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artdjgblog · 4 years

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Innerview: Carmen (Editor) / HOW Magazine

April 2008

Image: Gummi Bears (Disney, 1985-1991)

Note: Email Q&A

Question:

My interest is piqued a bit about the year you took off–why you did that, how you spent it, how it affected you, what you learned, etc.

Answer:

At the end of the past several years, I’ve been starting each new twelve month set with a list of what I learned in the previous. Items from this past year (2006) include: Things DJG Realized in 2007 -I found out that LOL in an email does not mean “Lots Of Love”. -I still get weird when I see LOL in an email even though I know what it means. -I realized I officially dislike the use of emoticons in emails sent to me. -I learned that internet “Phishing” does not involve jam bands and hippies. -I found out how to copy and paste pictures into myspace blogs. -I like to read about stuff on www.wikipedia.org. -I think that body spray is kinda cool. -I don’t think it’s cool to keep my mouth open when spraying Old Spice. -I am thankful for blow dryers with longer locks in winter. -I still love “Gummi Bears”, but it’s still not as cool as when i was eleven. -I love Chick Peas. -I don’t love Chick Pee. -I found out how I like my steak. -I don’t like pants pleats. -I can go on a diet and lose weight. -I like the way Chinese food smells in colder weather. -I feel that New York City is a very comfortable place because nobody stares. -I don’t like New Jersey (or turnpikes). -I can swim in the ocean and it is fantastic fun. -I found out the hard way that salt water really is salty. -I can wear flip-flops. -I don’t like the sound of flip-flops. -I like Branson. -I still don’t like to do laundry. -I learned what the clothing pattern “Hounds Tooth” looks like. -I can’t help but think of the ’84 Olympics logo when I see the pattern. -I don’t have to say “Yes” to everything. -I lose faith in my fellow man three days out of seven. -I am not a perfect person though either. -I get more and more irritated and more easily the older I get. -I have stopped sympathizing for those who know how to make terrible decisions. -I am trying to enjoy the little things in life…even if it’s a bad meal. -I have the same brain functions I had when I was five, just more polluted now. -I can’t stay up late like I used to and function properly. -I realized that sleep is an important ingredient to a healthy life. -I can get up at 5:00 am every day and enjoy it greatly. -I am a morning person when it comes to ME, alone and with a handful of hours. -I love to watch old movies in the early morning with a blanket and a kitty or two. -I am a “Glass Half-Empty” kind of guy. -I can never do, make or learn enough. -I study better and actually enjoy it now that my college loan is almost paid for. -I am starting to dress like my Dad and I like that. -I learned that Shadow meows quite frantically when ready to leave the basement. -I really warmed up to Alfred Hitchcok, Werner Herzog and David Lynch movies. -I can really relate to the movie “Punch-Drunk Love” and it is my favorite movie. -I love cashews. -I even like pecans. -I love squash. -I really like to hunt deer. -I enjoy writing. -I am no lecturer. -I get worn out easier now and realize when I need a break. -I feel more comfortable when I get to church late and leave early. -I can relate to the hit TV show “Friends” now (that I’m older) and actually enjoy it. -I like the original “Star Trek” series. -I like the television show “Angel”. -I love to start my Sundays with “CBS Sunday Morning”. -I am glad I no longer buy comic books regularly because I would be broke. -I still can’t get enough books, movies and music…so it all evens out the wallet. -I have stopped apologizing for my personal preferences in pop-culture. -I am getting more used to the idea of the MP3 and the digital music world. -I don’t really enjoy a live concert setting anymore in the majority of circumstances. -I learned to read and match the (+) and (-) signs on battery operated gadgets. -I love the feeling of coming home to my house, wife and kitties. -I still don’t know how to say properly for example, “Two pair, or two pairs of socks”. -I still have bad English and grammar…regardless of age, location and knowledge. -I have learned if it works, change it (especially in concern of my own work). -I learned that I am not a real graphic designer in standard weights and measures. Several important items stand out on this list that pertains to my year of slowing down the design machines and refueling… -I get worn out easier now and realize when I need a break-I can get up at 5:00 am every day and enjoy it greatly. -I have learned if it works, change it (especially in concern of my own work) -I don’t have to say “Yes” to everything -I learned that I am not a real graphic designer in standard weights and measures -I can never do, make or learn enough I ended 2006, my most fruitful in productivity and success, with extreme exhaustion and a head polluted with design takeover. And the near-death of my Grandfather frazzled me as well. Some would find a “head polluted with design takeover” as a good thing, and maybe when you’re naive to it…maybe? A realization of this can out-weigh on the full scale of the daily spectrum though. Also, a string of a few strung-out disappointing projects and disappointed clients pointed all arrows at the fact that DJG was starting to show some burnout and bitter. This scared me. Though, it was even scarier to just up and stop what I’ve started and worked so hard to build. Ultimately, my goal has always been to do the things that I’m doing full-time, and stopping all of a sudden would turn back the clock a bit on that. I just had to realize that what I had built was there all along and will always be, and only on the right kinds of full tanks of fuel. True, I’m a relatively young man, but in my early-early days of mining this strange, loopy-lop design odyssey, I never thought of burnout ever being an option on the design iron man meter. When you start to tackle anything, you’ll do most anything to make it happen. I had fire (and have had it for many years), even if it was threatened to be snuffed out by a couple of day jobs on top of it…i had a torch. I once swore that I wouldn’t stop until my skull was spilled (and I still believe this in some light). But, now it’s getting a little bit harder to perform with age settling in and being married…and trying to be more responsible. You know, life stuff? A major factor on most anybody’s tool belt is TIME. I just didn’t have a way to manage it properly anymore, even though I felt I had more than I used to. Add this to being a little annoyed and frustrated with the shaping of the design world and I didn’t feel too well about myself and what I was doing anymore. Back to my string of disappointing projects and clients…I know I can’t please everybody, but I do my best and give my all. Even though I make maybe twenty or thirty or forty bucks on average pop, I give everything I’ve got for something even so throw-away as a concert poster. I’ve somehow landed a comfortable position within the realms of the things I make, that I somehow have gotten a nice little pile of press, and I haven’t had much bad press at all (at least from all that gets passed down to me). And it’s not that I need press, but, it’s nice to share this stuff when I can, and again, ultimately I want to do this full-time and it’s hard to get there without press! Bad press and critiques are appreciated and needed for the most part, but there is a level of maturity and knowledge that must come with that from both parts. And I was on the receiving end of a couple that were pretty brutal and uncalled for, considering that I was getting paid twenty bucks or less. And being that I am extremely critical on myself, and at the same time really enjoy my little works, it can be hard to heal some sliced fingertips. People are taking themselves way to seriously too (though, haven’t they always?). It’s like they threw all their toys away right when the clock marked thirteen, along with any pinch of heart they once had…discarding and disguising all that miracle grow that helped them grow. The stress