CH7: Feel Good Productivity

[P1] 𝘾𝙃𝘼𝙋𝙏𝙀𝙍 𝟳 : 𝘾𝙊𝙉𝙎𝙀𝙍𝙑𝙀 When people say ‘burnout’, the image that comes to mind is an investment banker working eighteen-hour days in a Manhattan tower-block, or a full-time parent juggling seven jobs to feed five hungry mouths. So when I found myself lying face-down on my sofa on Christmas Eve 2020, telling my mum that I couldn’t work another day, I was both upset and a bit confused. It was three years since I’d left medical school, two years since my disastrous Christmas Day shift, and a few months since I’d taken a break from medicine to focus on my business. A glorious few months that had culminated in this: me FaceTiming my mother, the night before Christmas, moaning about my life. By this point, I was giving all my attention to my company. I had my dream job: running a small team to create something that I loved. Things should’ve been going great. But somehow, they weren’t. Even though my business was making way more money than I would’ve ever earned as a doctor, I felt sapped. For months, it had felt harder and harder to motivate myself to keep things going. What was once super-enjoyable had started to feel like a chore. And because I’d been dragging my feet, my work had started to suffer. What was going on? I used to love my work. Now I was drained just thinking about it. So here I was, telling my mum about it. At first, she said exactly what I expected: ‘You should have stayed in medicine, Ali.’ (She’d used that one before.) And then she said something that I hadn’t expected at all. ‘It sounds to me like you’re going through burnout.’

[P2] My first thought was: ‘Surely not.’ I was familiar with the idea of burnout, obviously. But I’d never thought that the word would apply to me. I wasn’t working desperately hard to make ends meet. I wasn’t even doing anything particularly intense. What right did I have to feel burned out? But over the next few minutes, I listened as my mum (a psychiatrist) explained that burnout isn’t just a thing that happens to overworked people in stressful jobs. It can happen to anyone when work stops feeling meaningful, enjoyable or manageable. When you’re burned out, you feel overwhelmed and undermotivated. You feel like you can’t keep up the pace, no matter how hard you try. After hanging up, I decided to take her advice for once and find out more. The previous year, I discovered, the World Health Organization (WHO) had redefined burnout. Burnout was not just a stress syndrome bound up with working yourself too hard. It was much more everyday than that. According to the WHO definition, burnout is an ‘occupational phenomenon’, characterised by ‘feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy’. And crucially, it isn’t related to the number of hours you’re working – it’s about how you feel. In time, this would lead me to an epiphany about productivity. For a couple of years, I’d been mindful of the importance of having a good time in getting things done. Since my first months as a doctor, I’d known about the feel-good effects of the three Ps: play, power and people. And in the years since launching my business, I’d gotten better at ‘unblocking’ myself – overcoming the uncertainty, fear and inertia that had once made me a chronic procrastinator. But now I realised there was something missing. Because the more fun I built into my day, the more I was taking on. And the more I took on, the closer I got to the final great obstacle to true productivity: burnout. If I couldn’t find a way to make my work and my life last, then all my research into the secrets of feel-good productivity would be for nothing. I’d mastered the basics of productivity – but I hadn’t yet mastered sustainable productivity.

[P3] So I started reading. And the more I read, the more I realised that there are three common forces that make us feel worse and in turn lead us to burnout. They’re easy to confuse with one another. But they’re fundamentally different. First up, there are the burnouts that come about from simply taking on too much work. Your mood is suffering because you’re packing too much into each day. I call these overexertion burnouts. Next, there are burnouts that relate to a misguided approach to rest. Your mood is suffering because you haven’t given yourself the deeper periods of time off that you need – not just little breaks throughout the day, but the longer breaks that recharge the energy of your mind, body, and spirit. I call these depletion burnouts. Finally, there are burnouts that relate to doing the wrong stuff. Your mood is suffering because of the weeks, years or decades when you’ve put all your efforts into something that doesn’t bring you joy or meaning, and it has worn you down. You’ve been using your energy in the wrong way. I call these misalignment burnouts. In the days after that FaceTime with my mum, I started to realise that I was suffering from a little of all three. I was doing too much. I wasn’t resting properly. And many of the things I was doing for my business weren’t bringing me meaning anymore. In every case, my mood was suffering – and so was my productivity. But a few days after that, I realised something more heartening: that each of these problems was solvable

