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Brain Overload and Why Your Doctor May Seem Like a Jerk

The human mind

Blogger Dr. Grasshopper, who practices internal medicine in a large urban hospital, posted this today: “Why Your Doctor Comes Across As An A**hole.” Does your doctor seem uninterested in you? Do you feel hurried out of the examining room? Do you ever feel like your big concerns are being brushed aside? Dr. Grasshopper’s post and the article it strongly recommends (“Neuron overload and the juggling physician” in The Lancet) help shed light on issues you and I might not have considered before. They also cover some interesting points about what needs to be fixed in our health care system. They’re the kind of thing practically anyone could benefit from reading in terms of understanding more about their health, their insurance, and their health care providers.

How we’re like doctors
But I have an additional reason to point to the Lancet article in this post, and it’s that many of us have the same problem those doctors do: too many things to juggle with a brain that is designed to only ever juggle one thing at a time.

In my post “How to Multitask, and When Not To” from a couple of years back, I talk about neuroscientist John Medina’s observations on how attention and focus work. His two key points are:

  1. We can only focus our attention on one thing at a time, and
  2. Every time we change our focus, we have to do extra work, and we increase the likelihood that we’ll make an error.

For example, if you’re studying from a textbook while sorta-watching a TV program in the background, then you’re creating constant interruptions as your attention moves back and forth. Every time you start paying attention to the program, your brain has to shut down everything you were thinking about what you were reading and then fire up pathways that relate to the TV show. When you look back to the book, the process has to happen again in reverse, but with a good chance that some of the pieces you had in your head a moment ago won’t be included in the re-activation and will be lost.

The benefits of single focus
Even if you only pay attention to 10 minutes of TV during an hour of studying, the number of times you go back and forth between those two things will make your studying much, much less efficient. It’s much better to study for a solid block of time and then watch TV for a solid block of time: you’ll remember more and still have more time to pay attention to the TV show (if that’s what you want to do with your time).

OK, most of us reading this already know that watching TV while studying doesn’t work well. The reason this applies to so many of us is that the same thing is true for any situation where we’re trying to give attention to two things at once–like trying to figure out what to do about a scheduling conflict over the weekend while composing an e-mail at work. It gets even worse when our attention is distracted by many different things.

An example
This is what can sometimes happen to me: I’ll be working on a computer task (for example), be distracted by a new thought about a writing project, realize I need to arrange something for one of the kids, then recall I still haven’t returned a friend’s phone call, then remember that I was supposed to be working on the computer. Each change of focus comes with an inefficient changeover of my mental setup, and the whole process is likely to be enhanced by stress at having so much to worry about and guilt at not getting more of these things done. What’s worse, I may not be staying with any of these tasks long enough to make actual progress.

How not to fall into this trap
The solution is a good organizational system that’s always kept up to date (so that you don’t have to worry about whether or not there’s something in it that you haven’t checked or updated recently) and setting up tasks one after the other, never intermixed if you can help it. (See my post “Useful Book: Getting Things Done” for what I suggest is the gold standard for organizational systems.) If you add to that organization and focus a habit of getting rid of tasks and distractions that aren’t important in your life–or at least getting comfortable with giving them such a low priority that you understand they may never get done–then you have an approach that can yield a much calmer, more productive, and happier day-to-day existence.

Will this help doctors? Maybe not. After all, the problem doctors face is that they’re required to do more work than they can do effectively and at their highest level of skill. Insurance companies and related forces prioritize doctors’ practices. Fortunately, most of us are the ones prioritizing our own lives.

Photo by lovefaucet

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How to enjoy the dullest tasks

States of mind

I’ve mentioned before in posts like Some Steps for Getting into a State of Flow how even as seemingly unappealing a job as doing the dishes can be not only easier, but in fact enjoyable under the right circumstances. Here are some specific ways to enjoy drudgery:

1. Get into flow. Flow is a highly focused state when we are working hard to do something exceptionally well, using all of our attention. Getting into a flow state requires knowing what you’re doing, having minimal interruption, having a specific (and challenging) goal in mind, and having some way to judge how well you’re doing. World-class violinists, writers, programmers, physicists, tennis players, and highly accomplished people with all kinds of other specialties get into it often, but it can be done as well with very humble tasks. How quickly can the dishes be washed, or how perfectly, or with how little wasted water, or how quietly? See Some Steps for Getting into a State of Flow for more information on this.

 2. If the task doesn’t require much attention, use the opportunity to focus your attention on something you really like. This was what I did today, listening intently on headphones to songs for which I wanted to learn the words. I was literally disappointed when I ran out of dishes to wash and had to stop. Some other activities I’ve done that have made dishwashing really enjoyable have been talking with a visiting friend, singing, helping with my son’s homework, talking on the phone (using a headset phone), and even watching movies on a laptop set up behind the sink.