of cramming the work in-between the day job and life stuff and having to deal with people on top of that was beginning to roll me over. Situations like this should tell a person rather quickly which guns they need to stick with. Mine have always been constant cannons, so it was almost too late before it registered completely with me. And I must say this now, I’ve had some incredible clients and a few bad apples are just part of the crippled ladders in the design orchard. But, still they just hit at the right-wrong time for me. I pretty much can make whatever the heck I want and when I want and I pretty much have complete parental rights to my work. Though, that is getting increasingly harder with the land of computers and everybody thinking they are a graphic designer because they can change the decorations on their blog and have the ability to pass a digital file labeled “NOT FOR PRINTER” to the printer anyway without my consent (this is rare anyway as I don’t do a lot of professional print projects). That’s all fine and dandy and just the shape of things in a whole different story of communication all together. But, the idea of the graphic designer just doesn’t get much respect these days. Maybe it’s always been like this? I don’t know. I could just tell that in my little area this was true OR, I was just getting old and bitter. Also, with this web 2.0 world, or whatever the heck version it’s on now, my main work, the ageless poster piece, is starting to show it’s age as everybody gets their information from myspace and other blogs. I’m guilty just the same as I’m more of a comfortably spoiled house cat than anyone. So, really, I feel that most design work I see around has become more for decoration or afterthought (similar to the bulk of moviemaking). Though, isn’t all design decoration in some way? My primary area of work has been in the independent music industry. It’s a path that I happened to fall into and found a connection with. And after many lack-of-heart feelings coming home from well-oiled design studio meat market visits in design school, I wanted my own thing or a quick exit. I wanted what was coming out of my system, to be of my own system, as I’m very protective of my work like a mother bird. I wanted something that gave somebody a “something” and in-turn something that gave me back something inside…and all of that gushy stuff. The music scene in general hasn’t been in my heart like it once had when I started this. Maybe because I barely have enough time to slide down for design that it’s easy for me to neglect the music side? I still love music and devour it daily. Though, my first involvement was more one-on-one with bands and I was always going and going, which gets harder as I grow older. I really enjoy being at home now and ever since early childhood, I’ve enjoyed locking myself up or out, and making things. I don’t go to many concerts anymore because I tire easily, most live music settings push my buttons rather quickly, and I am not in a position to network like I once was. And thank the good lord of Full House that I don’t live in poverty anymore with about ten musician roommates. It was fun for the first few months and I consider those days very crucial and special to my development, in a strange way. Though, I consider all days very crucial to my development…in a strange way. It can be mighty discouraging when some musicians I work for tell me that they don’t see the point in trying to achieve an artistic endeavor on the side of a full-time day job. This is the biggest kick to the pants. The same person who shucked the day job responsibility and overall, ability to pay the rent and his graphic designer has told me this. It made me feel like a fool and worthless. Due to my situations and relationships (it’s certainly not my charisma or good-bad looks) I’ve never had to promote my design work at all (well, except for competitions and magazines which cost more money than what I make in a year). Getting the work has never been an issue for me. I’ve never had to promote myself or throw myself on inbox door stoops before now. People, projects and inquiries have somehow come to me. Though, an obvious global positioning has thrown a wrench in this and I don’t get out much. However, even when I used to get out, I didn’t work myself around by any means. I’ve always believed in the work speaking for itself and I’ve always believed that early success can lead to early exits. I’ve felt that I’ve needed to earn my design stripes on my painting shirt, like a Dalmation dog earns its spots. I’m now finally at the still sheepish point where I’m learning the values of shameless self-promotion and taking all that I’ve built and have been sitting on to work smarter, not harder. Though, I still plan to work my hardest. It’s hard though because whatever small amount of time I have, I try to make something new with that, as opposed to rubbing knee-caps. And I really don’t care to go to my own art openings or other shows because I’d rather be home creating or studying instead of looking at old news. I get a little strange at art shows. Sometimes I end up being disappointed all together. A like-minded friend, Chad T. Johnston (a writer) and I, have been working non-stop of late because approaching 3.0, we both feel that we have a lot more to say in this short life and we hope to whip our day job blues in order to work smarter, not harder and fill up the spit cans with what we’ve got to say. Through our conversations I’ve realized that I have said a lot in this small amount of time with design so far. And my lot is not full yet by any means. I’m still young. I took a good look at the past 6 years and realized that I’ve fulfilled most every goal that I had marked in my opening day cement. Though, I think that if I were to die today that I would day satisfied in certain lights, but not within my own personal paper trail I hope to leave imprinted on the Earth. I have much more work to do here. I suppose though I haven’t done too bad compared to other brackets. And some days it’s all just out of my hands. But, I don’t believe in sitting on them. Before 2006 hit, I used to think I could spin these design wheels fast and forever. I was wrong. Early last year I just didn’t care anymore for popping the bubbles on the asphalt. I’ve always been very much in tune with what I put to paper, but I also felt like the work was definitely headed in the direction of, more for me instead of for my clients. I enjoy making things for people greatly and the great relationships I’m able to share with my clients, beyond a poster, logo or CD design (heck, I get invited to birthday parties and everything). But, it can become dangerous for a designer when the work starts to take over and becomes more important than the cause…when the designer becomes the cause. Of course, why do the work at all if you don’t like it? I love what I do and it’s medicine for me in strange ways. And it means a lot to me when people stop to take a thought or a giggle home with them because of something I’ve bent my back over in the basement. It still baffles me that I have a small following of eyes attracted to my silly things and that people say there is “something” to the something I’m saying. Though, this can become dangerous when crossing personal paths upstairs. And I don’t know of anybody in this life who doesn’t have tugs of war of whatever sort they might be kicking out their insides. It’s a hard wrestle when you know you have the potential to be sitting on a bit more golden colored eggs than the average man-child in his basement, but not know how to get them to hatch and/or how not to suffocate them. And sometimes you want to settle for bronze because then so many people won’t see you standing there. Every semester for the past five years the handfuls of professionals and mostly students, randomly contacting me has swelled. This means so much to me that these little things that are trickling out are flying about and popping bubbles with their beaks to make new bubbles for thought and inspiration. At the same instance it gets me crazed because I have to keep this up, even when I don’t feel like it on some days. So, my portfolio has gained a lot of weight, but do I make any money? That answer is NO…and