Ever considered why we do what we do? Why we bought that car or those clothes?
Was it really because we needed them or was it some other reason.
Edward L Deci in his book "Why We Do What We Do" talks of a sense of responsibility, how what we do affects others, how the irresponsibility of Doctors affects their patients, how the irresponsibility of managers affects their employees.
Deci's book is about motivation and the distinction between whether behaviour is autonomous or controlled, free and volountary , or controlled to act in response to external pressure.
The difference between the two is choice, the question of whether someone really chooses to do something or whether those actions are controlled by an external agent.
He tells us it is also an understanding that is essential for locating and anchoring ones true self amongst the seductive and coercive tides of modern culture.
Many Years ago when I, with a number of colleagues, was half way through an apprenticeship in the Merchant Navy, I was told a story by a member of the St Johns Ambulance service, a man who had been retained by the college I was attending to give us sufficient understanding of the principles of first aid to allow us to survive long enough to qualify as navigators.
Two years earlier we had turned up, aged 16 or 17 years old, having each been given apprenticeships with different shipping companies. We were desperate to be unleashed on an unsuspecting world but our companies rather sensibly had insisted that before we went to sea we should spend a few weeks learning what the sea looked like and possibly enough information to allow us to come back in one piece from our first trip.
Thus we found ourselves, for the first time in our lives, listening earnestly to a member of the St Johns Ambulance service as he taught us some very simple principles that, a thousand miles from professional medical help, might allow us to save ours, or our colleagues, lives.
This was important stuff and nobody was playing the fool.
Nearly forty years later I still remember how important it felt to be told, without any drama, how many minutes we would have to live if we sustained a compound fracture that broke an artery, and in rapid order exactly how each one of us could be completely responsible for saving someone else's life in the same situation without any equipment, armed only with the knowledge that the Ambulance man was going to give us.
We listened as he told us about the pressure points on the human body. Places where the arteries on their way from the heart to our limbs, pass over solid bone.
Knowing where these points were we were told that by applying pressure we could nip the artery between our fingers and the bone and therefore stop arterial bleeding. By knowing this simple thing he gave us the ability to save someone's life just by pressing in the right place.
We were very impressed.
Two years later, after collectively sailing all over the planet, we returned to the UK to begin the technical and professional part of our education that would lead to our qualification.
Part of this education was a refresher on the first aid element of our initial training.
This was again handled by the St Johns ambulance brigade and again the emphasis was on the sort of crush injuries and breaks that might be expected in the industrial environment.
This time however there was no talk of pressure points, instead it was suggested that we put a dressing over the gaping wound and if the blood continued to come through, stick another one on top. Bearing in mind how little time we had to save the life, and the unlikely event that we would be carrying sterile dressings, this seemed a pointless and ineffective alternative when we knew how immediately effective the pressure points were.
This is the story the St Johns ambulance man told us.
He told us how the previous year a member of the St Johns display team, the best of the best, had been waiting to catch a bus on his way to work when a young woman, trying to catch the same bus, had run across the road in front of a car.
The car hit her and she landed in the road like a sack of spuds. The St Johns man rushed to help and saw the end of her broken Femur and the life draining from her body as a result of the damage it had done. She had about two minutes to live.
The St Johns man kicked in to gear. He found the femoral artery where it passed over the pelvic girdle and he pressed, he stopped the flow of blood.
At the same time he was organising the scene, someone called the ambulance, he had someone else stop the traffic and another get blankets from a shop to keep the woman warm while he waited for the ambulance, all the time maintaining the pressure on the artery that was stopping the woman from dying.
The ambulance arrived 10 minutes from the time of the call, exactly eight minutes after the woman should have died.
The St Johns Ambulance man let them take over, he told them exactly what had happened, the condition of the woman and what he had done.
The professionals were impressed and asked for the name of the St Johns man. They told him that his actions had without any shadow of a doubt, saved the woman's life and they wanted to make sure that he got a medal.
They took the woman away and after a short stay in hospital she was sent home to rest while the leg that she had broken because she did not look before dashing into the road, healed.
During that time she was advised that if she sued the St Johns Ambulance man there was a good chance that she could win an action for indecent assault against him. So she sued.
The key moment when it came to court was when the prosecution asked the St Johns man, "Did you put your hand up her skirt while she lay unconscious in the road?"
The St Johns Ambulance replied truthfully that in order to press on the femoral artery, and thus save her life, he had put his hands up her skirt.
The woman won her action, the St Johns Ambulance service paid her claim and the hero was found guilty of sexual assault.
In order to protect itself and its members from this sort of action in the future The St Johns Ambulance Brigade stopped teaching people how to save each others lives using pressure points.
Nothing has physically changed, we still have these points and we can still save each other's lives by compressing them, if someone had told us where they were and how to do it. But, because of this case, for over forty years nobody has been told about them.
How many lives have been lost during the last forty years that could have been saved so simply?
The real question though has to be who is responsible for those deaths?
Is it the woman who was told that no harm would be done because the St Johns Ambulance Brigade carried insurance and would pay?
Is it the solicitor who's advice precipitated the action?
Is it the practice of setting people targets to achieve that forced the solicitor to chase the woman into hospital in order to achieve his monthly quota of damage actions?
W Edwards Deming told us "If we set targets, those targets will be achieved even if their achievement destroys the organisations that set them."
Well done Mr Deming, you got that right.