is nobody takes it, you know, because it's nobody's job, nothing gets done on the problem.


And so a lot of times, you know, these these problems emerge from the gaps between silos in authority. One of my favorite examples of this is related to the website Expedia. So this is the travel site, you know, where you can book flights and hotels and whatnot. Sure. Back in 2012, this guy named Ryan O'Neal, he started doing some research on their call centers. They have a one 800 number where you can call if there's a problem.


And he finds out that for every hundred people who book a reservation on Expedia, 58 of them end up calling the call center. And it it just blows his mind. Like, this is an online travel site. This is supposed to be all about self-service, what's going on here. And so he digs into this. Turns out that the number one reason people are calling is to get a copy of their itinerary. That's it. Oh, I get a copy of their itinerary.


20 million calls were placed in 2012 for a copy of the itinerary. And so they all just kind of collectively slap their foreheads at once.


And and when their attention is pointed at it, it becomes a very easy fix. You know, the issue was a lot of these things were getting caught in spam. And so, you know, you can change the way you send emails or people thought it was a solicitation and deleted it. And then you can add self-service tools so people can go back online and get their own itinerary. You know, as as a technical problem, this was not a big deal.


But what's interesting about it to me is, I mean, this is a 100 million dollar problem, like 20 million calls times five bucks apiece. And nobody was aware of it basically until Ryan O'Neal does this work, is he the CEO or just know he was in the customer experience group. He was just, you know, a guy a couple of levels below the CEO and he's just doing this research. And and it turns out that that Expedia, like virtually every other company, is divided into these silos.


You've got marketing team whose job it is to to get customers to the site. And so they're measured on how many people can they attract. And then you've got a product team whose job it is to make a great website that kind of funnels people toward a transaction. And so one of the things they might be measured on is what percentage of people who visit end up doing a transaction. Then you've got the tech team and they're measured, you know, on things like uptime for the server.


And and then you've got the call center and they're measured on how quickly can I get somebody off the phone and how happy are they when they hang up. Yeah, and all that kind of makes sense on a micro level. But then when you ask a simple question like whose job is it to keep customers from needing to call for help, the answer is nobody.


Right. Nobody in that whole system. And in fact, it's even worse than that because none of them even stood to gain. If that happened, like nobody would get a bonus, no one would get praised. And this is what happens so often in organizations is is we get so hung up on specializing in on efficiency that we miss bigger problems, like we're so focused on how can we reduce the amount of time it takes to deal with an itinerary call, which was the case.


You know, can we get it down for three minutes to two minutes of 45 seconds? And you forget there's a bigger issue here was why does anybody need to call for an idea? How do we stop the calls? Right. In general? Right. Corporations don't have someone in charge of. Right, like looking at all the different components of the system and then and then figuring out how they're interacting and asking those big question, that's not really a position that exists.


Right. And you can't really major in that, can you?


Well, I mean, sadly, it does exist, but it's it's one person that's the CEO, the CEOs, you and really the only person who lives above the functions and silos. But it's just it's such a buzzkill that these things would have to escalate to that level to be dealt with. And in fact, that's what happened. Inexpedient. It did have to escalate to the CEO. The CEO took it on and said, this is madness. We need to do something about this.


And then the leaders of of the silos came together to work on it collaboratively. But but you're right. You wish that there was some more organic solution to this where where people were more naturally crossing silos without it having to come from on high. There's no pre-set space for workers to step out of their job. You read it like in essentialism that book. They talk about Bill Gates. You know, he had it baked into his schedule. It was every couple months.


And he took a week and he just he just thought he just thought about bigger global issues at Microsoft. And he left the trees to look at the force in it for him was so crucial. And for all these other great CEOs and stuff, it's so important to leave your narrow point of view to try to gain some perspective and to start doing some of that synthesizing. Exactly right.


And what you're what you're focusing on here is something that I call in the book Tunneling, which is a term I stole from another book called Scarcity, a psychology book. That's great. Here's the essence of tunneling. A woman named Anita Tucker for her dissertation at Harvard followed around a bunch of nurses for hundreds of hours, just shadowed them to see what their days were like. And she pretty quickly discovered that they're always solving these weird problems that pop up.


You know, sometimes they're simple, like their department runs out of towels. And so they have to run down the hall and steal some towels or another group or, you know, sometimes it's medication that's not available when they need it. Sometimes it's really weird. Things like Anita Tucker writes about this one day that that a nurse was trying to check out a woman who just had a baby. And part of the check out process is to recover that security anklet that they put around, you know, so no one takes the wrong baby home.


And in this case, it was missing, which is a big deal because now you've got a security threat. But they found the anklet in the baby's bassinet. So problem was solved. And then weirdly, the exact same thing happened a few hours later, a different mother, different baby, missing anklet. This time they couldn't find it. And so they have to go through another protocol to make sure the mom's taking the right baby home. And so Anita Tucker writes that these nurses, they were resourceful in solving problems.


