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On Deeper Reflection
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Online Medical Education on Emergency Department (ED) Critical Care, Trauma, and Resuscitation
Online Medical Education on Emergency Department (ED) Critical Care, Trauma, and Resuscitation
13:26
ODR 007 – Liberterian Free Will, Blame and Shame
Episode in
On Deeper Reflection
This Article is a Must Read if you Found this Episode on Free Will Interesting
The Lucretian Swerve
Attributions
While 1% of this episode may be independent thinking, the rest was surely based on influences too countless to cite. Some that clearly remain foremost as inspiration are the article above, Dan Dennett’s work, Sam Harris’ book, the book, Four Views on Free Will, and all by poor undergrad professors that had to put up with the utter annoyance of my stubbornness.
One of the Most Critical Articles to Read on the Topic
Chun SS et al. Unconscious determinants of free decisions in the human brain. Nat Neurosci. 2008 May;11(5):543-5. PMID: 18408715
Image by Narcournus
Now on to the ‘cast
21:10
23:36
ODR 11 – Email Part 2 – Tactics & Logistics
Episode in
On Deeper Reflection
More on Last Episode
ODR 1 – Email Part 1 – Email is Not the Problem, You Are!
The Joybox
Deep Work
No Email You Don’t Want to See
Turn off email notifications!
Receiving
Touch Once (listen to prior episode)
Filter Relentlessly
One Email Address but many! Add the dots! Then you can filter based on this
Amazon filters to Deliveries App
Filter all messages with the word “unsubscribe” into a separate mailbox
Do not mark emails as spam UNLESS THEY ARE SPAM
Mark Spam Messages as Spam
Your Piss Poor Planning is not my Emergency
Do not let your email inbox be someone else’s To Do List — Tiago Forte
Processing
Stop Filing/Foldering
Can Actually Link Emails to Your Task Manager
Task Management on Calendar will have the link
Better Yet, Create a Email Forward to Your Task Manager Inbox
Future Homer/Ikigai
Avoid the Snooze Button
Triage 2 App on IOS
Sending
Is this the right mode of communication
Craft a good, useful subject line
BLUF-allows contexual understanding
CTA upfront if you are making a pitch,
Lose the Steps of Back & Forth
Use Autofill and Templates
Send Later (Boomerang)
Emojis / Emoticons b/c tone is tough to relay
Compose Better Emails
Use Scheduling Programs
Send Less emails if you want less emails
One idea per email
Short is Better
BLUF or TLDR
Write email like you speak
No Reply Necessary
If it is important, do not put in the sender until ready to send
Enable undo send in gmail
Do not CC unless you need to
Don’t Reply All and Take it Off Default
If you don’t want the staff to respond to all, put them in as BCC
Prune Forwards and Replies
When the Subject Changes–Change the Subject
Following-Up
Loop Closure
Auto-Return if no-reply
Eliminate Email-Induced Anxiety
Random
Services Mentioned
Boomerang
Sanebox
Fastmail
Learn Search
Newsletters
RSS
Email Bankruptcy
Consider Sending Out a Message
Other Stuff
Have a strong password
Consider 2FA
Never put anything important in your work account
Download and archive work email
Now on to the Show…
36:24
ODR XX – NonViolent Communication
Episode in
On Deeper Reflection
This episode is based on one of the most important books I have ever read: NonViolent Communication – A Language of Life by Marshall Rosenberg
Nonviolent Communication is one of the most powerful ways of speaking with people that I have ever come across. It eliminates useless strategies like judgment and proving yourself right and instead gives you absolutely tactical techniques to get the things you need for happiness for yourself and your interlocutor.
NVC is not a new, gimmicky set of dictum. It boils down the philosophies of Stoicism, the psychological approaches of CBT and cognitive psychology.
Marshall Rosenberg was a psychologist trained in the classical analytic, but found it unsatisfying and for the most part, unhelpful.
Speaking Giraffe vs. Speaking Jackal
NVC is not really a theory or a guide to behavior–it is a language!!!
Giraffes only hear feelings & needs, never thoughts
Jackal language is about judging, criticizing, analyzing, moralizing and accusing. When we feel unfairly treated, accused or when we want to impose our wishes, we tend to use the language of the jackal. Jackal language is separating. Giraffe language is unifying.
