"Compared to Ranger school, combat was easy..."

The United States Department of Defense, at Defense Secretary Pete Hegseth's direction, recently announced a controversial plan to begin mandatory testosterone testing for all male service members age 30 years and older.  Secretary Hegseth has previously stated that he believes that screening troops for "testosterone deficiency" is necessary to keep them operating at their "absolute best".  Sean Parnell, a spokesperson for the Pentagon said that "by proactively identifying and treating suboptimal hormone levels," we will "invest in the health of its warfighters, strengthen their performance, and maximize force readiness."  The plan for the moment excludes female members in the military.

The Pentagon's plan is controversial because (1) medical professionals currently do not recommend universally screening testosterone levels in men (testing is recommended only for those individuals who report signs and symptoms of decreased testosterone, including low libido and depressed mood) and (2) there is limited, if any, evidence to suggest that replacing testosterone has any appreciable effect on energy, vitality, physical function, or cognition (testosterone replacement can, however, improve sexual function and bone density).  Importantly, the Pentagon's plan does acknowledge the limited medical benefits of testosterone replacement, and the new policy does not make testosterone replacement mandatory.

As I was reading about this new Pentagon policy, I couldn't help but think of a study that I read a few weeks ago showing that men and women respond differently to arduous physical training.  In addition, there is evidence to suggest that certain high stress military environments can deplete the body's normal testosterone levels, at least in men.  For example, consider what participating in the Ranger Training Course (RTC) does to a soldier's body.  RTC (also known as "Ranger School") is a rigorous 62 day small unit tactics and leadership course designed to push soldiers to their absolute extremes.  The mixed martial artist and Ranger Tim Kennedy reportedly once described RTC as "a place that starves you and denies you sleep for over two months."  Colonel Robert "Tex" Turner claimed that he once woke up from a dream while serving in Vietnam and said, "I woke up in my foxhole in a cold sweat. I had a nightmare that I was still in Ranger School. Thank God that I was in Vietnam. Compared to Ranger School, combat was easy."  Several studies have shown that soldiers have progressively lower levels of testosterone and growth hormone during RTC, and by the end of their training (if they make it to the end - only about 50% of soldiers complete the entire training course), most soldiers have testosterone levels that are consistent with a medical diagnosis of secondary hypogonadism (if you are interested, the links to these scientific studies are here, here, and here).

Historically, female soldiers were not allowed to complete the Ranger Training Course.  However, since the first two women - Kristen Griest and Shaye Haver - graduated from RTC in 2015, approximately 175 female soldiers have completed the training to become eligible to wear the Ranger Tab on their left upper shoulder.  Accordingly, Samantha Goldenstein and colleagues conducted a study to determine if females would experience a similar decrease in metabolic, growth, and sex hormones during RTC.  The results of their study were published this past year in the July issue of the Journal of Applied Physiology.

Goldenstein and her team studied 26 men and 10 women who completed RTC.  They measured body composition, resting energy expenditure, energy balance, and blood and urine levels of key metabolic, growth, and sex hormones at baseline (prior to starting RTC) and then at periodic intervals during the three different phases of training (general field, mountain, and swamp training).  Overall, as expected, energy balance was negative in all three phases, which resulted in an average loss in body mass and decreased resting energy expenditure throughout the entire course compared to baseline.  However, males experienced a larger negative energy balance in the first two phases (but not the third phase) compared to females.  

Thyroid hormone remained suppressed during all three phases in male soldiers, but only during the second phase (mountain phase) in females.  Growth hormone was suppressed in all three phases in both males and females.  Similar results have been reported in a study of females participating in a 61-day Antarctica expedition (similar decreases in body mass and resting energy expenditure, but no significant change from baseline in thyroid hormone).  Female sex hormones (estrogen, progesterone, and testosterone) only changed during phase 2 (mountain phase) of RTC compared to baseline.  Male testosterone levels were significantly lower than baseline during the first two phases (but not phase 3).  Finally, inflammatory markers did not change significantly in either males or females (this may be due to the transient nature of the increase in inflammatory markers associated with acute exercise).

Goldenstein and colleagues conclude that "Females exhibited minimal alterations of physiological status that were largely phase-specific, whereas males demonstrated consistent changes in many markers of health across the course, despite experiencing similar energy deficits."  They go on to state that "male physiology may disproportionately be affected in multistressor environments." 