[P4] 𝗢𝗩𝗘𝗥𝗘𝗫𝗘𝗥𝗧𝗜𝗢𝗡 𝗕𝗨𝗥𝗡𝗢𝗨𝗧𝗦 𝗔𝗡𝗗 𝗛𝗢𝗪 𝗧𝗢 𝗔𝗩𝗢𝗜𝗗 𝗧𝗛𝗘𝗠 I chose to start by focusing on my sense of overexertion. I realised that for some time, I’d been taking too much on. At first, I wasn’t sure what to do about this: I couldn’t just give up on my business, after all. But then I caught a glimpse of the solution. Shortly after that meltdown to my mum, I found myself listening to an interview between Tim Ferriss and world-renowned basketball player LeBron James. I’d never been much of a basketball fan, but I soon found myself in a research rabbit hole watching clips of the LA Lakers on YouTube. As I learned more, I chanced upon a fascinating insight: that it’s almost like there are two versions of LeBron James. First, there’s LeBron the sprinter. The man who can gain possession of the ball at one end of a basketball court and, before you can blink, be standing beside his opponent’s net. The man who can run at 17 miles an hour. The man who’s one of the fastest NBA players in history. And then there’s LeBron the walker. The man who lackadaisically wanders the court when he isn’t in possession of the ball. And the man who sees no need to run when he does get it. Why would he, when he’ll routinely hit the basket with shots from over 10 metres away? Many commentators thought this contrast explained LeBron’s frankly weird longevity. LeBron had dominated the NBA since the mid-2000s. In a field where athletes at their prime play for an average of four-and-a-half years, and an average of fifty games in their seasons, LeBron’s been playing an average of over seventy games per season for nineteen years. How was he able to sustain his position over a multi-decade career? The answer, it seems, relates to all that walking. Sports analysts have trawled through reams of on- and off-court data for LeBron and other NBA players, and spotted the same thing. Although he’s a man who can sprint at the speed of a car coursing through the suburbs, LeBron is on average one of the slowest players in the NBA. In the 2018 season, his average speed during games was 3.85 miles per hour (more or less walking speed); he ranked in the bottom ten of all players who played for at least twenty minutes per game. During the regular season, he spent 74.4 per cent of time on the court walking, a time unmatched by almost anyone else in the league. Unexpectedly, LeBron James offered me my first hint as to how to overcome my sense of fatigue. Overexertion burnouts, I realised, come from the negative emotions that arise when we do too much, too fast. We accept more work than we can do, and fail to take the breaks in our working day that we require. We sprint all the time.