The System
There are essentially two major parts–The four component speech creation and emergency empathy
The Four Components
1. Observation without Evaluation
There’s nothing good or bad but thinking makes it so.
Shakespeare in Hamlet
Avoid generalization, only specifics (generally good to avoid the past as well)
Separate the observation from the evaluation or better yet, eliminate the evaluation
You are the most inconsiderate person–you are always late
J Krishnamurti: “observing without evaluating is the highest form of human intelligence”
See page 30 for more on pitfalls in observing
2. Feeling
Internal emotional states vs. thoughts/judgment
If you can replace I feel with I think–then it is not a feeling
If I feel is followed by: that, like, or as if then it is not a feeling
If I feel is followed by a name or pronoun (whether he, you, or I), then it is not a feeling
Eliminate the feel–and see if it still works I feel sad to I’m sad works. I feel
Could you feel it alone on a desert island–Ignored is not a feeling, unimportant is not a feeling, resentment is not a feeling b/c they require another to judge/act. It is a thought about how someone else is judging us
p.45 has a list of positive and negative feelings
Stoicism/CBT–We are the only ones responsible for our feelings
We are responsible for everything we do (Replace I have to with I choose to)
Do not connect the feelings to the observations through cause and effect. They relate–they are not caused by.
When I observe X, I feel Y
Even break it down to good/bad
People are disturbed not by things, but by the view they take of them –Epictetus
“There is nothing either good or bad, but thinking makes it so” from “Hamlet” by William Shakespeare
3. Needs
Rosenberg identifies human needs as safety, understanding, respect, warmth,
autonomy, etc. When needs are expressed indirectly through assessments
and behavioural diagnoses, people are likely to hear criticism and
behave defensively or start talking back.
Needs
https://github.com/cognitivetech/Marshall-Rosenberg-NVC/blob/master/NVC-Training-3_The-4-Part-Model_Marshall-Rosenberg_transcript.md#universal-human-needs
To be Heard!!!!!!!!!!!!!!!!!!!!!!
4. Requests
Make the request–would you mind repeating back what you heard me say–I want to make sure I am not causing any misunderstandings
Specific, Doable, Optional, Positive Language
not vague, sweeping, negative, or demands
If they refuse, then they must make a counter-request
Can you repeat back what I heard–I wasn’t as clear as I needed to be
You can never make anyone do anything!!!!
All conversation is transactional–when you think it is not, then it is usually b/c you are passively not acceding to the request
A request could be for the person to repeat back what they heard
I would like to know how you feel about what I just said
Or what they are thinking
Would you be willing…
Whatever is done is given with joy-never a sense of obligation or fear of punishment
Logistics of the 4-Parts
Rapidity / Laconic
Speed of Light-connect feeling to needs then immediately connect to request
40 words or less then check in with a request
When I see that __
I feel __
because my need for is/is not met.
Would you be willing to __?
Need to make NVC sound like normal language otherwise people begin to feel managed
My Take
Stop (Hand Out) (Stop the Amygdala Hijack)
Breathe (Hands Up & Down)
Space between Stimulus and Response from Victor Frankl. In the space between is our evaluation of events which creates feelings. Need to let go of this evaluation!
Emotions You are Feeling (Hand to Heart)
Your Needs or Wants (Hand to Head)
Your Request (Hand to Mouth)
Emergency Empathy and Empathic Listening
Self-empathy–When their Jackal language matches your inner jackals–that is the hardest to maintain giraffe ears
They are just (badly) expressing feelings and needs
Just ask–it is fine if you are wrong
Were you saying–give benefit of the doubt
Empathy for horrible acts–do you need to do this–only if you want communication and to effect change
A great tool for showing empathy is paraphrasing or the repeat-back. This means reflecting back what the other person just said in a way that demonstrates you understand, e.g., if your child says “I hate school!” then you can reply “Are you feeling sad because you’re not enjoying your classes?”