So, what does all of this mean?  First, in regards to the Pentagon's new policy of measuring testosterone levels in male soldiers, marines, sailors, and airmen, the timing of when testosterone levels are measured will matter a great deal.  Measuring testosterone levels following a lengthy deployment or period of arduous training would not make sense, as testosterone levels would be expected to be lower than normal at these times.  Second, males and females clearly react differently to chronic stress, and further information is required to help support the overall health of our military members.  Third, we need to determine the impact of these changes in endocrine function on the overall health with additional studies.  To that end, this same group recently published a study on the sex differences in physical performance, sleep, and psychological response to RTC (see their follow-up study here). 

"Meetings are broccoli"

Several years ago, I posted (see "Death by Meeting" from March 2020) about an online article written by Michael Mankins for the Harvard Business Review (see "This Weekly Meeting Took Up 300,000 Hours a Year") that claimed that one weekly executive level meeting ended up costing an organization 300,000 hours per year!  Mankins estimated that one of the executives attending that weekly meeting spent up to 7,000 hours per year meeting with direct reports in order to prepare for it.  Each of the executive's direct reports in turn spent time with each one of his or her direct reports to prepare for the meeting with the executive.  And so on.  And so on.  If you add up all of the hours spent meeting in order to prepare for just that one weekly executive meeting, the total time spent in meetings by the organization was a mind-blowing 300,000 hours per year! 

Mankins asked a fair question (more than fair actually) about whether all that time spent in meetings was worth it to the organization?  He added that the 300,000 hours per year didn't even include the time spent outside of meetings gathering information and preparing for the upcoming meeting.  He then stated, "Research shows that 15% of an organization's collective time is spent in meetings...No amount of money can buy back that time.  It must be treated more preciously."

A recent working paper from the National Bureau of Economic Research (NBER) provides some additional perspective on how much time (and money) is spent in meetings.  David Deming and colleagues utilized a large administrative database managed by Statistics Norway and covering "the universe of workers and firms" in the country of Norway, with a specific focus on data collected from 2022 to 2024.  The data was linked to a national survey performed by Norstat which sampled approximately 10,000 individuals who worked at least 20 hours per week at the time of the survey (a 3 month period from May to July in 2025).  Here is what they found:

1. Workers spend a lot of time in meetings.  

The survey showed that the average worker spends approximately 4.7 hours per week in meetings (12% of the standard 37.5 workweek in Norway).  While about 40 percent of workers attend less than one meeting per week, 21 percent spend up to 8 hours per week in meetings.  Among those workers who attend meetings on a regular basis, the average time spent in meetings is about 80 minutes per day.

2. Organizations spend a lot of money on time spent in meetings.

Deming and his team estimated the annual labor cost of meetings by combining the number of hours spent in meetings per worker per week combined with an individual worker's wages.  The average worker accounts for 88,000 Norwegian kroners (NOK) (US $9,000) every year, which when extrapolated to the entire Norwegian economy accounts for NOK 230 billion (US $24 billion) every year!  Similar to Mankins' analysis mentioned above, these estimates do not account for time spent organizing or preparing for meetings or for travel time to and from meetings.

3. There is a lot of heterogeneity in the time spent in meetings between different industries and different types of workers.

The average cost of meetings (using the method described above) is highest in the knowledge- and coordination-intensive service industries, such as finance, insurance, information and communication, professional services, and administration.  The average cost of meetings is lowest in the transportation, agriculture, manufacturing, and retail industries.  Managers attend meetings much more frequently compared to non-managerial workers.  College-educated workers also spend more time in meetings.  Similarly, the time spent in meetings is higher for professional and technical occupations compared to production and manual occupations.  Finally, perhaps not too surprising, workers in remote and hybrid employment arrangements spend more time in meetings than workers who are primarily office-based.

4. Meetings play a larger role in organizations with greater complexity and coordination needs.

Individuals who work at larger firms spend more time in meetings.  Similarly, workers in capital-intensive firms, firms with higher revenue per worker, and heavily unionized firms also spend more time in meetings.  These patterns suggest that meetings are necessary in those organizations in which substantial communication and coordination between workers is required.

