Happy hypoxia in life and business

Is your company peacefully drowning?

Read this warning!

Underwater activities and breath-holding period are extremely dangerous. Do not attempt to test any theories herein or that you came up with on your own. If you’re thinking about going to BUD/S and being a SEAL, I’m especially talking to you. Several people have died before even getting to BUD/S during such activities. You are not as smart as you think you are.

I am not a doctor. So if you’re experiencing any symptoms at all, do not rely on this article to diagnose yourself. Hypoxia is a real danger of coronavirus (COVID-19), but this article is not intended to provide advice on this subject.

You can drown without knowing it. It happens. Under the right (read: wrong) circumstances, a diver underwater can get less oxygen than they need and pass out — without even feeling like they are out of breath.

In the middle of the coronavirus pandemic tons of healthy adults have shown up in emergency rooms under their own power and in good spirits. When nurses check their vitals during triage they discover that these patients have deathly low oxygen concentrations in their blood. They have come to be known as the “happy hypoxics.”

Photo: engin akyurt

While preparing to become a Navy SEAL my classmates and I had to do a ton of training “evolutions” that tested our comfort in the water far beyond what the average person can imagine. The names alone are a mixture of bald shock value and elusive mindplay: “drownproofing,” “lifesaving” (a trainee drowned a year or two ago), “pool competency,” “mask appreciation.”

I passed “the tread” only because I was fairly confident that when I finally started drowning — which, by the halfway point, I surely wasn’t ruling out — that the instructors would save me.

And then there is “the breath-hold.” (There are actually two, but the first one scares the most recruits and claims the most failures.)

In this way men become frogs.

During what is called Dive Phase, you learn a lot of “dive medicine.” One thing that was drilled into us was that the human species’ potent urge to breathe comes from CO2 buildup — not from oxygen deficiency. So as long as you have a way to expel enough CO2 (carbon dioxide), you can circle the drain and perish unless you or your dive buddy promptly notice the signs and symptoms of hypoxia (lack of oxygen).

To clarify, if you’re underwater without breathing equipment like a SCUBA tank and regulator, you can’t expel the CO2 in your tissues.[1] So it is highly unlikely that you would become hypoxic without everything in your living being screaming at you to bolt to the surface. (I’m not a doctor, so do not test this.)

This phenomenon was so interesting to me at the time. After all, schooling, logic, and experience all point to a direct connection between what you feel when you’re out of breath (or holding it) and what your tissues need most of all: namely, oxygen intake as opposed to CO2 expulsion, though the latter is not trivial.

Recently I started wondering whether hypoxia can serve as a mental model in other areas of life due to its memorable properties. The ultimate danger of hypoxia is catastrophic (read: death). It builds over time, often undetected. The final and most distinguishing feature of hypoxia from other metaphors (like carbon monoxide poisoning for instance) is that the metric used most commonly to measure health (urge to breathe or not) has an interesting character: completely reliable — until occasionally being completely useless.

With this mental model in mind, I wonder where else we’re drowning, unaware.[2]

Photo: engin akyurt

People who get fired often don’t see it coming. When a high-growth VC-funded startup let half of us go a few years ago, many people including myself were naively optimistic until the last hours.

Similarly, romantic relationships often end suddenly and with complete surprise to one of the parties.

There likely are examples in your business where you are measuring the wrong things. Sometimes this is purposeful. Other times, you are aware, but there’s no better way than to measure a proxy. And still other times, you are measuring precisely the wrong thing.

Being clear about your known-unknowns and its siblings is crucial to avoid unforeseen catastrophic outcomes as much as possible. To do this you need information.

An organization is nothing without information. This is perhaps a less trivial claim than it may seem at first glance.

I have worked for more than one high-performing company that claimed to be “data driven.” Sometimes too much is measured but with little insight revealed. Other times data is used as a substitute for a point of view. And we all know cases where the most important information flowed poorly to those at the top.

More interesting is that information is often viewed one-dimensionally in such companies: namely, on metrics. And while these indicators are clearly critical, such an obsession narrowly scopes information so that things like org charts, roles and responsibilities, communication protocols, and process flows are ignored. In a way such documents are a kind of meta-information that profoundly affect the flows of base-level info, which I suggest constitutes the oxygen of an operation.

With this new mental model of hypoxia in hand, you need some handy ways to ensure your company stays above water.[3] Try these:

  • Reassess your worst-case scenarios. Run simulations if you can. Talk to those employees most familiar with the operation. (Usually these people don’t have fancy titles.)
  • Ensure your meta-information, especially communications protocols and reporting lines, is well thought out and broadly disseminated.
  • Measure the right things. Establish secondary indicators that can tell you if a proxy metric should be questioned.
  • Have some healthy skepticism when things are “too good to be true.”
  • Ensure healthy flow of information and fidelity of transmission. This can be hardest in romantic relationships but more important there than anywhere else.

Unfortunately they don’t make SCUBA gear for tiny birds. If they did, maybe we would’ve brought canaries underwater with us to detect hypoxia.

If all this talk of drowning without knowing it calls for some levity, imagine your dive partner is a canary. Your rig goes down.

And it’s time to buddy breathe.

Related: Sri goes deeper into the above ideas in episode #27 (“Happy Hypoxia”).

About the author: Sri hosts The Warrior Poet podcast, a show on the philosophy of leadership based on his experience in the SEAL Teams, at Harvard Business School, on Wall Street, and in tech. Shows every Monday. Follow him on Instagram @sri_the_warrior_poet and @sri_actually.

All the way wet (aka footnotes)

[1] You can expel some CO2 into the air your lungs were filled with when you submerged, but this is not enough to reduce your urge to breath. After all, your body continues to produce CO2 whether or not you are breathing. Up to a point, of course → the raw-material oxygen that helps make up CO2 will eventually run out. But you probably won’t be around to see that.

I’ve always wondered why the CO2 doesn’t just continuously fill empty lungs so that you could breath out a steady stream of “exhaust air” until you died of hypoxia. My hypothesis is that once you exhale, the shrinking of the lungs contracts alveoli and other lung apparata such that gas exchange cannot occur.

Maybe this is why one sage SEAL instructor used to tell us that it was helpful to exhale small amounts during a breath-hold. Because the lungs in this case would be still mostly expanded, CO2 could still be transferred from the blood stream to an exhale-ready gas form.

But I am not a doctor, and this is not Quora.

PS. That instructor was the same guy who would’ve needed to save my life if I had blacked out on the tread.

[2] On the other hand, “waterboarding” could be what we call situations where you’re completely aware you’re drowning — but you’re actually not.

[3] Pun fully intended. Mixed metaphor regretful.

Not Siri. Sri (shree'). Navy SEAL, podcaster, machine learning, father. Trying to understand jazz. Trying to find huevos rancheros.

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