This type of question lets the person either agree that you understand, or they will clarify what they really meant. When you’re confronted by an angry person, this tool can be especially helpful. from: Nonviolent Communication Summary: 11 Best Lessons From Marshall B Rosenberg -) Echos of Negotiation–Make paraphrasing a habit (Chris Voss)
Are you feeling X because you need Y
There is a reason that but is a homophone for butt, when you use it in conflict, it makes you an ass
Ask them to clarify their response in terms of a request
Do you want advice or for me to just hear you (just assume they don’t want advice until they tell you)
4 levels of response evolution
Blame yourself
Blame them
Communicate nonviolently
Care for their emotions and needs But never by putting yours aside Only if you can genuinely feel the space for it and your needs get met as well
Evaluation/Criticism/Praise
moralistic judgments are a dead end
Compliments are just as bad as criticism
Evaluation is by Observations and feelings
What the person did
What needs that fulfilled
What that made you feel
NVC for Conflict Resolution
Your Needs
Their Needs
Verify you both understand eachothers
Empathy
Strategies
Keep a list
Righting down conversation
Roleplay–let them take your role. mediator pretends to be 1 side
Ask yourself what was your intention
Anger
do not make judgments
Someone cut you off–their kid is in the hospital
Anger=unmet needs
express feelings and needs
Scream nonviolent
I feel sad b/c I need!!
Overall Maxims
There are only feelings and needs
The only things people say of any use are Please and Thank You
We must value the other person’s needs as much as our own
NVC doesn’t equal NICE!!!! NVC is not about pushovers–assertive NVC
Doesn’t need to be rigid. You can abridge steps or communicate nonverbally–it doesn’t need to be rote. Intent is what matters
Vids to Watch
San Fran Seminar
{{video: https://www.youtube.com/watch?v=l7TONauJGfc}}
Now on to the Podcast…
34:53
ODR 1 – Email Part 1 – Email is Not the Problem, You Are!
Episode in
On Deeper Reflection
The ODR Podcast
On Deeper Reflection is a podcast on making our lives as happy and productive as possible! Today’s episode deals with the bugbear of many in medicine–email.
1. Understand the Technology
Email is an amazing Technology!
Async-Mail
Sync-Phone, Telegraph, Text, Chatapps,
Email-Asynchronous with instant delivery–but this should not mean instant viewing
Philosophy is wrong, not tactics
Bad Solutions
An article on just keeping emails in inbox misses the entire point. There are only two acceptable solutions and ignoring email is definitely one of them, but inbox zero is the better version of that.
Inbox Zero
Arrival Rate vs. Departure Rate
Every inbox item costs you decision dollars
We don’t want to make decisions
Too Much Email-No!!!!! Too Much Stuff
I Just Check Once Per Day
Vs. I set aside time to do Deep Work
Analogous to I took Facebook off my phone…
2. Email Should Spark Joy
Used to have combined work and home
Never, ever do this!!!! Separate Work and Email
Work Check Once, while at work or every day depending on your job
Horrible human being would email on Friday afternoon with something horrible
3. Don’t treat an async tech as sync
Don’t expect or encourage real-time use
It is fine to reply right away, but dissuade the belief that you will consistently
Pacing
4. Your Email Inbox cannot be your ToDo system
5. Just 1 Touch
DoIt
SystemIt
DelegateIt
SaveIt
UnsubIt-goes back to brings joy, true joy–not dopamine hit
FilterIt
Trashit (actually archive)
SpamIt
Maybe-Bringit Back Services
6. Archive, Don’t Delete
7. Search, Don’t File
8. Inbox Elimination to Keep You Honest
Too Many Inboxes
Gmail Mailboxes
9. Cut out Back & Forth Steps
10. For Some Use cases, Are Slack/Basecamp/Teams the Solution?
Books to Read
You need to prune down to what is important!!!
Life Changing! We’ll do a book club on this one ASAP
Now on to the Podcast…
32:29
ODR 1 – Email Part 1 – Email is Not the Problem, You Are!
Episode in
On Deeper Reflection
The ODR Podcast
On Deeper Reflection is a podcast on making our lives as happy and productive as possible! Today’s episode deals with the bugbear of many in medicine–email.
1. Understand the Technology
Email is an amazing Technology!
Async-Mail
Sync-Phone, Telegraph, Text, Chatapps,
Email-Asynchronous with instant delivery–but this should not mean instant viewing
Philosophy is wrong, not tactics
Bad Solutions
An article on just keeping emails in inbox misses the entire point. There are only two acceptable solutions and ignoring email is definitely one of them, but inbox zero is the better version of that.