5. Workers report that meetings are necessary to facilitate coordination.

When workers were individually surveyed, the three most common stated reasons for participating in meetings were to receive updates on projects and tasks, facilitate collaboration and problem solving, and discuss planning and strategy.  In contrast, networking, informal conversations, administrative matters, and feedback conversations accounted for a considerably smaller share of meeting activity.  These activities were stable across different industries and occupations.

6. Meetings are beneficial to organizations (and to the workers).

Workers in firms with higher wages, total revenue, and average revenue per worker spend more time in meetings.  Importantly, the opportunity costs associated with the time spent in meetings is higher in firms paying higher wages, which suggests that either firms receive larger benefits from the communication and coordination activities that occur during meetings or (less likely) they are more tolerant of unproductive time.  Importantly, wage growth over time is higher for workers spending more time in meetings (in fact, meetings are the strongest predictors of wage growth), suggesting that workers benefit from the time spent in meetings.  Workers in the organizations that spend more time in meetings reported substantially more learning on the job, which suggests that meetings not only facilitate coordination and communication to the benefit of the organization as a whole, but also that they help to facilitate learning and professional development for the individual workers.

There's no question that the quality of meetings can be improved.  For example, there have been several excellent articles on improving the quality of meetings published by the Harvard Business Review (see the link here).  The bottom line though is that we would be short-sighted to do away with meetings altogether.  As the authors of the NBER study discussed above conclude, "Meetings are the broccoli of work – widely disliked, but probably good for us anyway."

When you know...

I recently came across this great cartoon from The New Yorker magazine by Paul Noth.  Those of you who are familiar with the famous "Trolley Problem" (see also a great video clip from Harvard professor Michael Sandel, who introduces his course on "Justice: What's The Right Thing To Do?" with a discussion of the "Trolley Problem" ) will recognize the point immediately!

The "Trolley Problem" is a philosophical thought experiment first described in a 1967 article by Philippa Foot, an American philosopher (and, on an interesting side note, granddaughter of former US President Grover Cleveland).  While Foot described the thought experiment, Judith Jarvis Thomson dubbed the experiment the "Trolley Problem" in a 1976 paper.  

The thought experiment basically asks whether it is ethically acceptable to kill one person in order to save five people.  In essence, the problem is usually set up as follows:

1. There is a runaway trolley moving down the tracks. 

2. Up ahead, on the tracks, there are five people tied down to the track and unable to move. The trolley is heading straight towards the five people and will likely kill them. 

3. You are standing some distance off in the train yard, next to a lever. If you pull this lever, the trolley will switch to a different set of tracks. 

4.  Up ahead on the side track, there is one person tied down to the track and unable to move.  

The reader is left to ponder one of two choices - do nothing, in which case the trolley will kill the five people on the main track, or pull the lever, which will divert the trolley onto the side track, killing the one person (but saving the five).  

The "Trolley Problem" has become very popular since Philippa Foot's first description in 1967.  The television sitcom M*A*S*H, which was about a U.S. Army mobile army surgical hospital (which explains the abbreviation) during the Korean War and ran on CBS from 1972-1983 used a version of the problem in its series finale episode, "Goodbye, Farewell, and Amen", which aired on February 28, 1983.  More recently, the problem also featured in episode 19 of the television show The Good Place (check out the video clip).  It's been the subject of a number of articles and books, both in the popular press as well as the academic literature.  

Kudos to The New Yorker for identifying one of the most frightening possible uses of artificial intelligence (AI).  On the one hand, it doesn't seem so realistic that AI would ever make a decision involving the kind of ethical trade-off posed by the "Trolley Problem".  On the other hand, I could envision several real-world scenarios that involve a similar ethical decision posed by the "Trolley Problem".  

Two patients need an organ transplant.  There is only one organ available for transplantation.  Who gets it?  

Alternatively, imagine a critically ill patient admitted to the intensive care unit (ICU) who is not expected to live.  If the patient's organs could be harvested, five or six lives could be saved, assuming the patient could donate both kidneys, liver, heart, and lungs.  Should the medical team continue to provide care for the patient, or should they withdraw support and proceed to harvest the patient's organs?  

Alternatively, two patients need care in the ICU.  There is only one available ICU bed left.  Who gets the bed?

Imagine autonomous (driverless) vehicles!  If the car encounters a sudden brake failure, should the computer force the car into a barrier in order to stop it, thereby risking the life of the passenger?  Or should the computer force the car out of traffic and on to a sidewalk, risking the lives of pedestrians who may happen to be walking there?