They were spontaneous, they were improvisational. They didn't need to run to the boss every time something bad happen. And so it's like this this really inspiring portrait of nurses. But if you flip it around and look at this from a different perspective, you realize what I'm describing here is a system that never learns, never improves, because these nurses had gotten good at working around problems. And in fact, what what surprised Anita Tucker so much was she didn't find a single instance of where nurses were doing like root cause level analysis, like, hey, why were these anklets falling off?


What can we do to make sure this problem doesn't happen next week? And and to be clear, like this is not to poke at nurses or throw stones at them.


Well, especially now the time this is this would not be the environment to do that. I mean, let's wait until we're all healthy and then we'll start. Yeah. Then we'll throw stones at nurses.


So, I mean, I think all of our sympathies are with the nurses. Right. That that what could they have done about this? Like they've got 12 patients who need them right now. I mean, can they just pause everything to do like a formal root cause analysis and try to get the manufacturer on the phone? And I mean, it's absurd. Yeah, but when you think about it, if we can't figure out a way around that trap, it just dooms them to continuing to solve or work around the same problems every week and every month, forever more.


And so, you know, back to your point, you know, about Bill Gates and others, it's like we need a way to allow employees to step off of that hamster wheel and engage in systems analysis. To be clear, this is not like some some genius idea. I just thought up. People are actively working on this, like in health systems. They have what they call a safety huddle in the morning where they'll get together a bunch of doctors and nurses and they'll say, OK, looking back on yesterday, were there any near misses where something almost went wrong and what were the circumstances?


And today, do we have any complicated patients that we need to talk through to make sure we have all of our ducks in a row? So that would be the ideal forum for this nurse to have said we had this weird thing happen yesterday where two babies both had their security anklets fall off like we need to look into that. So I think it doesn't take much. We don't have to revolutionize the way people work, but we do need to build in these little escape valves where they can kind of step out, as you said, step out of the trees for a second to see the forest and then and then get right back in.


And it feels like it has to be a cultural thing where businesses recognize there's going to be two dead days a month or whatever it is. And that's the cost of doing business. And ultimately, it's going to save us a lot of money. But I guess it takes courage, right? Because a lot of these things are hard to measure their long term goals. They don't bear immediate fruit. So so it takes some willingness to spend the time and capital to see in the long term how it works.


Is that one of the big hurdles? I mean, it's always hard in the moment because, I mean, even even as a dad, this happens all the time where, like, you're constantly in these situations, like getting your kids shoes on or, you know, getting them out the door or whatever, and you face this fork in the road where you could do something the right way and it would take like 10x what it would take to just do it the quick way.


Yeah. You know, and so you always do it the quick way because it's faster, but then you do it the the quick way a thousand times in a row. And you would have been better at just, you know, deviating and fixing the problem once and for all one time for the sake of of not getting back in the river again and again and again.


Yeah. The ounce of prevention.


I was just thinking scale in these Circuital. I had a big issue with a big company earlier this year. It was a catastrophe, to say the least. And it was exactly this. It was a breakdown of like that companies so huge, the scale is so large that like, you know, I couldn't talk to the same person more than once and nothing was getting communicated. But I could also recognize from their standpoint, like, how could they possibly fix it?


They probably think, oh, this is just too big. This is impossible to do.


But yeah, I was and let me just piggyback on that, because I thought at the same thing when you were talking about the Chicago school district, although you get the economy of scale with great numbers, do you also transversely get it just gets almost impossible to manage. It must be exponential issues as things grow now. Yeah, I think it cuts both ways. You know, back to that quote about every system is perfectly designed to get the results.


It gets like if if you're getting good results, then the inertia is in your favor. You know, the system is kind of baked properly. But but if you're not, it can be a tall order. And, you know, Chicago Public Schools, it took them a good 15 years to turn it around. I mean, this was this was not a quick win situation. And it took some fundamental ways of redesigning the way they serve students.


One of the biggest shifts they had to make was a mindset shift where before teachers would think about their role as it's my job to teach a. Good lesson, it's my job to test that students have learned the things that I've shared, but if they fail, that's ultimately the kid's fault. That's that's a problem on their shoulders. And in the new model, what they realized is it's not just the kid's problems that are problem. And now if a kid fails, it gets a joint problem of the teacher and the student.


That part of their role is to support the student. And they started doing this really innovative work. This is based partly on the work of a woman named Elaine Allensworth, an academic who studied the situation and found something fascinating that you could predict in the ninth grade who was likely to graduate and who was likely to drop out with 80 percent clarity, ninth grade. So all of a sudden, you've got four years of advance warning. And so that kind of opened the door right where they start to think, hey, maybe we really could change this.


