Simplify.
Somehow so recent, but also so long ago, I made my word for 2024 “flow.” (If you’re interested in that process, consider investing in some Legos and going here: Want to Find Flow?) Flow is the “mental state in which a person performing some activity is fully immersed in a feeling of energized focus, full involvement, and enjoyment in the process of the activity,” according to positive psychology. When reviewing my 2024 while preparing for 2025, I can say that I found it more often than I would have had I not chosen to focus on it for an entire year: I experienced it more often during rounds and meetings, I built several Legos, and I read way more books for pleasure than I had in 2023. This year, I’m going to build on finding ways to create flow by just plain making more time to create them by simplifying.
When I reviewed my 2024, there was just, ah, well, a lot. There was just a lot. We expanded our division’s services at the start of the academic year, so there was a lot of patient care. With three new (amazing, bright, and big-hearted) colleagues, there was a lot of, “Nope, don’t worry about it, I didn’t know that as a new attending either, here’s how you do that…” We’ve found that we’re probably getting the short end of the stick when it comes to billing as a division, so there’s been a ton of new brainstorming, documentation, and time in the EMR to make up for that. I had a lot of travel up to Ohio to spend time with my grandma in what turned out to be her last year of life. While the time I spent was fantastic, it wasn’t easy, and I often felt like I could use a few days off after coming home, but the schedule didn’t permit that. And while the beginning of 2024 was to build muscle (given my fear of falling off a curb, breaking a hip, and dying debilitated and unable to complete my own ADLs), the end of the year shifted to losing the extra weight I’ve been carrying around. Any of you who have lost significant weight knows it takes time, effort, and way more mental energy than physical energy. What made all that possible? Finding flow more often than not, and having an unflappably supportive partner, a loving family, and fantastic colleagues. Even with all those advantages, though, 2024 was a lot.
I’ve been experimenting with simplifying for the past few weeks. For example, I noticed the dot phrase I was using when admitting bronchiolitics needed zhuzhing every time I used it to reflect the new billing things I’d been doing since I’d initially written the dot phrase. Rather than continuing to do the same zhuzhing for every single bronchiolitic I admitted, I took thirty seconds to change the dot phrase to include the new billing language. Over a call night, it may have only saved me a total of ten minutes, but it saved me an immeasurable amount of annoyance. Since then, if something can be simplified by spending less than thirty seconds in the EMR, I’ve been doing it. I’ve done little experiments like this before, but they’ve always been in the name of efficiency. This year, efficiency feels gross to me: it feels like making something speedier so I can shove more in. This year, I’m simplifying to give myself a well-deserved break. How else am I going to simplify this year?
Block off time for “life admin.” I’ve been blocking off time in my schedule to answer emails for about a year, and it’s been fantastic for my mental load. After managing two estates for family members who have passed away in the last three years, I can tell you that (even when there are not a lot of assets involved) the amount of time necessary to sort everything is significant. I’m going to block off a couple of hours a week to deal with all mail that’s come in over the previous week, schedule things that need to be done for the house, make sure all our finances are where I think they should be (and cancel subscriptions that have outlived their usefulness). Running errands, making six months’ worth of hair appointments, grocery shopping, meal-prepping, and even doing laundry can be put in this time.
Group “like with like.” One of the biggest things complicating my time is task switching. I frequently must task switch in the PICU, but when I let it creep into my non-ICU time, it just slows things down. What does this look like? During the time I block off to answer emails, I answer all emails dealing with a specific topic during the same time rather than going in chronological order. “Research project A” emails get dealt with, then “Teaching” emails get dealt with, and so on. I will start doing this with the mail associated with my grandma’s estate, literally creating piles according to the topic and then working through one pile at a time: bills to be paid, Medicare to be fought with, the lawyer's needs, etc.
Notice my pain points and do something about them. If the same annoyance keeps coming up repeatedly, I will ask myself, “How can I simplify this?” My brain will probably devise some things to try until that pain point is resolved. If not, I will lean into AI and ask Google Gemini how to fix the problem. I’ve started using Gemini to brainstorm things, and it’s a fantastic resource to just bounce ideas back and forth with. I’m going to ask it for the best method to mass unsubscribe from email lists as soon as I’m done writing this.
Limiting goals. This one’s rough. Many productivity experts recommend limiting ourselves to no more than three main goals at a time (and most say that if something is vitally important to you, you make it your singular goal for as long as it takes to accomplish it). Obviously, you can’t stop going to work when your primary goal is maximizing your relationship with your kid before they go to college (otherwise, paying for that kid’s college will be pretty tough). But what if every other goal you had got deliberately placed on a back burner with a “done is better than perfect” attitude or responses to involved colleagues that you “can’t get to that for another 6 months”? I have some low-hanging fruit work projects that can have a solid endpoint, so I will make one my primary work goal until it’s complete. All other things that must be done will be delegated if they can be or completed with the absolute minimum of my time and effort. And my other goal is to lose weight. Anything not easily connected to that one work goal or losing weight will be deliberately put into a holding pattern.
Marie Forleo has many mantras, one of which is “Simplify to amplify,” the idea that we actually get further when we focus our time and energy. Honestly, “amplifying” feels too much for me right now. Making “simplify” my word of 2025 will give me a break while keeping my life on track. Who knows? Maybe I’ll be in a headspace to amplify in 2026.