I knew that one coming in, so no surprises there. I’m in my seventh year of this game (in a professional manner) working full-time day jobs on top of my passions. Some past pavements even found me with a part-time job on top of the day-time job and then saving the nights and weekends for design (and a girlfriend too). So, the issue is not about a lack of work ethic, passion or drive, nor is it a lack of ideas or imagination. I’ve don’t believe in having a lack for any of that. And designers that do have an issue in those areas need to possibly reconsider what they’re doing. But, with me it’s been more the issue of a fire being lit. Interesting enough, it takes fire to keep it lit and to burnout with. It’s just a healthy balance that you’ve got to keep tending to. So, I realized that whether I made things for myself or for others, I would pretty much even it out as I don’t make any money and I’m still making and doing the things that I love and enjoy and need to be doing. So, there is nothing to lose there in some fashion. This is something I have learned…balance. Last year I still had a few loose ends and commitments to fulfill. But, after learning to finally say “NO” to a few new projects coming in (which is very hard for me), I started to just do things completely for myself, for me and the basement and my wife and the kitties to only see. I didn’t stop producing, I just took it a different direction. I’m also in the process of spitting out some writings and special little projects with a few others that will be trickling around one of these days. I suppose I’ve always felt more in kin with old folk artists or the older generation(s) of designers/illustrators than younger graphic designers in my approach and ethic. I’m not really sure, and I’m not a fan of labels other than a “maker of things”. I just wish to make the things that need to come out of me and share them with others if need be. Back to TIME…without having time to fully spend with the development for some of my more important design children, and with the lacking ability to muster through multiple all-nighters like I once did, I needed to find a healthier balance. I’ve learned that a lack of sleep will catch up with you eventually. So, I switched roles and started getting to bed early and up early. My day job doesn’t need me until 9:00am, so that gave me a solid four hours (I walk four blocks to work, so no travel time), minus thirty or forty minutes of dish washing, eating breakfast and getting ready. For the first four or five months I did nothing but read books for the first hour in the morning and the rest of the time I tinkered with little things here and there or filled up on movies. I also took back my time at the day job by not eating lunch with the rest of the office. Instead, I changed up my lunch time all together and started eating at 3:00 or 3:30 in the afternoon. Even this little shift in scheduling helps build self-control and strength. AND, i was tackling a diet and being that I like to be alone, it helped me to find some peace in the work place and to keep filling up the uncovered wagon w/sideboards at the all I can eat pop-culture buffet by way of books. It’s always been filling up. If I’m not doing anything, I have to be doing something. There is just not enough time in the day for everything I wish to devour. But, I try my best. It’s hard at first, but, after a week or so I looked forward to waking up at 5:00am. As I would hit the pillow, I couldn’t wait to get up for myself. In the past I had always hated going to sleep because it meant that I had to get right up and get to work for somebody else. I would roll off the couch in my janitorial outfit on a few hours of sleep and immediately walk out the door. Getting up for myself was like a new life for me, up with my own crickets. There is something almost dream-like about being awake in the early morning hours before most everybody else is crawling out of the sheets. It’s that time of day when the possibility of the prayers getting to the last of the line first, is a greater than. I’ve always thought that even though I can be too entertained when I’m alone and with my work, I’m still not completely alone in my scribbles in the big picture. I guess it’s my way of worship to a much bigger palette? There is almost a “last man standing” position of feeling, in a sense(s) to getting up in the early a.m. for me as well. It’s not too unlike an old “Twilight Zone” episode. It’s easy for me to day dream of being the only person left, just sitting in my basement making things because it’s so easy for me to spend a lot of time alone and I enjoy it. Though, then I get to the food issue. I don’t want to eat my cats or wonderful Millie. So, I would need a vast supply of well-kept hot dogs or something? Perhaps my farm boy roots are digging into me of late as well with getting up and into my fields early. I guess I’m a young whipper-snapper. I think that if I ever manned a fully-staffed studio, I would have it start really early and we’d crank out stuff like mad. My dirt feels fresher in the mornings without the junk clouds of the day following me. When I’m at my day job all I want to do is go home and make stuff. And I’ve been blessed with the jobs that I have had, as some have found me sweeping parking lots and literally digging thru junk clouds and bringing stuff home to create with. And…they’ve been pretty good jobs! Heck, at one of my janitorial positions, I had some free time on a few occasions to make posters. I’ve worked in data entry work the past two years and of late have been playing the spoiled meat in a cubicle sandwich. It’s a great job, but many days I can’t focus because I feel stuck and the fact that I’m too self-involved and can’t sit too still in my own mind or concentrate can boil quick. It can be triumphant, yet very troubling to carry this. My after school special isn’t reserved for a certain slot of time. I’m always on the inside jungle gym. Though, after an eight hour day of chasing another man’s dream, it can be hard to have the muster sometimes to come home and want to do much for me…especially the older I get. This happened just the other day as I couldn’t sit still at work for the pile I could be creating at home. I finally got home and I was so dog gone tired and defeated. Many days of this can ruin a man, but it’s got to be worth fighting for and in some odd cases can be fuel. And it’s alarming to see the time stack up and be filed away when you’re working for somebody else. It’s easy to put the personal goals and cares on another branch and just wish the weeks away fast. So, getting up early and wittling out a chunk of time on my tree, was a very crucial foundation to a much healthier life and helped dust the frame(s) for me. Another thing that I wanted to do was make overall life changes and diet. Working non-stop, not sleeping and not eating well starts to speak pretty quick and I wanted to whip this before it got serious later in life. Now, I’m not guaranteed the next paragraph, but I want to make this one I’m in right now lead up to it in whatever formal best manner that I know best. Though, shortly after taking grooming classes at age eleven in 4-H, I stopped tucking in my shirt and combing my hair. So, here I am. It’s taken me many months (heck, 29 years) of wrestling and hair tugging of who am I and what the heck am I doing. And I think that I don’t think I can turn it off. What is the conclusion? Well, I am not finished by any means. I always plan to be making my best work as I see myself a work in progress, though I see myself as my only competition too. I’m always cracking my whips. I am at my best when I am alone and making things and it can turn to bad as well. It’s just a matter of a healthier balance of everything else to where I don’t dive too far into DJG. Though, maybe if I just work hard enough I can get a special spot out by the back dumpster up there next to the much-bigger, name-tagged cubicles in design heaven? Who knows? I do know that I am just a man first thing. Second, I am a man who happens to make things. I believe I borrowed that from another man who made things once, but I can’t find whose fingernails it belongs to. Or, perhaps I need to stop thinking and just get to making? -djg