And so this metric, by the way, is called freshmen on track. Like, are you on track to graduate? And if people were they were three and a half times more likely to graduate than people off track. And so they start organizing these meetings in school called freshmen success teams where they would get together, everybody together, biology teachers, math teachers, English teacher's assistant principals, coaches. And and remember that Rockford example where they went homeless person by name, by name.


They did the same thing in Chicago public schools. They would go student by student on the list of people who were off track and they would figure out, hey, what are we going to do about David? He's not showing up to school. We need to get somebody calling home to make sure he comes in on those days when he's absent. And so student by student, that this progress happens and these success teams started getting students to school more often.


They started boosting their grades. The teachers were helping out. And it starts to move these on track numbers. And then four years later, exactly as predicted, they start graduating and higher and higher numbers to the point where in twenty eighteen the graduation rate was something like seventy eight percent. Wow. I mean, that's crazy. Up by more than 25 percentage points.


I mean, just well and you're talking about tens of thousands of kids at the exact that did or didn't graduate. Yeah.


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OK, I want to ensnare you now with what we know about upstream thinking, yes, on a couple of different pet project, thoughts of mind of a boy.


Let the ensnaring begin. Let's do this. Yeah, so so obviously right now, covid-19, there's a lot to look at in terms of upstream here as you've seen this unfold, because I have some provocative views as you've seen it unfold. Was your was your upstream alarm going off like mine was like, wow, this is literally this is where we're at, we don't even know how many people have it because we can't get these tests. Like it's such a glaring example of systemic issues.




It was just a complete failure of of management. And what's so depressing about this one to me is I think there are a lot of truly unpredictable things that happen in the world that leaders have to deal with. I mean, 9/11 is a classic example. Like it's hard to blame someone for not being ready for planes flying into skyscrapers, you know, and I guess, yeah, if an asteroid hits Earth, like, we're going to give a lot of tolerance to our leaders for dealing with that.


But a pandemic and even a coronavirus pandemic is something that people have been talking about for years and years and years. We knew exactly what needed to happen to be ready for this. And yet the preparations were continually, you know, swept under the rug, underfunded. I mean, I credit the public health people who knew what the game plan was and did as much as they could to prepare. But, you know, when you're perpetually prioritized and underfunded, what are you going to do?


I mean, it's not on their shoulders. And so I think it was it was one of those situations where we were able and in fact, did foresee a potentially huge problem and we just didn't get our act together.


So my let me I got to do a disclaimer. You should social distance. You should wear a mask. You should wear gloves. You should do everything. Everyone's saying I am for all that I am.


The CDC is telling you I am not a protester with a rebel flag on my Hummer. With that said, I was of the opinion that many of us in California had already had it. That's certainly the verdicts out on that. But as Monica and I would argue about this and people would say, well, we would have seen a bunch of deaths, like there would have been all these unaccounted for deaths throughout California. And I and this is a meeting where my brain goes.


Do well. You think there's a czar somewhere overlooking all the deaths in California and communicating daily or weekly or monthly with the CDC that there's some kind of coordination between states, counties in the CDC? That's a pipe dream that's not happening. I said, you know, people are dying in nursing homes, undoubtedly with symptoms that look like pneumonia. That's the most common way an old person would die. So, A, there's probably no reason to even look into it to begin with.


And then the times that their samples were sent out and they said, oh, they didn't have the flu, OK, well, they're not going to fund and launch an investigation. And now this just came out. So they've concluded that the woman in California that died on February six died of coronavirus. We're just lucky that her tissues still exist in the morgue, that they could discover that.


But that woman asked for tests from the CDC and they're like, get real. Someone just died of some respiratory. You know what I'm saying? No conspiracy theory. Just an overly generous view of that. There's someone watching over all this stuff. Does that mean.


I don't know. I think I think you're too cynical about. Oh, OK, good. Yeah, good. Please. But I think that there are people who are paying attention to this. And I think that there is there is a rhythm and a pace at which people die that that is pretty well understood. And when when deviations start to happen from that, I think public health people start getting curious. I mean, this is one of the things that happens invisibly that none of us are even aware of that actually helped this covid process from being even worse than it is public health.


People have built these amazing what they call surveillance systems around the world, which is not like creepy or, well, surveillance, but just an awareness of, you know, kind of what ailments are popping up where. And I remember I talked to this woman named Julie Pavlin, who worked on infectious disease for the army, and she told me this story that just kind of blew my mind. And I don't I don't remember the date of this, but they had like six cases of the flu pop up in one clinic in South Korea a few years ago.


And somehow, you know, this clinic was plugged into this international surveillance system. And so somebody in the U.S. paid attention to that was like, hey, this is weird. We went from zero to six and the same day. Could you fly some samples to to a lab in San Antonio? We want to check this out, see if it's all the same strain of flu. And we want to see if this season's flu vaccine is good for this strain.


