Monthly Archives: September 2014

3 Ways To Build Better To-Do Lists (3 of 3)

This is a continuation of a thread of posts (part 1, part 2).

3.  Put the whole project on a list and off your mind, or don’t use one at all.

Computers are simple creations.  Despite dramatic advances in artificial intelligence – and the ensuing debate on what constitutes “intelligence” – our multi-core, multi-gigahertz processing machines touting terabytes of storage can’t make a decision that it wasn’t programmed to do.  Continue reading

3 Ways To Build Better To-Do Lists (2 of 3)

This post is part of a series (part 1 | part 2 | part 3)

2. if something needs to be done at a certain time, make it a calendar event, not a TODO ITEM.

Computer are actually incapable of recognizing time. When you tell the computer to “wait 1 second,” it actually converts 1 second to the number of CPU cycles to wait before executing your code.  This means that if another program suddenly tries to execute high priority code right before your timer is up, the CPU will go run their code and leave your program hanging to dry.   Continue reading

3 Ways To Build Better To-Do Lists

This prolific (and also very nice) guy wrote extensively about the importance of checklists in medicine, and how we need more of them. If you work in healthcare and are now accustomed to doing “timeouts” you have this man to thank.  Some people say checklists make medicine sound like a cookbook, making doctors work like computer software following instructions.   Continue reading

The bliss of doing the same thing over and over again

Some people say that happiness and fun is a function of spontaneity, to do the unpredicted.

But sometimes the opposite is true.  My wife spent the past two weeks on night shift while I continue to work regular day shift.  For two weeks our schedules overlap only between 6pm to 9pm on a lucky evening assuming she doesn’t return home late in the morning and need those few extra hour of sleep, and assuming that her service doesn’t require her attention earlier.

We spend those three hours after she wakes up doing the same thing every day.  I begin dinner on the stove, always shortly after returning home and before she wakes up.  We share a meal over a discussion, always about her night, my day, and everything in between.  After dinner, we put Netflix on the TV, always following The Mindy Project, laughing either with or at the show.  Her pager always rings during this time.  We say our goodbyes, and off she goes to work.

Rituals are an important part of life.  It’s what makes the high-achieving medical student through the arduous months of studying for the USMLE.  It is what brings you to brush your teeth every day long after mom and dad stopped urging you.  And for young busy professional couples that rarely spend time with one another, it’s what gives you the sense of bonding, signaling that this is our time together.


: a formal ceremony or series of acts that is always performed in the same way
: an act or series of acts done in a particular situation and in the same way each time

From Merriam-Webster Dictionary

Getting past that gotta-get-this-done-but-too-busy-right-now feeling

In the state of Pennsylvania you need a special permit to practice medicine outside of the supervision of an attending physician, called the unrestricted license.  For most residents, this is not a requirement – your training license allows you to train, and your unrestricted license allows you to practice, well, without restriction (really, it’s not that complicated).  Usually this means moonlighting.

Moonlighting is actually a glorious thing for a resident.  You get hands-on experience for problem solving, and the extra income goes a long way to supplement rent, food, and student loans for an in-training doctor. Continue reading

The journey of a thousand miles

The best question you can ask your doctor sending you off for a bunch of tests – blood test, biopsy, x-ray – is this: how will it change what you do next?

In my work as a resident in radiology, one of the most important teaching focuses is Recommendation.  Although not commonly placed in a diagnostic report, the element of advising your referring doctor is implicit in your Impression of the radiologic examination.  It took a while for me to recognize what it means to fully embrace the role of a consulting physician:  Your colleagues are in doubt about their next step, and your job is to help them decide.

This has two implications:

(1) If the doctor ordering the test is 100% sure about what their next step, then your test is extraneous and therefore should be cancelled.

(2) If your test will not help the ordering doctor move closer to that next step at all, then your test is unhelpful and therefore should be cancelled.

In life, many of us have been “stuck” before too.  We have overarching, bird’s eye view of what we want to accomplish.  We know that these goals are divided into smaller goals, and smaller goals, and yet smaller goals.  But we are “stuck” because there is nothing that connect us from where we are to where we want to be.

As a radiologist, if you can help a doctor find the right next step, then you’ve done your job very well.

As a friend, if you can help someone make that connection between where she stands and where she wants to be, help someone make that single next step, however small, you will have been a great friend.

It begins with a single step.