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warriorsquest · 7 years

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Hot Shower - with @TenaciousDoctor and @Warrior_MD

Jane: *Life had a way of throwing rocks at you when you least expected it. And lately the rocks turned into boulders. It was hard to keep up with the constant influx of patients and I was close to burnout. Even ghosts need a break. I could feel myself edging closer to the ‘shout and slam doors’ phase and I knew it’s because I hadn’t slept much or not at all to be more accurate. I had grown accustomed to long hours and little sleep. That’s a surgeon’s life, but now there were emotions involved and that is what was draining me. Manny had been avoiding me and I needed to talk to him before things got out of hand. He was out of line when he operated on Crhis. Cop asked me to talk to Manny about the situation. It wasn’t fair that the brothers or anyone else in the mansion should be worried about putting their lives in the hands of a doctor. The thing is, I had no idea how to bridge the subject with Manny. He had shut me out and refused to talk about it every time I approached him. I closed the clinic door behind me and walked down the tunnel to the gym where I knew I would find him. Taking a sigh of relief as I walked in and saw he was alone. Perfect.* Manny, we need to talk. Now. And don’t give me that bullshit about being busy.

Manny: *I always liked working out it was my to-go-to place when not working. These days it was a shit load of working out and not enough working. I still hadn’t been allowed to leave the mansion, their name for this place I referred to as hell, comfortable hell but still hell. I still blamed it all on Jane, fair or not, my frustration had to be directed towards someone and she was an easy target. She and that damn man they called Cop was nagging at me to get with the program and it didn’t help the matter any at all because the more they nagged the more I felt that I had to rebel against it. That was all I had to play on. I refused to give in to them, to her. NO way in hell! I heard the gym door open and before I could stop the treadmill to turn around to see who it was I heard her voice. Out of spite I took the remote to the entertainment center and turned the volume up as far up as I could without it being painful and speed up the treadmill. If that didn’t say not interested I don’t know what would.*

Jane: *Taking a step forward I stared at Manny. Damn, he was handsome and watching him on that treadmill sent all kinds of sparks flying through my body. I had to force myself to peel my eyes off his body. My eyes narrowed as he turned the volume up, blasting the music loud enough to drown out any conversation. A few more steps and I closed the distance between us. My hand reaching out to slow down his treadmill and then taking the remote and switching the music off. Crossing my arms over my chest I spoke firmly* I am tired of your shit. This isn’t a prison and you are not a prisoner. Everything the Brotherhood is doing is to keep you safe. I’ve told you this a million times. For heaven’s sake, I know I tricked you before and you have no reason to trust me, but this can’t go on any longer. Do you hear me?

Manny:

*If it wasn’t for the fact that I had to keep my focus on the treadmill and running I would have grabbed her arm just to get the remote back. But she’d always been quick and grabbed it stepping out of reach. The only way I was getting it back was getting off the damn machine and taking it back. I listen to the same song she sung many times since my arrival and she was amazingly gorgeous when she was mad, happy well fuck it when breathing, but I refused to let that deter me. I shut the treadmill off grabbing my water and towel and got off. “Keep it. I am done anyway.” I said sticking my face in hers before stomping off to the locker room. The second I got inside still annoyed with her presence but I wasn’t sure it was only that. I loved Jane, I’d always loved Jane, that had never been the problem, the problem it wasn’t reciprocated and that was why her betrayal stung so bad. Not only didn’t she love me, she didn’t respect our friendship. Toeing off my shoes, I pull my socks off throwing all of it in my locker, I heard her coming into the room as I pulled my shirt off. It made me hesitate for a second but only a second before I pulled my shorts and briefs off in one go.*

Jane: *Following Manny into the locker rooms I didn’t notice him getting undressed until he removed his pants. Oh God… He was beautiful. I had never seen him naked before but this was a treat. I didn’t avert my eyes, nor did I step back. I kept my gaze on him and took in everything he had to offer. I was vaguely aware of my breath catching and my hand sliding up to my throat. I felt my body heat up and tingle all over. The last time I felt this was was with Vishous and we all know that didn’t work out. But this wasn’t a new man in my life. This was Manny. My oldest and most trusted friend. Exactly. Friend. Why was I feeling this way? I gulped a few times, trying desperately to swallow but my throat went dry and the camels were nowhere to be seen. I felt my cheeks flush and spoke before thinking* Uh.. I… we…. *Shit, get it together, Jane* We need to talk once you’re dressed. I can’t focus when you’re looking like that.

Manny: *Reaching into my locker for my towel, I knew there were dispensers in the showers with soap and shampoo, this place was even better than the Hilton when it came to service. I wasn’t going to make a big deal out of being naked and having Jane there but it was her gasp and then her blunt stuttering words that made me pay attention. Was Jane affected by the fact that I was nude? Not that I looked bad, I knew I had a good body, hell I worked hard enough for it but that and finding someone sexually attractive were two very different things. Dropping the towel back down I turn around to look at her, smug smile playing on my lips. Studying her it was obvious the way her eyes roamed over me that she enjoyed what she was seeing. Oh, this was too damn good, her cheeks were flushed, her eyes heated, just like that. I could feel my body reacting to the way she was reacting to me. She wanted me, I wanted her, she wanted to talk and sort things out, what I could offer her was angry sex. She wouldn’t know that. Moving slowly until I stand before her my smirk widens. “What’s the matter Jane, you’d think you hadn’t seen a naked man in a while. Let me help rectify that.” I reach for her blouse with my hands ripping it open sending the buttons flying and just as she is about to protest I pull her up against my sweaty chest and kiss her with all the power and hunger that I’ve collected since coming there.*

Jane: *Everything spun. The room. My head. Manny’s words were lost to me. The only thing I could hear was the rush of blood and my head was pounding in a good way. My entire body went on high alert. My brain was giving orders to my limbs, but there was no obeying today. My body had it’s own mind and it wasn’t listening to reason. It was only responding to touch. His touch. His hands on my body. His lips claiming mine. I melted into his touch and didn’t hold back. I wanted this. I wanted him. All logic went out the window and I gave in to the moment. Letting him do as he pleases, even though I could feel his touch was rough and fueled by some level of anger. It didn’t stop me from responding to him. My hands moving up and down his chest and then down his arms and firmly resting on his hard ass. Nails digging in at the same time my teeth cut into his lower lip. Biting, scratching, scarring… I didn’t care. I also didn’t care if anyone walked in and saw us right now. Audacious, I know. The only thing that mattered right now was Manny and rough sex with this glorious man*