And and so it turned out that it was which was a great relief. But even if it wasn't, it still would have given them a lot of lead time maybe for the next season's flu vaccine as that new strain of flu spread around the world. So there have been some incredible strides in figuring out what's out there, figuring out what's going wrong, tracking the incidence and getting early warning of these things before they happen. We have to bear in mind, even as far as a lot of aspects of this response seem like a calamity, it could have been a lot worse in the absence of some of these systems that have been built over the years.


I'm regular. Leigh blown away with how good a lot of the systems are. There's no question, I guess my point was more, you can't find something you don't know you're looking for. If it's not what they're looking for, I don't know how they connect those dots. And I think this this situation is unique in that it had the liability that it disproportionately killed old people. And you ask less questions when old people die, I think. Or there's less, you know, it's not like, oh, is a twenty four year old jogger who died in his kitchen as long as that 82 year old man who smoked for fifty five years.


Case closed.


I think if in February or fall or whenever if the California hospitals were running out of ventilators, they would have been like, wait, something is happening here because we don't normally have this situation. I think a red flag would have been waved as like something is off. So many people are getting pneumonia. They wouldn't have known what to look for, but the signs would have appeared that like, oh, no, we don't have resources. That's not normal.


I totally agree with you in situations where the numbers. So you're looking at country to country now, even state to state, the mortality rate is so drastically different, wherever you're at, wherever you get this disease right.


If you compare New York's percentage of people who die of the known cases, it's just it's tenfold of what Californians is. So, yes, in New York, you would definitely notice it. But there are areas that you might not notice it. When we're seeing places like California, there's some some pockets where it's it's a really low number of fatalities versus cases in in in those situations. I think it would be easy to miss it. Yeah, it's scary.


We're going to get into the weeds of. Yeah. We don't need to do. Now, I have to say that California was in Los Angeles specifically, and California was one of the first states to really start implementing all these hard core changes. And so I credit that for the difference in what we're seeing now with mortality rates.


And that may be that very well may be the case. But if there were people with it in January, we now know that there was we just weren't social distancing.


You know, we are not well. And this is a good example of one of the core ideas in the book, which is just, you know, there are different kind of layers of upstream. You know, what we're experiencing now, social distancing and so forth is kind of the problem is already amongst us. And how do we limit the damage? That's like a half step upstream and then a couple of steps before that is how do we get early warning of this problem so we can really prepare?


I mean, think about the the amazing fact that we had like six or eight weeks of early warning on this thing, maybe more. I mean, there's there's rumors now that they were discussing it last fall. I mean, that's an incredible luxury to have. Even if it was wasted. The mere fact that we could have done something is is phenomenal. And then you can keep going upstream. I mean, we theoretically could have prevented this years in advance.


You know, I was reading I'm going to forget the gentleman's name, but a guy who is a researcher of the origin of viruses and the transmission from animals to humans, and many of these flu related viruses come from bats, you know, and even bats in specific regions of China. You know what I mean? This is not like a problem that's too far fetched to ever solve. It boils down to like there's these caves of bats in China that we need to be monitoring on a regular basis.


But the issue is, you know, in good times when nothing like this has happened and the guy who climbs around and bat caves in China, like wants you to triple his budget, you're like, but we've got other things that are more urgent. You know, we can't afford to really be investing in that right now. And then five years later, the coronavirus hits and you think, oh, we're crazy.


Well, and that is where I'm incredibly sympathetic to the government and all these states, which is next week it'll be a hurricane and then it'll be an earthquake and then there'll be some fires. So, yeah, there's about nine trillion things we should be working preventively on and there's just limited resources, time and all those things. But you just kind of touched on the very last thing.


I didn't really win any supporters in that argument. Remember conceding defeat for now, but I'm going to now pivot.


The other issue is yes, upstream, as you start moving further and further back in time on how these problems are created, the logical conclusion has to be childhood. We want to talk about where to invest money. Right. It's so big. But if you really are committed to upstream thinking, I feel like all roads just have to lead back to an investment in childhood.


Well, this is one where I where I definitely agree with you. And in fact, there's there's a ton of research that's come out in just the past few years to back that up. Didn't you have what's the name of the surgeon general in California?


Oh, Nadine Burke. Terrorist cases to so good. Yeah.


So the work on ACS Adverse Childhood Experiences shows that there's this lifelong impact from trauma happening in childhood trauma ranging from, you know, physical and sexual abuse to, you know, the parents getting a divorce. It's a spectrum of things and they're finding lifelong health consequences. I mean, physical health as well as mental health. Again and again, we're finding that it's those first two or three years of life that are just absolutely foundational. And it's not like this is a problem that you couldn't ever solve.


It is solvable. I mean, it's going to take a lot of people and a lot of resources, but we know who the collaborators will be. It's it's the families first and foremost. It's the schools. It's the politicians. It's the social service agencies. And just as one example of a way we handle this in the U.S., there's a program called the Nurse Family Partnership that is is very well known, very research based, where, you know, young women who are having their first kid, often teenagers having babies out of wedlock, often low income, a whole host of problems, you know, depression.