Inbox Zero
Arrival Rate vs. Departure Rate
Every inbox item costs you decision dollars
We don’t want to make decisions
Too Much Email-No!!!!! Too Much Stuff
I Just Check Once Per Day
Vs. I set aside time to do Deep Work
Analogous to I took Facebook off my phone…
2. Email Should Spark Joy
Used to have combined work and home
Never, ever do this!!!! Separate Work and Email
Work Check Once, while at work or every day depending on your job
Horrible human being would email on Friday afternoon with something horrible
3. Don’t treat an async tech as sync
Don’t expect or encourage real-time use
It is fine to reply right away, but dissuade the belief that you will consistently
Pacing
4. Your Email Inbox cannot be your ToDo system
5. Just 1 Touch
DoIt
SystemIt
DelegateIt
SaveIt
UnsubIt-goes back to brings joy, true joy–not dopamine hit
FilterIt
Trashit (actually archive)
SpamIt
Maybe-Bringit Back Services
6. Archive, Don’t Delete
7. Search, Don’t File
8. Inbox Elimination to Keep You Honest
Too Many Inboxes
Gmail Mailboxes
9. Cut out Back & Forth Steps
10. For Some Use cases, Are Slack/Basecamp/Teams the Solution?
Books to Read
[aawp box=”0804137382″]You need to prune down to what is important!!![/aawp]
[aawp box=”0349411905″]Life Changing! We’ll do a book club on this one ASAP[/aawp]
Now on to the Podcast…
33:42
EMCrit Wee – Getting Things Done 2019 Update
Episode in
On Deeper Reflection
[featimage]
Original GTD (Gettin’ Sh*t Done) Posts
EMCrit Podcast 136 – Getting Shit Done
EMCrit Podcast 209 – GTD Redux – Opportunities, Time, & Future Selves
Switched to Todoist
Todoist Summary
Integration with Gcal
IFTTT and Zapier
Massive Action Planning by Tony Robbins
Write down the results you want to achieve. (be specific, quantitate if possible)
Write down your purpose (compelling reasons why you want to accomplish this goal–use trigger words, emotion)
Develop a sequence of priority actions.
or as Carl Pullein discusses, OPA:
Outcome, Purpose, Actions
Inboxes are Deadly
Prune, prune, prune
Use email inbox for everything (shortcut/workflow on ios & boomerang on firefox)
Inbox Zero
Boomerang
Subconscious Cognitive Bandwidth
It is not the time, it is the weight
Checklists
If anything you do is:
1. Fiddly &
2. Infrequent
Make a checklist
Directly Responsible Person (DRI)
Who is the the DRI directly responsible individual from Jobs/Apple
Problem for Future Homer
Why we don’t care about our future selves
Now on to the Wee…
23:56
EMCrit Podcast 209 – GTD Redux – Opportunities, Time, & Future Selves
Episode in
On Deeper Reflection
A few years ago, I put out a podcast on Getting Things Done–people seemed to really like discussing this topic. I am giving a lecture on this subject this week. It has gotten me thinking about some of the higher level aspects of GTD and I thought I would share some of them with you.
Deciding on Opportunities
Present you vs. future you
Petrie Triangle
Matt Davella’s Yes? Checklist
Here’s mine if you want to use or edit it for yourself… Should I Say Yes?
☑️ Does it excite the hell out of me?
☑️ Would I do this regardless of money?
☑️ What will I have to give up to do this?
☑️ Will it contribute beyond myself?
☑️ Will I grow from this experience?
☑️ Will I regret not doing it?