Manny: *It did take me at a surprise when Jane collected herself as fast as she did. It only took seconds before her hands slid over my body, her mouth hot on mine biting, nibbling and kissing me back with as much passion as I did. With my hands still on her blouse I pull it down her arms and off dropping it where we stand before reaching up to undo her bra pulling that off too dropping it to the floor as I start maneuver her towards the showers. My fingers slid down her neck, collarbone to cup her breasts in my hand, my thumbs rubbing over her nipples pinching them between my fingers. She gasps and I swallow it right up taking the opportunity to explore her mouth with my tongue. Fiddling with the button and zipper in her pants I hook my fingers into them and push them down and over her hips letting them drop to the floor. Lifting her up I encourage her to wrap her legs around my waist as I walk us into the showers turning the first one on the second we get in there. My cock is fully hard rubbing against her as we move and all I can think about is how badly I want in her. To fuck her up against the tile and shot my load inside her, mark her, make her mine.*

Jane: *My lips bruised as our kiss grew in intensity. My skin bruised as his hands moved roughly over me. I felt every touch and welcomed more. My mouth eagerly opening and letting him in while my legs wrapped around his waist. We were moving and the next thing I felt warm water coating me. We were in the shower and I was naked. Good. This was where I wanted to be. With Manny. My brain was doing some kind of urgent plea but my body’s drumming response was drowning it out. My back and head hit the tiles and within seconds I felt his hard muscle push into me, stretching me wide open to accommodate his thick length. My head fell back, his mouth sucked and latched onto my throat. My orgasm was instant. Waves of unbeatable pleasure washing over me and I knew he was only getting started. My body’s reaction to his was unlike anything I had ever experienced and somewhere a voice told me I was his and he was mine*

Manny: *It was crazy the intensity, how we gone from fighting to sex, one intensity to another in matter of minutes. When her back hit the tiles both our bodies moved and cock was right there by her entrance and before I even knew it myself, barely, I pushed inside of her tight heat. A loud groan left my mouth, “fuck yes! So good, Jane, so tight and warm. Baby…” I slammed into her and just like that she came, the inner walls of her core massaging me as I moved into her. It was so erotic it almost felt like I was floating. I kept moving wanting to bring her to the edge once more and have her tumble over with me. “You going to come again for me Jane, huh?” My hips were moving fast my dick sliding in and out of her, my eyes locked with her. Her legs were tight around my hips, heels digging into my ass cheeks and her fingers clawing at my shoulders, but it only enhanced the connection. I could feel my orgasm start to roll through me. “Now!” I roared demanding her to come again hoping it would work. With a last push I buried myself in her and I came my body shivering with the intensity.*

Jane: *The command in his voice was similar to the command in V’s voice but yet so different. My fingers scratched a trail up his back and my toes curled as my heels dug into his ass. The orgasm that ripped through me send bolts of energy throughout my body. My core clenched around his cock, milking him while my own orgasm kept going. My body trembling and relishing the feeling. Every part of me felt alive. Every part of me wanted and needed this. Needed him. I closed my eyes and whispered* Your wish is my command, always. *I didn’t open my eyes to see his facial expression. His body’s reaction to my words were enough. We both knew I was telling him that I would be willing to do what he wanted from this point on. We also both knew that I was stubborn, but my words to him were a promise of some sort. A submission.*

Manny: *I studied her, my eyes roaming over her face. Her eyes were closed and I knew she did that because she admitted to something, private? Intimate? Was this another game? It didn’t look like it, she looked honest and sincere but could I trust it? She broken my trust before and yes we had sex, and it had been amazing. Hell, give me fifteen minutes to rest, a redbull and I’d be set to go again, maybe. She did that to me. I’d wanted her so long and now when I had her, tasted her, scented her like this all sexed up there was no return. The locker room door squeaked as someone pushed it open, still buried inside of her, Jane’s legs loosely around my waist, I turned my head to yell at whoever it was. “Get out! There’s no room for you here.” I heard a dark chuckle and I recognized it to be Cop’s. “No room my ass, but it reeks of sex in here anyway.” I was about to tell him to fuck off when the chuckle ebbed out and the door closed. Slowly I slipped out of her but still holding her close. “We should probably wash up and take this elsewhere, hm.” She nodded with a smile and wink turning her back towards me showing off that sweet ass, that made my hands make grabby hands and turned her face up towards the water.* #HotShower #SASBDB

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queenbethbdb · 7 years

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Hot shower

Manny:

#Manny #Jane #Hot Shower #SASBDB

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kristinsimmons · 4 years

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Burned out on Burnout?

By SANJ KATYAL, MD

If you are like most doctors, you are sick of hearing about burnout. I know I am. There is a big debate on whether burnout is real or whether physicians are suffering from something more sinister like moral injury or human rights violations. That doesn’t matter. In the end, no matter what name we give the problem, the real issue is that physicians are in fact suffering. We are suffering a lot. Some of us—around one physician per day—are forced to alleviate their suffering by taking their own life. Each year, a million patients lose their physicians to suicide. Many more physicians suffer in silence and self-medicate with drugs or alcohol in order to function.

We are losing more physicians each year to early retirement or alternate careers. There are an increasing number of coaches and businesses whose single purpose is to help doctors find their side gigs and transition out of medicine. This loss comes at a time of an already depleted workforce that will contribute to massive physician shortages in the future. Perhaps even more troubling is that those physicians who remain in medicine are often desperate to get out. It is the rare physician these days that recommends a career in medicine to their own children. We now have a brain drain of the brightest students who would rather work on Wall Street than in a hospital.

As a physician trained in positive psychology, I have been committed to helping other physicians and students improve their well-being. The focus on well-being is a welcome change in medicine. But is it enough?

Many of us no longer experience the same levels of meaning and fulfillment that should be inherent to the practice of medicine. We want to spend more time with our patients but we trade presence for productivity. We crave meaningful connections with the sick but find ourselves hoping this will be their last complaint. We want to go home energized after a day of serving others but find ourselves too exhausted to play with our kids.

Physicians are among the most intelligent, hard-working and (yes) resilient people in the world. Do we really need more resilience modules to help us get through our days? We are suffering because we have lost our ability to focus on what matters most. We are suffering because we refuse to stand together in the defense of our colleagues and the ideal practice of medicine. It is time to reclaim the joy and meaning in our work and in our lives. It is time to live the kind of life we all dreamed of living when we were young. We may be suffering but we are not weak. We are strong. We are already resilient enough. It’s time that we started acting like it.

Rather than assume a passive victim role of an under-appreciated, burned out physician desperate to leave medicine, we can use our unique combination of intelligence, creativity and grit to take back control of our personal and professional lives.

So how do we do this?