And maybe they smoke and they're matched with a nurse to be with them from, you know, six or nine months before the baby's born through, say, 18 months. And that person becomes like this mentor and this counselor and this, you know, medical adviser for these women. And the outcomes are are amazing. I mean, it crosses all these areas. To your point about childhood being the thing, you start to see all of these ripple effects from getting that right.


It is the source of the river. Exactly. Yeah. And so I think it seems like this is an area where maybe we could this is probably just dreamy eyed, but that we could get bipartisan agreement. You know, that's like who's against investing in childhood, for goodness sakes? Well, again, I could see where some conservatives would say I didn't have the kid. Conceptually, you can make a logical argument. Fuck that. It's all about the pocketbook.


So the medical expenses that are incurred because of ACS are so much more costly on the backside of it than they would be on the front side.


So if even if you're only motivated by money, still an incredible investment to get rid of so many of these costly things we deal with societally. Amen. Yeah, I think the Arawa I would just be incredible for interventions like that, that there's just so many different aspects of life where it would show up, ranging from better health, better mental health, better education, you know, tighter families on and on and on.


Yeah, you brought up fires, the fire department. How many fires are set by fucking dudes passing out with cigarettes or alcohol? I mean, there's there's any number of ways that these things manifest themselves.


Yeah. And what often makes this tricky, I mean, just to get into the weeds a little bit is in issues like this where the payoffs are kind of split up. Again, all the ways we just talked about, it's hard to find one person to pay for them because the benefits accrue to, you know, 10 different players, like they call this the wrong pocket problem, which which means that, you know, the person who does the paying often isn't the person who reaped the benefits.


So like that nurse family partnership program I was talking about, it's really hard to get this thing funded. I mean, evidence shows a dollar invested in this program yields you six dollars and fifty cents in returns, real returns, money returns. And yet it's really hard to get this thing funded because that's six dollars and fifty cents a split across 15 different agencies. Right. So you get you get one person to pay for it. And then all these other agencies just kind of free ride on that and get the benefits.


And the question is, how do you deal with that? And just to supply some good news here, I mean, this is fundamentally a good news book. Like I wrote this book to say, hey, this is super hard, but there are people who are nailing this wrong. And in South Carolina, I mean, this is not a liberal haven we're talking about in South Carolina. They've done one of the best experiments in the country to get NFP funded.


So they they basically did this elaborate Rube Goldberg contract structure to get NFP expanded to thousands more women who are in these troublesome situations. And they're going to do a controlled study to to monitor the results carefully. And basically, the deal is if if they get the oral, why they think they're going to get, then the state will step in and pay for this forever more because they know it's a good deal. Right. And if it doesn't work, they offloaded the initial cost of this program onto a bunch of partners and foundations so the taxpayers not out any money.


And so you can see they're like, that's how liberals and conservatives can play together. Yeah, everybody wants healthier kids. Everybody wants healthier mothers. And if you can figure out the finances and there's a lot of devil in the details, but if you can get it right, you've got an engine there to get upstream.


Yeah, well, I'm with you, Dan, and we really appreciate you talking to us. Thanks so much for having me. I do have to admit, I do feel like a little jealous to not get, like, the attic experience and to be sitting on the couch.


Come back, you'll write another book, right? You're not you're not forty six, are you? No, no. I'll be back. I'll take you up on it. Couldn't even get like a gratuitous selfie out of the whole thing. But yeah. Thanks, thanks for doing this remotely. It's a good fun. Absolutely. Dan. And I hope everyone checks out your book. Upstream, the quest to solve problems before they happen and yes, write another book and we'll have the attic experience, please.


All right. Take care. Bye.


Thanks. And now my favorite part of the show, the fact check with my soul mate, Monica Padman. Welcome, welcome, welcome to the fact check.


Oh, hello, a double welcome, we've just popped the air on in your apartment because it's going to be a sweltering 88 degrees in the Rock and Los Angeles area today.


Scorcher, a real barn burner. So it's Tuesday, Cinco de Mayo, but it's not when this airs.


Well, yeah, but that's OK, is it? You don't like to keep the illusion alive now. They know you guys know, right. That we're not recording this day of they're smarter than that.


Yeah, but they might not want to know. It was recorded a week ago. Something happens when things feel old.


Well, it's not clear to me. Was recorded two days ago. This is Thursday's episode, right? Yes. It's Tuesday. OK. OK, you want you on that one fair and square clean. It was a clean victory.


Happy Cinco de Mayo. Sorry to ruin the happy birthday.


Gabby Shepard, my niece. She's a Cinco de Mayo baby. Oh, that's fun.


You know, a lot of people feel like Cinco de Mayo is tricky. Why cultural appropriation? So who we all celebrate St. Patty's Day. We're not Irish. We can all party on Cinco de Mayo. No country is sitting there going, wait, another country celebrating this day we celebrate. They would be so flattered. There's four kids in college saying it's a cultural appropriation.