[P5] ⚙️ 𝘿𝙤 𝙡𝙚𝙨𝙨, 𝙨𝙤 𝙩𝙝𝙖𝙩 𝙮𝙤𝙪 𝙘𝙖𝙣 𝙪𝙣𝙡𝙤𝙘𝙠 𝙢𝙤𝙧𝙚. The solution? Follow LeBron’s lead. Conserve your energy. Do less, so that you can unlock more. 𝘿𝙊 𝙇𝙀𝙎𝙎 In 1997, there was only one thing anybody wanted to ask Steve Jobs: what happened to OpenDoc? Over the previous five years, Apple engineers had worked hard on the software platform, which they thought would revolutionise the way users created, shared and stored their files. And then Jobs returned as Apple’s CEO, and cut the program almost immediately. At the time, many thought that Jobs had made a historic blunder. But he justified it in straightforward terms. ‘People think focus means saying yes to the thing you’ve got to focus on,’ he said. ‘But that’s not what it means at all. It means saying no to the hundred other good ideas that there are … Innovation is saying no to 1,000 things.’ Jobs’ message was clear: no was just as important as yes. ‘I’m actually as proud of the things we haven’t done as the things I have done,’ Jobs said. It was the right call. Over the next decade, Apple would go from strength to strength – becoming, by the time of his death in 2011, the most valuable publicly traded company in the world. This lesson is important for the rest of us too. Do any of the following sound familiar? • A friend asks you if you want to go for dinner next week. You have a big deadline that day, but you’re sure you’ll be finished by then. The day in question rolls around, and you’re miles behind on your work – you can’t possibly go. • A colleague tries to schedule a boring meeting in a few months’ time. You definitely wouldn’t have time now – but by then you certainly will, right? Until, that is, the meeting is suddenly tomorrow – and it completely derails all of your other obligations. • A friend asks you if you want to play your favourite video game right now. You’re working on a massive task that you know will take weeks – but the deadline isn’t for months. Naturally, you find yourself playing World of Warcraft for six hours. Eight weeks later, you’ve missed your deadline. In all of these cases, we’re suffering from a simple problem – overcommitment. It is the first way we set ourselves on the path to overexertion: we say yes to things in the present, but in the long term, they’re going to grind us down. It’s easy to see why. Overcommitting is simply too easy. But that doesn’t mean it can’t be resisted. EXPERIMENT 1: The Energy Investment Portfolio ⚗️. 𝗘𝗫𝗣𝗘𝗥𝗜𝗠𝗘𝗡𝗧 𝟭:𝗧𝗵𝗲 𝗘𝗻𝗲𝗿𝗴𝘆 𝗜𝗻𝘃𝗲𝘀𝘁𝗺𝗲𝗻𝘁 𝗣𝗼𝗿𝘁𝗳𝗼𝗹𝗶𝗼 The first step to resisting overcommitment is to get a clear sense of where your energy is actually going. Before you can start saying ‘no’, you need to work out what you want to say ‘yes’ to. The idea of the ‘energy investment portfolio’ is simple. You simply come up with two lists. List A is a list of all your dreams, hopes and ambitions. These are things you would like to do at some point, just probably not right now. List B is a list of your active investments. These are the projects you’re actively investing energy into right now (or want to be). And by right now, I mean this week.

[P7] The active investments list should be limited based on how much time and energy you’ve got to invest in them. This will differ from person to person. I like to limit mine to around five but if you’ve got young kids or a hectic career, you might be ok with three active investments. Or two, or one. In every case, though, it’s wise to keep your active investments in the single digits. If you want to move a dream into your active investments list, you need to make sure you’ve got the time and energy to invest in it. When you’ve got a large degree of choice in what you could be doing with your time, it makes it a lot harder to commit to something in a given time slot. Our brain is always thinking, ‘I’m working on X right now, but maybe I could be working on Y, or possibly even Z.’ This is risky; if you’re doing a house renovation while working on a huge project at work, while also trying to learn Japanese, while also trying to get your blog off the ground, while also trying to coach your kids’ football team, everything is going to feel a lot more stressful. The energy investment portfolio is crucial in resisting the seductive logic of overcommitment. We tend to think we can do everything. It’s a myth. Sustainable productivity means recognising the limitations on our time. Everybody has them.

[P8] ⚗️ 𝗘𝗫𝗣𝗘𝗥𝗜𝗠𝗘𝗡𝗧 𝟮: 𝗧𝗵𝗲 𝗣𝗼𝘄𝗲𝗿 𝗼𝗳 𝗡𝗼 A common problem is that even when we know the importance of saying ‘no’, it can be hard to actually say it. How can we force ourselves to reject the offers that we don’t realistically have time for? My favourite idea comes from the writer and musician Derek Sivers, which he calls ‘hell yeah or no’. His advice is as follows: when you find yourself weighing up whether to take on a new project or commitment, you’ve got two options – either ‘hell yeah’ or ‘no’. There’s no in between. With this filter, you start finding that 95 per cent of commitments are ones you should reject. Rarely are things a ‘hell yeah’. They’re usually along the lines of ‘This could conceivably be useful or semi- interesting, so yeah, why not?’ These are justifications from your brain that you need to overrule. Think about how much you have on already. If it isn’t a ‘hell yeah’, it’s not worth doing.