When you consider all of the permutations of the "Trolley Problem", it's frightening to consider that one day in the not so distant future, it could be a computer, and not a human, making the decision!  Should we allow that to happen?  These are exactly the kinds of questions that will confront society as the use of AI continues to grow and expand.

An egg-citing study about Superchickens

I remember watching a cartoon growing up about a superhero chicken (see a video of the opening sequence here).  It was never one of my favorites, and I think the only reason that I watched it was because I knew it was going to be short and that another cartoon (that I liked better) would follow it.  Superchicken's alter ego was Henry Cabot Henhouse III (in a nod to the politician Henry Cabot Lodge, Jr), who seemed to be a mix between Batman's alter ego, Bruce Wayne, Zorro, and the Scarlet Pimpernel.  Superchicken's sidekick was a vegetarian lion named Fred, who also served as Henry's butler.  When called upon to fight crime, Fred would hand Henry his "super sauce" served in a martini glass, which would turn him into Superchicken after he drank it.  You just can't make this stuff up, folks!  

Well, it turns out that a professor from my Alma mater Purdue University created a whole henhouse full of super chickens, and he didn't even need any "super sauce"!  The results, though, are not what you would have expected.  Muir selectively bred the highest egg-producing hens in an attempt to create genetically superior egg producers, or super chickens.  His results were published in the journal, Poultry Science in 1996.  

Muir compared two kinds of selection for egg productivity in White Leghorn chickens.  The hens were kept in cages, with several hens per cage.  In the first experiment, the most productive hen from each cage was selected to breed the subsequent generation of chickens (within-group selection).  In the second experiment, all of the hens from the most productive cage were selected to breed the subsequent generation of chickens (between-group selection).  With the first experiment, Muir found that the most productive chicken achieved her productivity largely by bullying the other chickens in the cage.  After six generations of breeding, Muir learned that he had bred a hyper-competitive, hyper-aggressive group of chickens that attacked each other and sometimes even killed each other.  Egg productivity, in the long run, plummeted in the first experiment.  Conversely, in the second experiment, egg productivity increased with each subsequent generation.  By the sixth generation, Muir learned that he had bred a docile group of chickens that lived peacefully together and produced a lot of eggs (overall egg productivity increased by 160 percent).

Muir's results were important to the poultry industry and led to an industry-wide change in breeding practices.  However, after the entrepreneur and former CEO Margaret Heffernan discussed Muir's experiment and how the results apply to organizations in her 2015 TED talk, "Forget the pecking order at work", Muir's research started to get a lot more attention from outside the poultry industry.  Muir's experiment became a metaphor for how groups of individuals in organizations can better work together through cooperation rather than competition.  In her TED talk, Heffernan said, "If the only way the most productive can be successful is by suppressing the productivity of the rest, then we badly need to find a better way to work.  And a richer way to live."  

Behavioral scientist and author Jon Levy (see also his book, Team Intelligence: How Brilliant Leaders Unlock Collective Genius) suggests that too many organizations today are set up exactly like Muir's first experiment, in which the most productive individuals are rewarded for "hitting their numbers, even if they damage everyone around them."  Levy goes on to state that even professional sports teams are set up in this manner and thus fall victim to the "too much talent effect".  He cites statistics that reveal that when more than 50 to 60 percent of a sports team is composed of superstar-caliber talent, performance, in terms of wins and losses, actually declines (see also my post on the Shane Battier effect).

The bottom line here is that teams work better together when they work as a team, rather than as individuals.  When teams work together, collaborate, and cooperate, "the whole is greater than the sum of its parts."  Conversely, when the individuals on the team are competing with each other, the overall performance of the team suffers.  As Franklin D. Roosevelt once said, "Competition has been shown to be useful up to a certain point and no further, but cooperation, which is the thing we must strive for today, begins where competition leaves off."  

Pause and take a breath...