Well, it is not this. Yeah, sure. It's so silly. I do think it is different. A bunch of white people wearing sombreros and speaking in accents and stuff.


All of a bunch of brown people are draping American flags over their shoulders on Fourth of July and lighting off fireworks in Guam. You fucking great.


I'm flattered by that. It's again, you know, it's the the same reason it circles back always that Americans are in power and in charge.


Yeah. And other people are not.


Well, you know, we have different opinions on this, and I don't totally lovely. I don't not have that opinion.


If you put on Brown face, you know, that's an issue. That's that now you're culturally appropriate. If you're celebrating this Mexican holiday, you're fucking not in your head to something that's positive.


But people will try to make positive things negative because some people want to hate, hate, hate.


And it's nice to look at all sides. It is. I've looked at that side and I've concluded for me personally, I think it's silly. Doesn't seem like you looked at it. You don't have. I've heard the full argument. I've read articles about it.


And when my conclusion after reading the articles was this is preposterous. No one in Mexico is mad about this.


I don't know what they think in Mexico. I assume they think is fine. I surveyed all of them. OK, great, great, great.


Can I just say let's just let's get in a fight. This is the kind of shit that makes people think liberals are insane. We fucking shit on our brand so bad when we do shit like this.


I mean, it's so silly. I disagree. I disagree. Don't celebrate Cinco de Mayo. That's another country's holiday and you're white. But we like you, Pastor. No. Why does it have to be so defensive by the people who are reacting like you just said? Yeah. Take a second and think, OK, that seems a bit crazy and extreme. Why could that be true? Still feels like St. Patty's Day to me.


You really do a thousand percent.


You think there's a difference between St. Patrick's Day and Cinco de Mayo? Yeah, I think Irish people are different from Mexican people who get shit on and well, as is as well known in every single well, all my geography books, what they compare Mexicans do are the Irish people hated the Irish and they were racist against the Irish now.


Now not during the famine. Yeah.


But celebrating St. Patrick's Day was a movement and making them real people and not drugs. That's how you come out of that? Well, we are embracing and celebrating. I mean, I think people who are pro building a wall, no immigration, they like eating tacos on Cinco de Mayo. It's not like they're super empowered even in this country. And we're celebrating. But there's a disconnect. Well, listen, everything can't be racial. So people in the Ukraine have a standard of living.


That's a tenth of what ours is. They are almost equally disadvantaged and under prioritized on the global scene. But if they had some holiday that we celebrated over here, literally the only difference at that point, because the power dynamic would be the same, the structure and who has access and who's the head, Germany. That hasn't changed between the Ukraine and Mexico. But because they're white, that's cool.


Because they're brown. That's not cool. That is snow.


Ukrainians aren't oppressed here. Mexicans are.


There's also no Ukrainians are oppressed here. They come here and they have no means. And they were doctors in their country and now they're driving Hubers and they live in poverty and they're not empowered.


I mean, I think if we had a holiday or people were running our. Brown wearing whatever and speaking in their accent and, well, again, I said, if you're if you're imitating a generic Mexican accent, that's an issue.


I think it's fine. And I think it's extreme to say it's cultural appropriation. But I also get it. And I think to immediately dismiss it as like, oh, liberals like, it's just not paying attention to what's really going on. Well, I disagree. So the Native Americans have an issue with people, white people wearing the Indian headdress. That makes sense. That was a religious ceremonial headwear that people wore and not even all Native Americans would dare put that on.


So that makes sense to me.


The sombrero, there's no religious aspect to it. There's no there's nothing important about it. It's a fucking hat they invented, like the cowboy hat. So if they wear the cowboy hat, we're not like, oh, they're appropriating America. They're like, oh, we invented a hat that that works well to block the sun. They're wearing it. Yeah. But they're not also saying and Americans, you can't come here. It's different. We have a different relationship with Mexicans in this country where it's very political and divisive.


And so a lot of people don't want them here. Yeah. And then they're going to wear their hat and eat their food and act like it's fine in those cases. But it's not fine for them to be taking our jobs. And we should build a wall and it's not the same. Yeah, but then I think that just then turned into yet a different debate, which is is it hypocritical for people who are racist against Mexicans to be celebrating their holiday?


Thousand percent. You're right. They're dipshits. Yeah, yeah, yeah. I guess that's what I mean. And they're probably certainly are. Some people who hate Mexicans are xenophobic that are doing Taco Tuesday today. And that's one hundred percent.


I mean, those people are idiots. I also know, like I the Mexican restaurant down the street from my parents house, I know people who go there and eat there who are racist against Mexicans and can't put two and two together. But do you think the rode out that xenophobia is to have less interplay between the two cultures or more?