Through the intentional cultivation and utilization of our most precious resource – our attention.

Attention is the new currency

I used to believe that time was our most important commodity. Financial freedom, early retirement and years of free time to travel was my goal. This common objective is shared by many others I know. What I have come to realize is that the problem in our lives is not the lack of money or time but the scarcity of our attention. We are filled with thoughts, worries, and to-do lists swirling around in our heads. We need more presence and more peace – yet we find ourselves thinking about work while playing with our kids, surfing the internet while talking to our spouse, or checking our phones at the first sign of solitude.

Most of us, myself included, spend large portions of our attention in a low quality, widely distributed manner. We are problem-solvers so we are ready to react and deal with issues as they arise each day. This is tiring, so we take much needed breaks by checking our phones or browsing the internet. We then get back to our “work” which most of the time, has built in low level tasks that further disperse our attention (EMR, charting, email). When we finally make it home, we look forward to relaxing and recharging. We want to unplug from the daily stressors but most of us never really do. We continue to check our phones, even while playing with the kids, often while watching TV, and collapse into bed exhausted, wondering where the time has gone.

We can do better. The cultivation of attention can have profound effects on both our personal and professional lives. There has been a rapid increase in overall unhappiness in physicians. Many studies have shown clear adverse links between physician well-being and cost of care, patient satisfaction scores, retention/recruitment and medical errors. Rates of anxiety, depression and suicide are higher in physicians and begin to rise in medical school. Many distressed physicians are leaving medicine early which will only exacerbate projected physician shortages. As we think about strategies to improve physician well-being, we need a comprehensive approach that addresses the root causes of suffering. It is not enough to make physicians more resilient or mindful (another popular buzzword) if they are thrown back into a negative, inefficient work environment every day. The key to this new approach is a focus on attention.

Attention Capital Theory in Medicine: The Key to Professional Fulfillment

In an information-rich world, the wealth of information means a dearth of something else: a scarcity of whatever it is that information consumes. What information consumes is rather obvious: it consumes the attention of its recipients. Hence a wealth of information creates a poverty of attention and a need to allocate that attention efficiently among the overabundance of information sources that might consume it.

—Herbert Simon (1971)

For physicians, the most meaningful aspects of medicine are the time spent using their talents to alleviate suffering. At the heart of our profession is the daily contribution of hard work, knowledge and experience that can heal someone who is hurting. These interactions are what bring us joy. They provide meaning and impact to our lives. In the end, they are the reasons we went to medical school. But they are increasingly hard to experience. They are dwindling in both frequency and duration in the current practice of medicine. These small but rewarding interactions are what I call “physician zone” and we must learn to optimize our time spent in them. What makes up this zone is unique to each specialty. For internists, family docs, emergency physicians, it may be face-to-face interactions with a patient to formulate the best treatment plan. For surgeons, it may be the key moments in an operation. For radiologists and pathologists, it may be the actual time spent viewing and interpreting the images or slides. When we are in this physician zone, we are using our highly trained skills to meet the diagnostic challenge before us. To fully experience these “peak” interactions, we should be relatively free of distractions, fully immersed in the task at hand, and connected to the suffering before us.

The path to reclaiming joy and meaning in medicine is to cultivate the ability to direct our attention on valuable activities while minimizing the rest of our tasks. When we can design environments and create habits that enable us to spend more focused time in our physician zone, we will be more productive, more connected, and more fulfilled.

Modern healthcare and the current practice of medicine is increasingly complex with advances in technology, research, regulatory/payment models and of course more complicated patients and disease processes. We are bombarded with massive amounts of information and stimuli on a daily basis. Our ability to process large amounts of data, however, has remained constant. This imbalance between higher and more complex inputs and our stable processing ability has led to increasing fatigue, error, and overall lower satisfaction among physicians.

Attention capital theory, coined by Cal Newport, states that our ability to cultivate and direct attention is our most precious resource. To better understand how to apply this approach to the daily practice of medicine, we must explore key principles from the science of attention – cognitive load theory.

According to cognitive science, new information is handled and processed through our working memory (formerly called short-term memory). This information is then stored in long-term memory and can be retrieved as needed by our working memory. All of our formal and informal education is handled in this manner. Our working memory is a high performance engine that processes both new information coming at us and retrieving old information stored in our long term memory. Working memory capacity has a higher correlation with academic success than IQ in children. Optimizing our working memory can have profound effects on the quality of our output (high productivity, low error) and more importantly on our overall well-being.

The key insight from cognitive load theory is that while our working memory is essentially unlimited in its ability to retrieve old information stored in long term memory, it has a fixed capacity to handle new information from our environment. Additionally, our working memory is highly sensitive to the complexity (cognitive load) of the information being presented. This cognitive load is comprised of intrinsic load (the inherent difficulty of a problem) and extrinsic load (the environment and the manner in which the information is presented). Think of intrinsic load as signal and the extrinsic load as noise. In order to optimize our working memory performance, we need to improve the signal/noise ratio in our work (and in our lives).

Since we cannot often change the complexity of the problem before us (patients with multiple chronic diseases, cancer follow-up CT scan with extensive abnormalities), we must focus most of our efforts on reducing noise. To simplify our efforts, we can think of noise as synonymous with distractions. These distractions can be in the form of external distractions or workflow distractions. External distractions are found in our environment and our habits. These include smartphones, email notifications, and other low value activities. Workflow distractions include the disorganized manner in which the problem is presented (EMR with key information on multiple screens) or additional tedious steps that we are required to perform to complete the main task (data entry during patient encounter). As we often encounter both types of distractions throughout our daily work, we can face exponentially increased levels of noise. In either case, the cognitive price we pay to handle these distractions is through decreased performance (of our working memory).

We need strategies to help us focus our limited working memory on the intrinsic cognitive load rather than waste part of it to address extraneous loads (distractions). In medicine, that means focusing our attention on the critical moments and interactions each day that bring us the most satisfaction and meaning. In order to do this with the most concentration, the most presence, and the most connection, we need to eliminate anything that seeps away any of our precious attention or limited working memory. Anything that is not related to the actual problem we are trying to solve—the patient we are trying to heal, the study that we are trying to interpret, the operation we are trying to perform—is all wasted effort that leads to error, fatigue and diminished performance. Ultimately, it leads to a loss of meaning and joy in our profession.