[P9] ⚙️ . 𝙄𝙛 𝙞𝙩 𝙞𝙨𝙣’𝙩 𝙖 ‘𝙝𝙚𝙡𝙡 𝙮𝙚𝙖𝙝’, 𝙞𝙩’𝙨 𝙣𝙤𝙩 𝙬𝙤𝙧𝙩𝙝 𝙙𝙤𝙞𝙣𝙜. A second method is even simpler and involves a little reframing. It involves thinking in what economists would call opportunity costs. Opportunity costs reflect the fact that every ‘yes’ we say is a ‘no’ to whatever else we could’ve been doing with that time and energy instead. Suppose a co-worker asks you to take on some extra projects. If your goal is to get a promotion or raise, and helping out on extra projects is a way to get there, then you might be more inclined to say ‘yes’. But that doesn’t account for everything else you could be doing. Remind yourself what you’re saying ‘no’ to. Playing in the park with your kids? Catching up with a friend that you haven’t seen for ages? A good night’s sleep? Finally, there’s a method that comes from Juliet Funt, one of the world’s leading experts on the power of no. An adviser to CEOs and leaders of Fortune 500 companies, Funt is the author of A Minute to Think, a book about how giving yourself thinking space might be the secret to sustainable productivity. When I interviewed her for this book, I asked her what the most practical, actionable takeaway was from her research. She told me about a powerful concept: the ‘six- week trap’. The trap is when you look at your calendar six weeks from now, see all the blank space and think, ‘I could totally say yes to this.’ As the weeks count down, the space that was empty six weeks ago starts to look more and more full. By the time the day itself comes around, you’ve realised you really shouldn’t have said yes to the commitment – but you’ve done it now and you don’t want to disappoint people by reneging. Her solution is to ask yourself a simple question. Every time you’re presented with a request for a few weeks’ time, think: ‘Would I be excited about this commitment if it was happening tomorrow? Or am I only thinking about saying “yes” to it because it’s easier to make it a problem for my future self?’ It’s so tempting to think, ‘Six weeks from now, my schedule is going to be totally clear, so I’ll definitely have time and energy to do this thing’. You won’t. In six weeks, your life is going to be just as busy as it is today. If you wouldn’t say yes to something happening tomorrow, you shouldn’t say yes to it in a month or more.

[P10] 𝗥𝗘𝗦𝗜𝗦𝗧 𝗗𝗜𝗦𝗧𝗥𝗔𝗖𝗧𝗜𝗢𝗡 Our next strategy for energy conservation relies on two insights. The first is obvious: that humans are bad at multitasking. The second less so: that we’re not bad at it in quite the way you think. I learned this from a study undertaken by the computer scientists Rachel Adler and Raquel Benbunan-Fich in 2012. The duo developed an experiment in which people had to switch between six tasks: a Sudoku puzzle, a challenge that involved unscrambling some letters into a word, some ‘odd-one-out’ visual problems and so on. Next, they gathered a bunch of people and split them into two groups. In the no-multitasking group, the participants had to do each of the tasks in sequence. This means they had to finish the Sudoku task before moving to the unscrambling word task. In the multitasking group, different tabs were open for each of the six tasks and participants were told they could click between the tabs to switch between tasks. The outcome was surprising. Of course, the people who were massively distracted – those who were incessantly switching from task to task – performed badly. But it wasn’t the least distracted volunteers – those who focused solely on one task at a time – who performed best. When the researchers plotted a graph of ‘productivity’ on the vertical axis against the number of switches between tabs on the horizontal axis, they found an upside-down U- shaped pattern. There was a healthy level of distraction in the middle the highest performers were those who occasionally switched between tasks, but didn’t go overboard. Why does distraction have this effect? On the one hand, the erosion of our abilities when we change focus too often comes from what scientists call ‘switching costs’. These are the cognitive and temporal resources expended during the transition between tasks. Think of the mental effort required to disengage from one task, reorient oneself to the new task, and then adjust to its demands. This was the problem affecting the volunteers on the right-hand side of the chart. On the other hand, when we spend too long intently focused on one task, we’re also likely to burn through our cognitive resources – so our focus declines too. This was the problem affecting the volunteers on the left-hand side of the chart.