But it's not interplay. It's like white people are hanging out in a room with other white people eating tacos and wearing sombreros. That's what's happening again. Like now I'm like I feel like I'm getting a little forced into a box that I'm like, really poor. Believe in that. Yeah. And I don't. But it requires some examination. I think everything requires some examination.


And that is what I just think Cinco de Mayo is clearly a step in the correct direction. Not yet, not in the wrong direction, but what do you have to say about what I just said about it's just white people hanging out with other white people? It's not like it's causing I have no white people hanging out with other white people. So. But you're saying it's bringing people together. It's making them aware the food. They enjoy the food.


Oh, I like the food. I'd like to go there. Oh, I heard it's really authentic there. Oh, and then I go there and then I see all the people like comingling is the solution. So Kazakhstan, I don't know what they eat in Kazakhstan. I don't know what they wear. I don't know anything. I'm more xenophobic about Kazakhstan because I don't even know what the fuck happens in Kazakhstan. So if my culture started getting interwoven with Kazakhstan, I started having oh my God, I love their fucking sausage and I love this and I love that.


Now I have an interest in Kazakhstan. I might want to go visit Kazakhstan. It's in my mind they're starting to become d other and more.


Oh, like you know. Yeah. Yeah, I agree. All right. So urban legends at that part was very interesting. I thought in this episode. It sure was. I like urban legends. If you go to Wikipedia, you can see a big list. But what's your your favorite one is the coffin one. I mean, it's so preposterous. Yeah, it's funny.


I mean, I guess that that kidney one's the best thing. It's got to be the best.


Yeah. That's a really good one and one that everyone knows. I'm trying to think if there was any moment that I actually believed it.


Did you. I'm sure I did.


I have had a few encounters that have had a big impact. One Bloody Mary, that's probably the I think the most famous one.


OK, well, you know, you go into a dark room and stare into the mirror and say Bloody Mary three times and she appears, yeah.


Oh, you know, there was another really popular one when I was in high school that it was that gang initiation. OK, so gang members who are being initiated into a gang, they drive on the road with their lights. Yes, I know that when you if you high beam them to let them know that their lights are off, they then turn around and murder. Yeah. That's how they get it. That's real.


No, that's absurd.


I don't know, because if someone's going to risk committing murder, which everyone would acknowledge, it's a risk they're going to kill an enemy, not a random person. Makes no sense to you. You never know. The initiation would be like, go kill this guy who we hate. Oh, OK. Also the the one about this one, I still believe ish. So when I go into movie theater, I always check the see because there's one about I think still gang members or just people put needles in the seat with AIDS.


Oh sure. Sure, yes. You have to check the seat before you say I always check the seat before I sit. Yeah, it's a habit at this point.


But I also still believe in at 10 percent, you know, the cactus one or someone brings a cactus home to their house and they like I think they hear it making noises, but they're like what they've had and they keep listening to it. I must be imagining Boof. And then in the middle of the night it breaks up and like a thousand scorpions come in for me.


And now it is like on the roadside.


Oh my God. Have not heard that they're fun. No.


We looked up on the other day about a hamster up somebodies ass tube and it was that a two lovers, one put a gerbil or a mouse. It doesn't matter up his ass. It got caught. He had taken a paper towel tube. He had put that in his partners. But to get the vermin in there. And then so he wanted to see which. By the way, why do you need to see if something stuck in at rate he needed to see in there to get it out?


Oh, no, no, no. It was that he thought that the critter would be attracted to light.


That's what it was. Right.


So we lit a match at the end of the tube thinking the critter would come towards the light. And then a big pocket of methane gas exploded the man's ass and his lover's face that they went to the emergency room with a charred face and a blown out.


But that one spectacular. Yeah, it's steeped in homophobia, which is a bummer.


Yeah. But if you let's just make it. Let's just make it. It's a man looking up a woman say, yeah, how about that.


OK, so you said said the most common way an old person would die is pneumonia. So the leading causes of death among adults over the age of 65 are also among the most common cause of death among population as a whole. So in order one heart disease to cancer, three chronic obstructive pulmonary disease, four stroke, five Alzheimer's, six diabetes, seven pneumonia and flu, eight accidents, nine nephritis. Although no, this is for the general population or for people over over sixty five.


OK. Oh OK. Well what was wrong by a lot.


Yeah. Did the woman who died on February six die of Karani in California.


Yes, I've heard that in The New York Times. OK, yeah. You said in New York percentage of people who died is tenfold of California, of Corona, obviously in New York as of yesterday, a hundred and twenty six per hundred thousand people. And in California, six per 100000. So Tahnee. Hold. Yeah, wow, yeah. Wah, wah, wah, wah, wah, wah, wah, wah. Also, did you know the urban legend about, like, you know, like the girl is sleeping in her hands, hanging down off the bed and her dog is licking her hand and then she looks and it's a person.


It's a killer.