How to focus: Improve S/N

Increase Intrinsic Cognitive Load (Signal):

The cultivation of attention (improved working memory performance) can actually be made easier by increasing the difficulty of our work (increased signal). When the challenge of what we are doing matches our skill, it is easier to become engaged. Increased engagement has been correlated with higher levels of productivity, quality and well-being. Too little difficulty for our skill level (think EMR clicks, pre-authorization paperwork, or self-editing reports/charts) causes fatigue and boredom. This is often relieved by seeking out distractions. When our work is above our skill level (under-prepared for a lecture), we become anxious and overwhelmed—both of which are also relieved by distractions.

The degree of difficulty of our professional work is especially relevant to the current practice of medicine. In a 1992 study Survey finds Low Office Productivity linked to Staffing Imbalances, economist Peter Sassone found that technological advances allowed tasks previously done by humans to be completed with computers. The elimination of clerical positions resulted in short term economic improvement for the companies through lower overall staffing costs. What he found was that executives were now spending a larger percentage of their time on tasks that used to be completed by lower level employees. He believed that productivity enhancing computer systems were largely responsible for the shift to lower complexity work. These systems replaced some support staff and made clerical work available to everyone in the office. The decrease in the amount of time spent on high value, complex work resulted in an overall less efficient, higher cost, and lower productivity work environment. It also led to lower rates of engagement, higher rates of fatigue, and lower professional fulfillment. Sound familiar? This exact same phenomenon, the law of diminishing specialization, is occurring in health care. Voice recognition systems have replaced entire transcription departments of hospitals resulting in radiologists and cardiologists self-editing their reports. Now instead of focusing eyes on the image screen, most function as high price bobble-heads going back and forth between images and their VR screen. This has led to nonsensical errors, decreased “eyes on image” time, and lower productivity. We have shifted the cost of transcription from relatively low cost FTEs to some of the highest paid FTEs in the hospital. Other specialties have encountered similar results with the “death by a thousand clicks” of electronic medical records (EMR). These EMR systems, really designed for billing purposes, have automated the much of the clerical order entry that was previously performed by support staff. The remaining “automated” work is now largely performed by physicians. The underlying theme in the practice of medicine is that physicians are increasingly performing tasks that are well below their skill level. While the reduction in support staff may save a small amount of money, the corresponding decrease in “intellectual specialization” as Sasson reported, is actually more expensive in terms of productivity, quality, and well-being of physicians.

Decrease Extraneous Cognitive Load (Noise): Workflow distractions and low level tasks

So what is the solution? On a professional level, we can focus our attention to do the things that only we can do. I call this the “physician zone” and it may be the most important contributor to physician well-being. For the internist or ED physician, this may mean having a scribe in the room to take notes in the EMR so there can be direct face-to-face communication with the patient during the examination. This face-to-face interaction is the physician zone – most of the other tasks that physicians perform mainly support ancillary functions required to get paid. Currently, many of these tasks are sprinkled throughout the physician zone time, in between these critical interactions or added on to the end of the day (charting). For the radiologist, this may mean offloading tasks in the reading process to editors to be able to stay in the interpretive zone (radiologist version of the physician zone).

There is another reason to focus our attention on the key aspects of the physician zone that utilize our highly trained skill set. According to cognitive load theory and split-attention effect, distributing our attention between different information sources and trying to mentally integrate them produces extra load on our working memory. Splitting our attention between the patient and the EMR or between the voice recognition screen and the images increases the extraneous cognitive load which in turn increases fatigue and lowers performance. Multiple studies have shown that when physicians are able to optimize their physician zone time through more focused attention and delegation of clerical tasks, they are more productive, more accurate, and happier.

By redesigning our physician workflow, we can focus our attention on the critical steps that only we are trained to do. This does not imply that physicians should refuse to do things that are “beneath” them. For many of us, the most satisfying interactions of the day come from non-interpretive tasks when we leave our chairs or office. The way to maximize these rewarding interactions is to increase their frequency and our ability to be fully present. This can only occur if our workflow is efficient and does not require us to do tasks that will increase fatigue and stress. We can then function at the top of our licensure, better focused to perform our specific high value work while in our physician zone – so that we have more time and attention to have lunch with our technologists, a cup of coffee in the physician lounge or a few extra minutes (fully present) with an anxious patient.

Decrease Extraneous Cognitive Load (Noise): External Distractions and the Power of Rules

We have discussed how to improve intrinsic cognitive load (signal) by focusing our attention on meaningful work that requires our highly trained skill set and decreasing extraneous load (noise) by delegating low level tasks to eliminate workflow distractions. Another significant contributor to poor S/N and lower performance of our working memory capacity are external distractions, mainly found in our pockets.

Our minds are biologically wired to focus on anything that is threatening, pleasurable or novel. Many of the distractions found on our phones combine all three aspects and can be very difficult for us to resist. It is estimated that we spend less than 20% of our time actually present in each moment. While this has always been a difficult problem, the issue has become significantly worse with the advent of smartphones. Large social media conglomerates have hijacked our attention using behavioral psychology and addiction principles for their own profit. There will eventually be a backlash against these apps, ironically with more apps designed to keep us free of distraction and help us focus our attention. In the meantime, we can incorporate some simple strategies that can allow us to be more intentionally present and engaged in each moment.

The first place to start is to turn off all notifications except text messages – no sounds or messages on our lock screen or computers. The next step is to leave your phone in your office or backpack during the workday. Check it only after working in short sprints of 60-90 minutes. Another effective strategy is to leave your phone in a central place while at home (charging drawer) rather than in your pocket. Put it in airplane mode at least an hour before bed. No phones at the dinner table or at restaurants. All of these strategies are even more important to teach our kids because these digital natives do not know a world without their phones; we need to model the correct behavior for them. For kids, some common rules could be to leave phone in another room while studying (also in short sprints). While driving kids to activities, do not allow phone use in the car. This can be a time for conversation and may be the only uninterrupted time you have with them that day. Set daily limits for yourself and for your kids. Have a rule of how much social media time can be consumed each day. Don’t check your email for the first two hours of every day and only after you have completed an important task (exercise, meditate, creative work etc). There is an entire new field called digital well-being with a host of strategies to help us control these intentionally addictive devices. None of these rules or constraints will make you popular among your kids (trust me) but here is the underlying key principle: constraints create freedom and attention. By limiting our choices at each moment and not habitually turning to our phones at every chance, we are actually free to choose what to focus on with more attention and with more presence. This increased presence enables us to really connect with our patients, our kids, our spouse, and most importantly, with ourselves.

Attention to time

It is easy and tempting to blame all of the busyness and discontent many of us feel on distractions and excessive phone use (especially among our kids). While certainly a large contributor, distractions (phones) are not the entire problem. There have always been and always will be tempting forms of distractions that we can turn to (although perhaps not as intentionally addictive). The root of the problem is understanding the reason we seek distraction in the first place? It is usually to relieve some inner discomfort that we feel. Learning to identify this initial uncomfortable trigger is the key. So why do I feel like checking my email again or looking at my phone in the car? What is happening inside that I turn to this behavior – am I bored? Am I afraid of missing something important? Am I tired of being alone with my thoughts? The answer is usually habit and boredom.