[P13] ⚗️ 𝗘𝗫𝗣𝗘𝗥𝗜𝗠𝗘𝗡𝗧 𝟰: 𝗖𝗼𝗿𝗿𝗲𝗰𝘁 𝗖𝗼𝘂𝗿𝘀𝗲 But as we’ve seen, distraction isn’t always the end of the world. In fact, the most productive people tend to be those who get a little distracted – but don’t allow it to derail their productivity. For the rest of us, this might not be so easy. I sometimes like to use an aeronautical metaphor. Imagine you’re on a flight from London to New York. You get an announcement halfway through the flight saying, ‘Because of heavy winds and turbulence, we’ve altered our course by a few degrees.’ No biggie, you think. Until the pilot carries on talking. ‘Because of this, we’ve decided to abandon our original destination and head towards Buenos Aires instead.’ In most aspects of our lives, if things go slightly wrong we don’t let ourselves get blown entirely off course. The annoying email from your colleague means the project gets slowed down by a day, but not cancelled outright. You hurt your leg running, so you need to stop exercising for a week – not forever. The heavy winds make you land five minutes later than planned, And yet when it comes to our day-to-day working patterns, many of us get ensnared by a perverse logic – one that the blogger Nate Soares calls ‘failing with abandon’: • ‘I’ve spent five minutes on social media; I might as well continue to do so for the next three hours.’ • ‘I missed my morning workout; I guess today is a write-off, and I’ll just binge-watch TV instead of getting anything done.’ • ‘I skipped a day of my language learning app streak, so I might as well give up on learning the language altogether.’ Failing with abandon is a common reason we waste vast amounts of energy. The key thing is getting back on course. Again, the solution is a simple reframing. As we’ve seen, it’s not possible to completely eradicate distraction. So you need to give yourself permission to be distracted. Think of distraction as a temporary veering off-track – not an indication that it’s time to abandon your plans altogether. As long as we correct course, we’ll still end up at our intended destination.

[P12] 𝗘𝗫𝗣𝗘𝗥𝗜𝗠𝗘𝗡𝗧 𝟯:𝗔𝗱𝗱 𝗙𝗿𝗶𝗰𝘁𝗶𝗼𝗻 My first answer takes us back to the laws of physics. In Chapter 6, we learned about the frictions that prevent us from making a start on tasks. When you put your guitar in a distant corner of the room, you’re much less likely to pick it up than when it’s in front of the TV. When it comes to fending off distraction, we can invert this logic, creating obstacles that stand between you and the tasks you don’t want to divert your attention. Think of it as adding friction. Consider the example of the sports journalist David Lengel. In early middle age, with two young children and an all-consuming job, Lengel realised something depressing. He only got a couple of hours a night with his wife and kids – and he spent most of it on his phone. ‘Is this how it all ends?’ he found himself asking one evening. ‘Is this what we’ll do for the rest of our lives?’ His solution was to buy a Nokia. Not a modern Nokia with a touchscreen and dozens of apps. An old-school Nokia 3310, the famous ‘indestructible’ handset, replete with the 2D game Snake and clunky giant pixels. The effects were dramatic. At first, he felt oddly naked – everyone else on his commute was checking Twitter, while he just sat there twiddling his thumbs. But with time, that sensation subsided. ‘And then’, he wrote, ‘the magic started to happen. ‘I watched proper TV shows without straying, I read actual books without swiping and I enjoyed more shared experiences with my wife,’ Lengel recalled in a Guardian article about his experience. ‘And as a bonus, I was able to harass her when she was browsing Instagram.’ It had a transformative impact on his ability to concentrate – and to find joy in his life. Lengel’s method involved adding friction to his use of technology. But you don’t need to get a brick-phone to refocus in this way. Start with the obvious. Uninstall whatever social networks you’re addicted to from your phone. If you want to access them, you have to do so using the web interface. This momentary pause makes you reconsider whether you actually want to be spending time on Twitter, rather than doing so without thinking. If that isn’t working, log out. That way, when you next access the app, you’ll have to log back in, which will take a whole 30 seconds; very often this alone will be enough to stop you checking your feed at all. Next, move on to the more hardcore anti-technology methods. I get a lot of mileage out of tools that make the technology you’re using painfully slow. Thanks to the ubiquity of fast internet, the speed with which we can access energy-draining distractions has increased dramatically. One way around this is to install tools that artificially increase the loading time of certain apps, so you feel like you’re on a nineties dial-up modem. Every time I open up Twitter or Instagram, the app I have opens a screen that says, ‘Take a deep breath’, and after three seconds, gives me the option to open Twitter or Instagram. Usually, that’s all the time I need to think, ‘Do I really want to be doing this right now?’ Sometimes the answer is a solid yes. Mostly, the answer is: ‘Definitely not, I just clicked on the app out of habit rather than because I actually wanted to use it.’ And then I log off.