Oh yeah. Those are the funniest cuties in school. I know. It's called the lick tan. It's a real thing. It's a real legend. Yes. I'm not making these out. It's a real fake story. The story describes a killer who secretly spends the night under a girl's bed licking her hand when offered when she takes to be her dog. Oh, my God. Everyone knows that patient murderer.


The best ones are.


Can we talk about Alex Jones for one second?


Because they keep showing the clip now of him saying he's going to eat his neighbors. But, you know, well, eventually, as they're asked, have you watched him say at all now? I'm not going to watch that.


He's in like a suit. He's got to really like he's up the production value of his background.


I'm not sure what it is. It kind of looks like a nuclear proliferation match.


But at any rate, I'm watching him and he's screaming. He's talking about hanging his neighbor up and field, dressing him like a deer and gutting them.


And all of a sudden I'm like. The guy's smart enough to have his own show and a following, so he most certainly doesn't think this stuff right.


This is where we totally disagree. I feel like he knows how to give his audience what they want. That doesn't mean he doesn't believe it, though. The guys who have that podcast that's very popular, that's a white nationalist podcast. They believe it. They also are business savvy and know what to give their audience. But it's not like they're just doing that. I agree with you. I have a hunch Alex Jones is in on the joke on some level.


I think he believes a ton of it, but I also think he.


Why would we at why why would we cut him slack like that? Like, there's no reason that makes it better.


I think that makes him worse. If he was genuine, I have a lot more sympathy for him. But the notion that he's just a performer doesn't give a fuck what the collateral damages to me seems far more unethical. The thing I wanted to get to you with with you is more let's just assume for a second that he's in on it and then he's smart and that he knows what he's saying sounds ridiculous. How does his ego accept that other smart people are watching him going, what are you are so fucking stupid like?


That's that's why if that's the scenario, then he has sold his ego, I guess, for money, which is kind of fascinating. You and I wouldn't sell our standing as smart for any amount of money. We wouldn't be willing to take on a persona that we were dumb asses for money. You and I just wouldn't do that. So when I think it might be possible someone has done that, that that makes me deeply curious. That's so interesting because I can't relate at all.


I would not be able to sell people's opinion of me being a crazy dumb ass for an amount of money. That's a fascinating mindset.


Yeah, I just I personally don't know anyone who's doing that or believe anyone could truly do it. I also think it is business savvy in the way that he knows how to push the boundaries and get headlines and be on TV.


Yeah, I see nearly everything he does and I don't follow him.


But he he still I don't know that he believes I don't know if he thinks he would really eat his neighbors, but he believes the underlying concept behind it, which is that this is getting crazy.


The government has forced him in a position to have to eat his neighbors.


Right. So so then he knows how to take it to the extreme to get headlines and get attention. But he believes in the thing fundamentally. Yeah, that part. Yeah.


I think I don't think you can put on a whole I mean maybe you can, maybe you can put on a whole act for the rest of your life, but then then what's the difference then. You are that if that's what you've decided to be then you are. Yeah.


If a person is measured by their actions and not their intentions, I totally agree with you. But if we were to watch a movie about somebody who had this persona that really wasn't them, that would be a really fascinating personal journey to watch.


Sure. You know. Yeah. And I just have a suspicion that Alex Jones has to be hamming it up. He is having a pretty profound way that he doesn't really think. I mean, just I just really think Sandy Hook was a hoax. I don't think he could possibly think that.


I think he thinks there's a lot of things happening without our knowledge behind the scenes. You know, these things don't just happen out of nowhere. I yeah, I think he believes that conspiracy happens all the time. No, I don't know that he 100 percent believes in his heart that Sandy Hook was, but he believes it's possible. Sure. So why do you believe it's possible? Then you double down and now it's your brand.


But I do want to say one thing about conspiracy theories. If you've ever told a friend that you cheated on your girlfriend or if you've ever told a friend you cheated on your boyfriend. You have learned that that secret does not stay there. Mm hmm. Almost 80 percent of the time it's coming out. Yeah. And the notion that there would be all these people involved in this conspiracy, something that would take dozens of people to pull off and that the truth would not come out is insane.


People don't keep secrets, especially groups of 10, 20, 30, 40, 50. That is a complete fantasy that humans can keep secrets. It doesn't exist. Right. So for you to be a conspiracy, you know, you're talking what the whole media knows.


So many members of the media got a nudge that, hey, we're going to say that this thing happened, but it didn't happen.


And that person doesn't tell their wife and then their wife doesn't tell their girlfriend and doesn't get to somebody who wants attention. So they call the newspaper. That's not how the world works. People tell secrets. Yeah, there's no great kept secret. Yeah. OK, thanks for. I agree. I definitely 100 percent. Yeah. The notion that like 18 or 20 people plotted to kill JFK and none of them ever spoke is just to me seems implausible.


Very far fetched. Yeah. Agreed. OK, I love you. I love you. Happy happy Cinco de Mayo.