I Hit My Head and Learned Three Lessons

Emily Oster

10 min Read Emily Oster

Emily Oster

I Hit My Head and Learned Three Lessons

Combating fear, making backups, and showing up for yourself

Emily Oster

10 min Read

At the end of September, I went to a conference in Denver. The first morning, I went for a run when it was still dark, on a path that was also used by bikes. Exactly 3.40 miles in, I collided with a cyclist going the other way (I know it was 3.40 because, like all good runners, the first thing I did after sitting up was stop my watch). It wasn’t anyone’s fault — we tried to avoid each other and ended up playing chicken wrong.

I thought I was okay upon sitting up and figured I’d just jog it back to the hotel (yes, I thought this). But when I tried to stand, I passed out. A few minutes later, I tried to stand again, and passed out again. At this point, the cyclist called an ambulance, and 10 minutes later I was headed to the ER. The EMTs measured my blood pressure at “90 over … what do you write down when it just fizzles out at the second number?,” which prompted the use of lights and sirens.

When I got to the ER, there were perhaps 30 people waiting in a trauma bay. I’ve been to the ER before — the time I cut my finger trying to catch a falling French press — but never in a situation in which people were actually worried something was wrong. Within about 30 seconds, there were 10 people working: taking blood, doing an ultrasound, checking my pulse, taking off my shoes (sorry to that person), running a chest x-ray. They were talking in medical jargon, back and forth, about what they were seeing.

A few minutes later, the head doctor announced, basically, that everything was fine (“I think we can downgrade the trauma level”). It turns out I was just a person in good aerobic condition with a bike-tire-shaped scrape on her leg, a head laceration, and questionable judgment about run timing (no one said that last part, but I could tell they were thinking it). So after a confirmatory CT scan and some staples in my head, I was out. I had time to shower before the first conference session.

Obviously a primary lesson from this is that I was enormously lucky. The cyclist who I ran into stopped and helped immeasurably (he told me his name, I immediately forgot it, but on the off chance you’re reading this, cycling guy — thank you). The EMTs and the ER staff were amazing, and I got off easy injury-wise. I did not end up with a concussion, which I can only attribute to dumb luck. The only significant casualties were a ripped T-shirt and a broken water bottle.

But there were at least three other things that I got from the experience, two of which closely relate to the themes of this newsletter and one of which is more personal. So I thought I’d take a little break from our regular programming and share them here, in case they’re useful to anyone else and so you don’t have to have a bike collision to learn them.

Lesson 1: Understanding is the enemy of fear

The collision was scary, as was passing out. Surprisingly, though, I didn’t feel scared after that. Even in the ER, when like 10 people were working on me at the same time and talking over me to each other, I wasn’t freaked out. The reason, I realized later, is that I understood what was going on.

I’m not a doctor, but I spend enough time in the medical arena that I can speak a bit of the language. In the ER, a lot of people were talking and there were a lot of tests, but, for the most part, I had a handle on what was happening. This understanding was the antidote to fear.

The most important key to understanding what was going on was my ability to parse at least some of the medical jargon. I know what the word “hypotensive” means, for example, and also how it relates to my own health. And this got me thinking about the role of jargon in expert communication more generally.

In this context, “jargon” is language that makes sense to other people in your field but not to the outside world. There are two reasons why people use jargon. The first is that it’s an efficient shorthand. The second is that it’s a signal of expertise. When I say to an econometrician, “I’m concerned about the asymptotics in the paper,” I am both communicating effectively about an issue and signaling that I’m someone who knows what asymptotics are, that I’m part of this club.

Using jargon to communicate efficiently is good — there is a reason for a shorthand in emergency medicine. It’s nice for me that I was able to understand what was going on in the ER, but that’s actually not a key goal when you’re worried someone might have internal bleeding.

When we use jargon to signal our expertise, though, its value seems more mixed. Especially when we do it to signal expertise to people outside our field.

