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.

rit·u·al

noun
: 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.

Data is data

Data is the results section of a scientific paper.
Data is a graph on the dashboard.
Data is a powerful motivator when it puts what we already know about ourselves in numbers.
Data is necessarily biased because it cannot exist in a vacuum.
Data is rarely perfect or complete.
Data is the Wizard of Oz in whom we only see that which we desire to see.
Data is not meaning.
Data is not opinion.
Data is not a mirror mirror on the wall to reveal the hidden truth in it all.

At the end of the day, data is data. It’s people who write the Discussion sections.
People draw conclusions from analytics.
It’s people who create meanings.  People who form opinions.

Don’t confuse the two.

Sometimes it’s okay to just come up with an answer

Humans are lazy.  We don’t like to think hard.  Proven. In this smart guy’s book.

But sometimes people take brilliant decision science theories too far.

It’s true that very few decisions in this world can be made as black-and-white, but most of us find making a decision using black-and-white terms much easier than by “weighing all the pros and cons.”  This phenomenon is well studied and is called heuristics or attribute substitution – we make decisions by replacing a hard question with an easier one (subconsciously).

Case in point:  Continue reading

Write it down if it’s important.

Increasingly, I hear professors giving a lecture saying something like “don’t worry about taking notes because the PowerPoint slides will be posted.”  Having a copy of the lecture slides is obviously incredibly helpful when reviewing.  However, given that some of most solidified knowledge I remember came from painstakingly recorded class notes (or a very, very funny professor), the “do X because Y” correlation with note-taking strikes me as strangely dissonant.

A lecturer who recommends against taking notes makes the following assumptions.  (1) The delivered lecture/speech can be fully captured using a set of PowerPoint slides.  (2) Reviewing his/her PowerPoint slides provides near-identical experience as reviewing one’s own paraphrase of those relevant learning points. Assumption #1 is one the lecturer makes of the educational content itself and is outside of the learner’s control.  However, assumption #2 is one made about the learner, and I’m not so sure that it’s true.

In the digital age, the world has moved away from manual production of information and into data automatism.  Book used to require manual copying which was labor-intensive and expensive.  It gave the actual reproduction of writing value.  The advent of printing made the reproduction of information dramatically cheaper, but creating information de novo was still labor-intensive and considered valuable.  Then came the arrival of the computer file system and electronic books (quick age test: when you think “file” do you think a computer folder with word documents or an actual vanilla folder with paper files?).

On the other hand, the cost of creating good information improved more slowly.  The labor of recording creative thoughts has decreased: we no longer carve words onto tree barks; some of us even stopped writing on paper altogether.  However, creating information ultimately relies on an innate ability to convert thoughts into something the five senses can digest – words, images, sounds, gestures, dances.

So the underlying question is this: is “taking notes” a creative or replicative learning process for you?

Moving from past perfect to simple future

“What would have been” is easy to imagine.  It’s everything that we don’t have but we want, glazed with the syrup of optimism and a flare of fiction.

“What will be” is also easy to imagine.  It’s everything that hasn’t happened yet but will inevitably become pending our next actionable step, permeated with the grating texture of reality and a hint of truth.

The past perfect tense is exactly what it is – it’s perfect.  But “what would have been” is not quite past perfect.  It’s actually past conditional perfect tense. Conditional because we should have made that perfect decision in the past, but now it exists only in the imagination.

“What will be” is a simple future tense.  It looks ahead with a prediction of the near future.  It’s not quite “what will have been.”  The future perfect is a little far ahead, a little scant on realism.

Simple future isn’t necessarily better or worse than the past perfect conditional or the future perfect.  However, it is different, and we sometimes think too little about it.   So next time you found yourself looking back and thinking down a bifurcation towards a fictional future, it might be worth asking yourself “what’s the next actionable step, and am I willing to take it?”  It brings out the real you.

A Double Take on “What’s Your Take?”

“What’s your take?” is a question people sometimes ask when they want your opinions on a subject at hand.  Sometimes it also mean they are actually asking whether you agree with them.  If you were to agree, you get the opportunity to paraphrase their opinions.  If you were to disagree, the phrasing is such that you aren’t forced to start the response “No” as would be necessary with the question “do you agree?” (or risk not actually answering the simple yes-or-no question).

It’s an opportunity to create an engaging discussion without confrontation, a question worth pondering over for a few seconds before answering.