Time Tracking/Forecasting
Opportunity Cost
Deciding on Goals
Deep Work
[easyazon_image align=”none” height=”110″ identifier=”1455586692″ locale=”US” src=”http://emcrit.org/wp-content/uploads/2017/10/51kzUUHhMTL.SL110.jpg” tag=”emcrit-20″ width=”73″]
Time Blocking
Pomodoro technique
creator’s website
Getting Tactical re: Email
Put the call to action up top
Preempt the back-and-forths
doodle.com
Close the loop beforehand
Ask one ?, make it easy, and make sure it is not web-searchable/already answered
Resus Fellowship
Click Here for More Info on the Stony Brook Resus Fellowship
Now on to the Podcast…
32:10
ODR 1 – Getting Shit Done (GTD) [Part 1/x]
Episode in
On Deeper Reflection
So my friend Michelle Lin was kind enough to solicit a “How I Work Smarter” piece on her excellent ALIEM blog. One of the things I mentioned in that piece was a book called Getting Things Done. I’ve since gotten a bunch of questions and comments about the book. I’d like to take a brief diversion from the main topic of EMCrit and discuss a bit about the book and productivity for docs and resuscitationists.
GTD on ODR
The Books
Getting Things Done by David Allen (A new edition, the first in years will be out in 3-4 months)
The Organized Mind
The Philosophy
A clear mind eliminates stress and allows creativity, so…
Capture all the things that need to get done into a logical and trusted system outside of your head and off your mind, and…
Discipline yourself to make decisions about all the inputs you let into your life, so that you will always have a plan for next actions that you can implement or renegotiate at any moment
(altered from Mindzone Wiki)
Problems with the Book
Mindset of the Author
Based on an erstwhile paper-based world
Can be read as Dogma
The Steps of GTD
Collect/Process/Organize/Review/Do
1. Collection/Universal Capture
Index Cards
Drafts for IOS
Inbox(es)
Email
Paper Landing Station (The Traditional/Actual Inbox)
Pocket for Web and IOS
2. Process
What is it?
Is it an action, spam, or something non-actionable you want to keep?
Action Processing
Decide if you want to Do it, Don’t do it, Delegate it, or Put it in your system
Is it a project?
What is the physical next action that must occur to bring you 1 step closer to completion
Next Actions & Projects
Reference Processing
Things you just want to keep or references for actions
Eliminate Paper!
Evernote
Scansnap Scanner (this item will change your life)
3. Organize-If you are not doing it right now, put it in the system
NirvanaHQ or Omnifocus
GCal with Fantastical
Add all reference material as links in your system
Calendar
Only things that absolutely must happen at this date/time
Lists on Task Management System
Especially important to have a someday/maybe list, a waiting list, and have a thorough understanding of scheduled events.
4. Review
Daily
Try to process all email
Kill all paper
Clean off Desktop
Look at Calendar
Look at Focus and Inbox
Make a To-Do Card
Pack for next day
Weekly
(this list is from Mindzone wiki)
Loose Papers
business cards, receipts, etc. – put in in basket for processing
Process Your Notes
Previous Calendar Data
review for remaining action items, reference information, etc.
Upcoming Calendar
Empty Your Head
write down any new projects, action items, etc.
Review “Projects” (and Larger Outcome) Lists
ensure that at least one kick-start action is in your system for each
Review “Next Actions” Lists
Mark off completed actions & review for reminders of further action steps to capture
Review “Waiting For” List
Records appropriate actions for any needed follow-up & check off received items
Review Any Relevant Checklists
Review “Someday/Maybe” List
Check for any projects that may have become active and transfer them to “Projects” & delete items no longer of interest
Review “Pending” and Support Files
Browse through all work-in-progress support material to trigger new actions, completions, and waiting-fors
Quarterly
Higher Level Goals and a super-thorough version of weekly review
Yearly
Vision, Life, Clean Out All Files, Am I going in the right direction?
5. Doing
Happens naturally if you use the method above. However, I alter the canonical method with my daily to-do card and the focus section of nirvana
The Initial Dump (this comes first, but is being discussed last)
Incompletion Trigger List
You will fall off the wagon
Not a problem, redo the initial dump and start up again
Flowcharts
Here is a pdf of the simplified workflow from DavidAllenCo.
A more elaborate version is here:
GTD Flow from DavidAllenCo
Other People’s Take
Official GTD Site
Minezone Wiki Summary
Patrick Rhone’s Version (a bit outdated, but concepts are good. pdf)
The Email Charter (not really gtd, but worth a look)
Want a poster of the image you see above from Aaron Levie, just go to his site
A Pattern Language for GTD
Please tell me your thoughts on this episode. Use the comments section below
Update:
Numerous readers have also recommended doit.im
Now on to the Podcast…
46:25
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