[P14] ⚙️ 𝙂𝙞𝙫𝙚 𝙮𝙤𝙪𝙧𝙨𝙚𝙡𝙛 𝙥𝙚𝙧𝙢𝙞𝙨𝙨𝙞𝙤𝙣 𝙩𝙤 𝙗𝙚 𝙙𝙞𝙨𝙩𝙧𝙖𝙘𝙩𝙚𝙙. To do so, it’s helpful to draw upon a concept borrowed from the world of meditation. Teachers recognise that meditating is difficult, and that the mind has a tendency to wander. So in the final minute of many guided meditations and meditation classes, they often say something like, ‘If you haven’t managed to get deep into the practice, that’s ok. Don’t worry. You can simply begin again.’ A minute of focus is better than nothing. I often recite the mantra ‘Begin again’ when I find myself getting distracted. It’s a powerful reminder. Don’t fail with abandon. Regardless of how you’ve done – or how you think you’ve done – you can always return to what matters.

[P15] 𝗕𝗥𝗘𝗔𝗞 𝗠𝗢𝗥𝗘 In 2008, psychologists James Tyler and Kathleen Burns invited sixty undergraduate students into their lab. One by one, the students were asked to turn away from the researcher and begin a draining task: stand on one leg and count down by seven from 2000 (2000, 1993, 1986, 1979…) for six minutes. Students might have thought they were being tested on their arithmetic. In fact, Tyler and Burns were much more interested in the second part of the experiment. In the wake of their one-legged exertions, the students were randomly split into three groups. One got a one-minute break before proceeding to the next task; another got a three-minute break; and the luckiest group got a whole ten- minute break before proceeding. The experimenters then asked the students to come back into the main laboratory. Once again, they were asked to turn around to face away from the experimenter. But this time the task was different. This time they were given a handgrip and asked to squeeze it with their non-dominant hand for as long as they could. As they did, an experimenter secretly timed how long they could hold on. You might think that gripping something is purely a measure of hand strength. But that’s not what the researchers found. In fact, the key determinant of hand-gripping success was the length of their breaks. There wasn’t much difference between the first two groups: the one-minute group squeezed the handgrip for 34 seconds on average, the three-minute group for 43 seconds. The ten-minute group was different. On average, they squeezed the handgrip for 72 seconds. Their conclusion was simple: adding a break of just ten minutes between two tasks that require self-control seems to help combat overexertion. Tyler and Burns’s study hints at the last way to conserve our energy. So far, we’ve learned the importance of simply saying no and of eliminating distraction. Which misses a final ingredient. Because the truth is, within every day you need time for a break. And more time than you might imagine. In fact, the people who seem to get the most done are often those who’ve turned doing nothing for large chunks of time into a fine art. In one study, the software company Draugiem Group set out to find out how much time people spent on various tasks and how it related to each worker’s productivity. The workers who were most productive were not the ones who chained themselves to their desks. Nor were they the ones who gave themselves a healthy-sounding five-minute break every hour. The most productive workers gave themselves an almost unbelievable amount of time off: a work-to-break ratio of fifty- two minutes of work to seventeen minutes of rest. So the last step to conserve your energy is even simpler than the first two: find moments in your working day to do nothing. And embrace them.