Put simply: I think experts often imbue their communication with jargon because they think it makes them seem trustworthy and smart. It is tempting to think that mentioning asymptotics when I’m communicating with non-econometricians makes me seem like some kind of wizard who you should definitely listen to. This experience with my injury made me realize that … that’s probably wrong. In fact, it might literally be the opposite.

It may be that jargon doesn’t make an expert seem smart, it just makes people feel stupid and like they cannot understand. And that prompts fear or anger, or both. If understanding is an antidote to fear, then making sure people understand when we communicate is really important.

One of my primary goals with ParentData is to enhance understanding. To take academic papers and explain them without jargon. For me personally, much of the past 15 years has been about gradually learning how to communicate complicated concepts in a way that is (hopefully, usually) understandable. To some extent, this experience was a reminder of why I try to keep improving at that.

There’s also a broader lesson for when we are on the receiving end of expert opinion. There are times, during pregnancy and parenting and beyond, when you may have found yourself hearing advice or guidance that isn’t clear, and the reaction may be fear. It is worth asking: If I understood this better, would I feel less afraid? And if the answer is yes: ask. If there is time for a better explanation, you deserve one, and I’d bet in a lot of cases, it would be at least a partial antidote.

Lesson 2: Backup family systems

Waiting for the EMTs, I messaged two people: my husband and my executive assistant. They were both appropriately freaked-out — my husband wanted to fly to Denver, but the EMT told him to just hold off on that for now. I told both of them later that, until we could be more confident about there being no concussion, I would stay off screens.

And this is where I figured out an error in my family systems: we have no backup plans.

One of the first work-related messages that came through on the ParentData Slack channel after the accident was a link to our backup plan. This is a document we maintain to keep track of the necessary activities of ParentData, who is responsible for them, and who is the backup. If I couldn’t write for a week, what do we do? If the person who stages and sends out the newsletters is sick, who is in charge? We haven’t had to use this much, but when you need it, you need it.

My family doesn’t have this. For example, one of my family jobs is to plan out meals for the following week. I do this on Thursday mornings, but instead I was in the ER. Grocery shopping (by our wonderful nanny) happens on Fridays; without meal planning, she doesn’t know what to get.

I want to be clear: I know in the scheme of things, this is a small issue. At the same time, in a world in which I was somewhat incapacitated for some period, it wasn’t going to improve our lives to have the kids eat cereal for dinner for a week. I wrote a whole book about organizing your family like a firm; this was one lesson I missed.

This is an example of one of these “One Thing” lessons that we sometimes learn and try to change in response to. When I got back, we put together a backup family document that covers both this kind of emergency and also the more mundane question of who is in charge of things like lunches and snacks when I’m gone, or who does the trash when Jesse is out of town.

This lesson is little, but a point I try to make often is that it is fixing the little things that make your life run more easily. We made a backup plan; you might think about one too.

Lesson 3: I’m still 17 (in emotional age)

When I spoke with Jennifer Wallace about her book Never Enough, I talked about the spring of my junior year in high school, when I pushed myself harder than I think I should have, not wanting to let people (or myself) down. I said that, in retrospect, I wish I had taken more breaks, given myself more space to rest, maybe to fail a little.

We would all like to think, I suppose, that we mature with age and learn from our mistakes. I realized after this episode that … I am not sure I really have. I got out of the ER at 8:15 that morning. I took an Uber to my hotel (nicest driver ever, gave me a pep talk the entire way to the hotel, didn’t comment on my bloody shirt), showered, and showed up at my 9 a.m. conference session. I went to the conference. I recorded a podcast episode on one of my breaks. I went to dinner. The next day, I did it again, and then came home and parented for the weekend.

The only concession I made was to cancel my 16-mile long run on Friday. And you know what? I felt bad about it. I thought about going!