How many times have you been told to pause and take a deep breath, particularly when you've been visibly upset or stressed out?  I've read a lot about stress reduction techniques over the years, and breathing techniques always seem to rise to the top of the list.  So, I was particularly intrigued about an online article that mentioned how "tactical breathing" is used by individuals in the United States military to relieve stress and stay focused during stressful situations.  The technique is specifically called "box breathing" because there are four parts to the technique:

1. Begin by expelling all the air from your chest and keep your lungs empty for a four-count hold

2. Slowly inhale through your nose for four counts

3. Hold the air in your lungs for four counts

4. Release the air in your chest for four counts

Investigators at the Madigan Army Medical Center in Tacoma, Washington published an abstract in which emergency medicine residents performed the lifesaving procedure of tracheal intubation (inserting a tube into the trachea in order to facilitate respiratory support with a ventilator) while undergoing simulated stressful situations while using the "box breathing" technique.  The overall success rate in the control group (no stress, no "box breathing") was 96%.  The success rate in the simulated stressful situation without "box breathing" was 85%, which increased to 100% with the addition of "box breathing". 

If it works for the military and emergency medicine, maybe there is something to "box breathing" that we can leverage in our own stressful situations.  I plan to try out this technique and will let you know what I think! 

"Vienna waits for you..."

Our youngest daughter and I recently had a discussion on what songs have had the most influence on our lives (at least to date).  I came up with a list, and she did as well.  The top song on her list was "Vienna" by Billy Joel.  She seemed a little surprised when I told her, "Hmm.  I don't know that one."  She next told me, "It's one of his songs on the album The Stranger!"  I confessed, "That's a great album!  But, I still can't hear the song in my head."  She then sang a few bars.  "Nope."

Well, I went back and listened to the song on Spotify.  I remember now!  It is a good song, I just never connected the song with the last verse in the Refrain, "Vienna waits for you."

According to a New York Times article in 2008, Billy Joel claimed that "Vienna" was one of his two favorite songs.  Apparently, the song was inspired by a visit to Vienna to meet with his estranged father when he was in his early 20's.  Joel said that the song is a reminder, "You don’t have to squeeze your whole life into your 20s and 30s trying to make it, trying to achieve that American dream, getting in the rat race and killing yourself. You have a whole life to live."

The song was the B-side single to Joel's hit, "Just the Way You Are", which was his first Top Ten Hit in the U.S. as well as his first Gold song.  Both the song and the album won the Grammy Award for Song of the Year and Record of the Year, respectively, in 1979.  Despite the fact that "Vienna" was the B-side single (for those of you who don't know, the B-side was just an extra song that you got for buying the A-side single that you really wanted in the first place), the song became one of Billy Joel's most popular songs, and in 2024, it was the third-most streamed song in his catalog.  Apparently, the song was featured in the 2004 movie 13 Going on 30 starring Jennifer Garner, which certainly has helped its popularity (here is the scene from the movie that features the song)!

It's not often that I get to compliment one of our children for a great song choice, but I have to confess, "Vienna" is a great song!  Take a listen for yourself - the lyrics have a powerful message!

The Responsibility Poem

I've talked a lot about the importance of accountability in the past (see my posts, "The buck stops here!", "12 O'Clock High", "The Accountability-Authority Matrix", "Honor Code", and "You have to hold people accountable..." for a few of my favorites).  I also want to mention my post, "Who is Will Someone?", because "Will Someone" often gets asked to do a lot of different things on teams and in organizations.  Unfortunately, because "Will Someone" is not a real person, those things just don't get done.  "Will Someone" reminds me a lot of the four individuals, "Everybody, Somebody, Anybody, and Nobody" and a poem by Charles Osgood known as "The Responsibility Poem".  There are two versions, but I like the shorter version the best, which you can read below (I've also found this version with the title, "What Went Wrong"):

This is the story of four working people:

Everybody, Somebody, Anybody, and Nobody.

There was an important job to be done,

But Everybody was sure that Somebody would do it.

Anybody could have done it, but Nobody did it.

Somebody got angry because it was Everybody's job.

Everybody thought Somebody would do it.

But Nobody asked Anybody.

It ended up that the job wasn't done.

Everybody blamed Somebody;

When Nobody did what Anybody could have.

In other words, when everyone is responsible, nobody is responsible.  Just remember the tragic story of Kitty Genovese, a 28 year-old woman who was attacked, raped, and murdered on March 13, 1964 right outside her apartment building while at least 39 of her neighbors (see my post, "Who is my neighbor?" and the so-called "Bystander Effect") heard her scream yet didn't call for help or come to her aid - because "Everybody thought that Somebody would do it" instead.