Remember how time seemed to be endless when we were children? Summers lasted forever and years felt like decades. As we get older, time seems to fly by faster each year. The days seem like minutes and years seem like days. What is happening? Time is still the same for all of us. Our ability to pay attention to our time is the main thing that has changed. When we were young, everything was new and captivated our attention. We were fully present as we learned about ourselves and the world around us. As we got older, however, we settled into comfortable routines and mental models of life. The simple wonders of each moment were no longer enough to hold our attention. Play was replaced by work, close conversations with friends were replaced by quick texts and each day started to feel the same. There was not much new to learn or experience in our daily routines so we began looking forward to the weekend, our next vacation or even retirement. This only served to speed up time even more. Many of us are bored with our lives. We seek adventure and new experiences, even if only found on our phones. We can do better. We can slow time down while also fully experiencing the joy and wonder in each day.

The solution to boredom and routine is to cultivate attention, constraints and novelty about everything we do. If we can really pay attention to what we are doing (and we do this by imposing some constraints that force us to focus), we can find new things about the task, different ways to do things, and notice something we never noticed before. This provides novelty which in turn infuses a sense of wonder/fun into our lives. Playing catch again with my son? How can I throw the ball even harder or ask different questions to have a deeper conversation while catching? Reading another 100 cases today? Can I identify a subtle finding that explains the patient’s symptoms? Can I read the imaging study like it was my mom’s scan? Can I be thankful that I am able to read a complicated CT and think back to my training when things like this seemed so hard? Seeing my 30th patient in a ten minute slot? Can I treat this patient like I would my close friend? What suffering of theirs can I alleviate? Feel stuck in my career? What skills can I acquire to help solve important problems in the world? By increasing and focusing our attention to questions that matter, we can notice and appreciate the new in the old, the good in the mundane, and the minutes as they are passing by.

Pay attention to each other!

One other area in our professional life that demands our focused attention is the physician-physician relationship. Throughout our lives, we have grown up in a competitive culture that pits us against each other. Moreover, we have become accustomed to this “lone wolf” culture as a normal way of life. We hide our insecurity and vulnerability so we can maintain our edge. We bury our emotions and self-medicate to hide the pain. This approach has not served us well in training and continues to sabotage our attempts to practice medicine. Even worse, our lack of cohesiveness and collegiality has been exploited by hospital administrators and insurance executives profiting from our labor. To them, we are a fragmented, overpaid and whiny group who must be “taught” how to run the business of healthcare. It gets even worse. Physicians in general are reluctant to discuss mental health issues and are fearful (rightly so) of licensure/credentialing restrictions. Many feel that non-physician mental health professionals don’t “get what they are going through.” As physicians, now more than ever, we desperately need to do a better job of supporting each other. While a confidential formalized peer support for physicians by physicians is finally in place, we all have an opportunity each day to help our fellow colleagues. Rather than grinding through the workday, racing to retirement or our side gigs, we need to turn our attention to the suffering around us – in our patients, colleagues, and ourselves. It starts with simple acts of attention. After discussing a case with a colleague, ask them how they are doing? How are things at home? What sports are their kids playing and do they get to the games? Working with a troubled physician who appears to be struggling? Spend some regular time with them and encourage them to seek confidential professional help. Let them know that they are not alone. Ultimately, these are the moments in life that matter and we must learn to pay more attention to them.

Conclusion

Learning how to pay attention to our attention (meta-attention) can be transformative. Using principles from cognitive science, we can create a comprehensive approach (attention capital theory in medicine) to reclaim the meaning and joy that has been depleted from our profession. Increasing the difficulty of our work to match our skill level, delegating low-level tasks to help us focus on critical steps in our physician zone, creating rules to eliminate distractions, and noticing both the wonder and suffering around us may be more important than resilience training or wellness modules. Although well-intentioned, the majority of these solutions are band-aids and do not address the underlying root cause: our increasing inability to pay attention to what matters in life. Optimizing our ability to focus, perform meaningful deep work, and be fully present along the way are the keys to reclaim joy and meaning in our personal and professional lives. Instead of paving the way out for unhappy physicians, we can create a stable platform that attracts the best and brightest into the field, enables doctors to stand tall, thrive personally and professionally, and ultimately heal the world. It all starts with our attention.

Sanj Katyal, MD FACR is the co-founder of the Positive Medicine Program for Physicians and runs a free peer support group for physicians by physicians.

The post Burned out on Burnout? appeared first on The Health Care Blog.

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lauramalchowblog · 4 years

Text

Burned out on Burnout?

By SANJ KATYAL, MD

So how do we do this?

Through the intentional cultivation and utilization of our most precious resource – our attention.

Attention is the new currency

Attention Capital Theory in Medicine: The Key to Professional Fulfillment

—Herbert Simon (1971)

How to focus: Improve S/N

Increase Intrinsic Cognitive Load (Signal):

Decrease Extraneous Cognitive Load (Noise): Workflow distractions and low level tasks

Decrease Extraneous Cognitive Load (Noise): External Distractions and the Power of Rules

Attention to time

Pay attention to each other!

Conclusion

Sanj Katyal, MD FACR is the co-founder of the Positive Medicine Program for Physicians and runs a free peer support group for physicians by physicians.

The post Burned out on Burnout? appeared first on The Health Care Blog.

Burned out on Burnout? published first on https://venabeahan.tumblr.com

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kristinsimmons · 4 years

Text

Burned out on Burnout?

By SANJ KATYAL, MD

So how do we do this?

Through the intentional cultivation and utilization of our most precious resource – our attention.

Attention is the new currency

Attention Capital Theory in Medicine: The Key to Professional Fulfillment

—Herbert Simon (1971)

How to focus: Improve S/N

Increase Intrinsic Cognitive Load (Signal):

Decrease Extraneous Cognitive Load (Noise): Workflow distractions and low level tasks

Decrease Extraneous Cognitive Load (Noise): External Distractions and the Power of Rules

Attention to time

Pay attention to each other!

Conclusion

Sanj Katyal, MD FACR is the co-founder of the Positive Medicine Program for Physicians and runs a free peer support group for physicians by physicians.

The post Burned out on Burnout? appeared first on The Health Care Blog.

Burned out on Burnout? published first on https://wittooth.tumblr.com/

0 notes