I can and will excuse this by saying that, in fact, I was fine. I didn’t end up with a concussion, and the cut on my head is healing. But when I am honest with myself, I don’t know if it would have mattered. I might well have just pushed through until I collapsed. I know how stupid this is, just like I know how stupid it was at 17. But if maturity brings me only self-knowledge but no actual behavior change, what’s the point?

I do not imagine I’m alone here. In the end, this is really an observation about self-care, or lack thereof. How often do we do things — as parents or people — that we believe are expected of us, when what we need is to just say no or even, god forbid, cancel something? If we want to be able to show up for the people we love for the long term, we need to show up for ourselves now.

I like to think we can change, so maybe despite 43 years of not having absorbed this lesson, this might be the head injury that does it. And for the rest of you, learn from my head injury so you do not have to have your own.

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Being pregnant makes you tired, and as time goes by, it gets increasingly hard to get comfortable. You were probably instructed to sleep on your side and not your back, but it turns out that advice is not based on very good data.

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Is side sleeping important during pregnancy? Comment “Link” for a DM to an article on whether sleep position affects pregnancy outcomes.

Being pregnant makes you tired, and as time goes by, it gets increasingly hard to get comfortable. You were probably instructed to sleep on your side and not your back, but it turns out that advice is not based on very good data.

We now have much better data on this, and the bulk of the evidence seems to reject the link between sleep position and stillbirth or other negative outcomes. So go ahead and get some sleep however you are most comfortable. 💤

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📖 #ExpectingBetter pp. 160-163
📈 Robert M. Silver et al., “Prospective Evaluation of Maternal Sleep Position Through 30 Weeks of Gestation and Adverse Pregnancy Outcomes,” Obstetrics and Gynecology 134, no. 4 (2019): 667–76.

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How many words should kids say — and when? Comment “Link” for a DM to an article about language development!

For this graph, researchers used a standardized measure of vocabulary size. Parents were given a survey and checked off all the words and sentences they have heard their child say.

They found that the average child—the 50th percentile line—at 24 months has about 300 words. A child at the 10th percentile—near the bottom of the distribution—has only about 50 words. On the other end, a child at the 90th percentile has close to 600 words. One main takeaway from these graphs is the explosion of language after fourteen or sixteen months.

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Is sleep training bad? Comment “Link” for a DM to an article breaking down the data on sleep training 😴

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Having this realization, accepting it, reminding ourselves of it, can help us make the hard decisions and accurately weigh the risks and benefits of our choices.

#parentingquotes #decisionmaking #nosecretoptionc #parentingadvice #emilyoster #parentdata
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Excuse the language, but I have such strong feelings about this subject! Sometimes, it feels like there’s no winning as a mother. People pressure you to breastfeed and, in the same breath, shame you for doing it in public. Which is it?!

So yes, they’re being completely unreasonable. You should be able to feed your baby in peace. What are some responses you can give to someone who tells you to cover up? Share in the comments below ⬇️

#breastfeeding #breastfeedinginpublic #breastfeedingmom #motherhood #emilyoster

Excuse the language, but I have such strong feelings about this subject! Sometimes, it feels like there’s no winning as a mother. People pressure you to breastfeed and, in the same breath, shame you for doing it in public. Which is it?!

So yes, they’re being completely unreasonable. You should be able to feed your baby in peace. What are some responses you can give to someone who tells you to cover up? Share in the comments below ⬇️

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Potty training can feel like a Mount Everest-size challenge, and sadly, our evidence-based guidance is poor. So, I created a survey to collate advice and feedback on success from about 6,000 participants.

How long does potty training take? We found that there is a strong basic pattern here: the later you wait to start, the shorter time it takes to potty train. On average, people who start at under 18 months report it takes them about 12 weeks for their child to be fully trained (using the toilet consistently for both peeing and pooping). For those who start between 3 and 3.5, it’s more like nine days. Keep in mind that for all of these age groups, there is a range of length of time from a few days to over a year. Sometimes parents are told that if you do it right, it only takes a few days. While that is true for some people, it is definitely not the norm.