3. Simultaneously do something else useful. Our brains are designed to pay attention to only one thing at a time, but if the chore in question doesn’t require much attention, it’s sometimes possible to get something else done as you’re cleaning dishes or dusting. An example of multitasking while doing the laundry comes up in my post How to Multitask, and When Not To.

3. Use the time to think. If your life tends toward the hectic, with few opportunities to reflect, allowing your mind to wander onto whatever subjects most interest you as you vacuum or clean dishes can provide a welcome respite. To do this, it’s necessary to give up on any kind of resentment about doing the dishes and to point your mind in useful directions if it gets caught up in unimportant details.

4. Meditate. Meditation means narrowing our attention to a very specific thought or experience. Focusing intently on just the sensory details of washing the dishes–the feel of the water, the splashing sounds, and so on–can provide a means of meditating that can aid relaxation, alertness, and serenity, and the same can be achieved with vacuuming or any other household chore that doesn’t require any significant amount of thought to accomplish. The trick with this is to get used to focusing the mind back on only the sensory details whenever it wanders onto another subject. As with flow, this isn’t a useful strategy in high-interruption situations.

Photo by Nicholas Smale


How to Multitask, and When Not To

Strategies and goals


In my last post, “How to Get a  Lot of Different Things Done Without Going Crazy,” I mentioned molecular neurobiologist John Medina’s point that our brains are structured so that we can only focus on one thing at a time. In Medina’s book Brain Rules, he asserts, “the brain cannot multitask.” It’s a really important point, but he is making it in a confusing way, because Medina goes on to say he’s only referring to “the brain’s ability to pay attention.” As you know if you’ve ever driven the wrong way because your mind was on something else, doing a thing doesn’t always mean paying attention to it. Medina is telling us that we can’t multifocus. Multitasking is not only possible, it’s a terrific way to get dull things done without getting bored, if used in the right way.

But since we can’t focus on more than one thing at a time, that means that if we’re multitasking, we can have at most one thing tying up our attention at a time: past that first thing, anything else we do can’t be something requires attention: it has to be something we’ve done over and over the same way.

I like folding laundry, because I always use laundry folding time to watch a movie with my son. We dump all of the clean laundry in the middle of the living room, sit around the pile, and gradually transform the pile into neat stacks of folded clothing. We take our time, talk about the movie a little when we feel like it, and when we’re done we hardly feel like we’ve done any work. It’s my son’s favorite chore, and I count it more as leisure than work.

unicyclerBut it’s easier for me than for my son, because I’ve been folding clothes for decades, while my son has only been doing it for a few years. Several times every folding session, I’ll notice he’s stopped folding, his attention fully on the movie. Usually this happens with a trickier item of clothing or with a particularly gripping part of the movie. Not being as used to folding as me, he can’t do it entirely on automatic, so his brain needs some of his attention for the folding, and his attention is already taken up by the movie. Since he can’t pay attention to two things at once, the clothes folding just stops, and since he was doing it automatically, he may not even notice: he may just sit there holding the shirt, transfixed.

“Fold,” I remind him, and he takes the few seconds necessary to focus on the clothing and start folding it, at which point his brain can go back to the movie.

I can understand if you don’t think of watching a movie and folding clothes as multitasking (though since I write a lot of fiction and analyze movies for plot, character, pacing, and emotional impact as I watch, watching movies for me is fun work instead of just fun), but even using our attention for fun can make boring work enjoyable.

So multitasking is simple, but multitasking attempts are doomed to fail unless the extra tasks being done are near-automatic ones. In terms of prioritizing tasks if we want to get a lot done, this suggests that it’s helpful to save the really mindless ones for a time when we’re doing something else with our mind: planning, talking on a headset phone (they’re not expensive, and they’re a good way to get housework done painlessly for some people), or even relaxing with a movie. But since even automatic tasks require a little bit of attention from time to time, we generally can’t focus intensely on one thing while automatically doing another: for example, we can’t multitask and still expect to get into flow.

I’m not suggesting we need to fill every moment of our lives with as much productivity as possible, but when we have a lot of things in front of us to do, it can help to know that some of the dullest tasks can be done while our brains are elsewhere. While there are other good ways to accomplish boring tasks, there’s a certain satisfaction in getting two things done at once: it makes us feel organized and confident, and that feeling itself is a great motivator.

Replicated guy cleaning photo by waveking1
Photo of unicyclist Tom James by Elsie esq.


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