On Deeper Reflection
Podcast

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

14
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ODR 007 – Liberterian Free Will, Blame and Shame

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  
Children and education 3 years
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21:10

ODR 11 – Email Part 2 – Tactics & Logistics

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…  
Children and education 3 years
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36:24

ODR XX – NonViolent Communication

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…
Children and education 4 years
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34:53

ODR 1 – Email Part 1 – Email is Not the Problem, You Are!

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…
Children and education 4 years
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32:29

ODR 1 – Email Part 1 – Email is Not the Problem, You Are!

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…
Children and education 4 years
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33:42

EMCrit Wee – Getting Things Done 2019 Update

[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…
Children and education 7 years
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23:56

EMCrit Podcast 209 – GTD Redux – Opportunities, Time, & Future Selves

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…
Children and education 8 years
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0
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32:10

ODR 1 – Getting Shit Done (GTD) [Part 1/x]

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…
Children and education 11 years
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46:25
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