If you’re in the throes of potty training, hang in there! 

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlerlife

Potty training can feel like a Mount Everest-size challenge, and sadly, our evidence-based guidance is poor. So, I created a survey to collate advice and feedback on success from about 6,000 participants.

How long does potty training take? We found that there is a strong basic pattern here: the later you wait to start, the shorter time it takes to potty train. On average, people who start at under 18 months report it takes them about 12 weeks for their child to be fully trained (using the toilet consistently for both peeing and pooping). For those who start between 3 and 3.5, it’s more like nine days. Keep in mind that for all of these age groups, there is a range of length of time from a few days to over a year. Sometimes parents are told that if you do it right, it only takes a few days. While that is true for some people, it is definitely not the norm.

If you’re in the throes of potty training, hang in there!

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlerlife
...

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This is why the new medication Xolair is very exciting. It promises a second possible treatment avenue and one that works for other allergens. A new trail analyzed data from 177 children with severe food allergies. Two-thirds of the treatment group were able to tolerate the specified endpoint, versus just 7% of the placebo group. This is a very large treatment effect, and the authors found similarly large impacts on other allergens. 

There are some caveats: This treatment won’t work for everyone. (One-third of participants did not respond to it.) Additionally, this treatment is an injection given every two to four weeks, indefinitely. This may make it less palatable to children. 

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For children or adults with severe food allergies, they can be incredibly scary and restrictive. We may imagine that it’s easy to deal with a peanut allergy by, say, not eating peanut butter sandwiches. But for someone with a severe version of this allergy, they may never be able to go to a restaurant, for fear of a severe reaction to something in the air. Right now, there’s only one approved treatment for severe allergies like this and it’s limited to peanuts.

This is why the new medication Xolair is very exciting. It promises a second possible treatment avenue and one that works for other allergens. A new trail analyzed data from 177 children with severe food allergies. Two-thirds of the treatment group were able to tolerate the specified endpoint, versus just 7% of the placebo group. This is a very large treatment effect, and the authors found similarly large impacts on other allergens.

There are some caveats: This treatment won’t work for everyone. (One-third of participants did not respond to it.) Additionally, this treatment is an injection given every two to four weeks, indefinitely. This may make it less palatable to children.

Overall, even with caveats, this is life-changing news for many families!

#xolair #foodallergies #allergies #peanutallergy #emilyoster #parentdata
...

If you have a fever during pregnancy, you should take Tylenol, both because it will make you feel better and because of concerns about fever in pregnancy (although these are also overstated).

The evidence that suggests risks to Tylenol focuses largely on more extensive exposure — say, taking it for more than 28 days during pregnancy. There is no credible evidence, even correlational, to suggest that taking it occasionally for a fever or headache would be an issue.

People take Tylenol for a reason. For many people, the choice may be between debilitating weekly migraines and regular Tylenol usage. The impacts studies suggest are very small. In making this decision, we should weigh the real, known benefit against the suggestion of this possible risk. Perhaps not everyone will come out at the same place on this, but it is crucial we give people the tools to make the choice for themselves.

#emilyoster #parentdata #tylenol #pregnancy #pregnancytips

If you have a fever during pregnancy, you should take Tylenol, both because it will make you feel better and because of concerns about fever in pregnancy (although these are also overstated).

The evidence that suggests risks to Tylenol focuses largely on more extensive exposure — say, taking it for more than 28 days during pregnancy. There is no credible evidence, even correlational, to suggest that taking it occasionally for a fever or headache would be an issue.

People take Tylenol for a reason. For many people, the choice may be between debilitating weekly migraines and regular Tylenol usage. The impacts studies suggest are very small. In making this decision, we should weigh the real, known benefit against the suggestion of this possible risk. Perhaps not everyone will come out at the same place on this, but it is crucial we give people the tools to make the choice for themselves.

#emilyoster #parentdata #tylenol #pregnancy #pregnancytips
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