The Bliss of Zero

The clock hit 7pm. My thumb off the deadman switch on the dictaphone. The glow of the reading room workstation monitors reflected off my glasses. I squinted. A click of the mouse. A curious pause.

And then there it was. I saw…

Nothing. A worklist with zero unread exam.

Inbox zero, Epic Radiant variant.

Sunday night marked the end of the final call shift in my second year of residency.

The empty worklist got me thinking about zeroes.

The Zero-Task Worklist

That time when the worklist has 1 exam lingering from the previous week because of paperwork or IT error. Even as you could simply ignore its presence, the work is just not quite the same because every time you open that worklist, something in your mind tries to figure out why that 1 exam is on the list.

There is something magical about zero.

You know the feeling. Whether you are a radiology resident taking a long call shift or reading during the daytime, seeing your responsible worklist showing zero study can be one of the best feelings. The interesting contrast is that the bliss does not necessarily come from the fact that you are caught up.

The Zeroes Elsewhere

There is an entire life hacking movement on making small behavioral changes to make life a little more efficient. Life hacking is a little like what we do in radiology – a special macro, a new keyboard shortcut – small changes that makes the day’s work a little easier.

One concept involves zeroes.

Zero is a little like FREE!. Behavioral economist Dan Ariely writes that the difference between $1.00 and $1.01 is almost negligible, but the difference between $0 and $0.01 is far greater. People will line up for hours for something free. Zero cost has a special meaning.

David Allen, the author of best-selling book Getting Things Done (GTD) and founder of a company based on the same concept, champions zero. The most important element of GTD is getting everything onto some form of recording system. That is, keep a zero-item worklist in your mind.

And then there is inbox zero. In 2007 Merlin Mann presented at Google Tech Talk the concept of inbox zero (video here). It suggests that only when our email inbox is completely empty do we fully take our minds off the obsession to constantly check email. It is in fact a cure – checking email becomes a carefully planned action, lest it disturbs the bliss of zero-ness.


When on-call, a zero-item worklist is a blissful sight to behold. However, radiologists are not the only ones whose lives are in part managed by worklists. Any list that documents the amount of pending work awaiting your attention can use a little reorganizing. It can also give you that little extra push to get things done.

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Howard Chen
Vice Chair for Artificial Intelligence at Cleveland Clinic Diagnostics Institute
Howard is passionate about making diagnostic tests more accurate, expedient, and affordable through disciplined implementation of advanced technology. He previously served as Chief Informatics Officer for Imaging, where he led teams deploying and unifying radiology applications and AI in a multi-state, multi-hospital environment. Blog opinions are his own and in no way reflect those of the employer.

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