[P16] ⚗️ 𝗘𝗫𝗣𝗘𝗥𝗜𝗠𝗘𝗡𝗧 𝟱: 𝗦𝗰𝗵𝗲𝗱𝘂𝗹𝗲 𝗬𝗼𝘂𝗿 𝗕𝗿𝗲𝗮𝗸𝘀 The first way we can embrace the redemptive power of breaking is devilishly simple: schedule time into your calendar to do nothing. And schedule more of it than you think. Most knowledge work that we do today requires some element of what psychologists call ‘self-regulatory exertions’. This is our ability to control our behaviour, thoughts and feelings. Writing this paragraph right now requires me to self-regulate by resisting the temptation to go and do something easier, and to focus my attention on the words on this page. Psychologists believe that our ability to self-regulate is a limited resource that is easily depleted. The longer I sit on this chair writing this book, the harder it becomes for me to stay seated and keep writing: I’ve already ‘used up’ this resource. To conserve our energy levels during a work session, we need to find ways to replenish our energy. When I was working in the emergency department, I remember being surprised by the emphasis placed on this point. I’ll never forget being five hours into my first shift in the emergency department. The waiting room was teeming with over a hundred patients, some of whom were standing because there was no space to sit. The resuscitation bays were overrun with critically unwell patients, and we were having to see some of our patients in the middle of the corridor because every clinic room was occupied.

[17] I was completely out of my depth. My shift had started at 8am, and it was now 1pm. I felt guilty about working so slowly compared to the others, so I decided to skip lunch and continue working my way through the patients. But as I looked down the waiting list to see who was next in line to be seen, one of the consultants, Dr Adcock, tapped me on the shoulder. ‘Ali, as far as I know, you haven’t taken your break yet. Why don’t you head off now and grab lunch?’ Dr Adcock raised an eyebrow and tilted his head, his trademark ‘delivering serious news’ expression. ‘Thanks, but I’m good,’ I told him. ‘I’m not hungry, and there are a lot of patients to see, so I’m happy to power through and I’ll grab a coffee later.’ I assumed he’d pat me on the shoulder, say, ‘Atta boy, that’s the spirit,’ and walk away with increased respect for my amazing work ethic. He didn’t. Instead, he reached over my shoulder and switched off my computer monitor. As I turned to him, slightly confused, he smiled. ‘Look, I know it’s your first day and I like that you’re keen. But I’ve been in this game long enough to know that the patients are always going to keep coming. Unless you take a break, you’re going to lose focus, and you might make a mistake. That’s not good for anyone.’ I looked around at the chaos surrounding me. The emergency buzzer was ringing in one of the rooms across the hall. There were people on stretchers along the corridor. It was chaos.

[P18] Dr Adcock followed my gaze. ‘You can’t be of any use to anyone if you’re exhausted, but you can make more effective decisions if you take the time to recharge and refocus,’ he said. ‘No one’s going to die because you were having lunch. There’s always time for that.’ Amid the chaos that is emergency medicine, this was the one golden rule that all senior doctors enforced. You have to take a break every four hours. Before working in the emergency department, I thought that this would be like how Captain Barbossa describes the ‘pirate’s code’ in Pirates of the Caribbean – ‘More what you’d call guidelines than actual rules.’ I was wrong. The job of a consultant was like that of an army general, managing the movement of troops on the battlefield. And a big part of that was ensuring that every doctor was taking a break every four hours, and to make sure no area was understaffed because of this rule. I still think about that fateful lunchtime in the emergency department to this day. Every day, before starting work, I think about when I’ll be feeling most overexerted and I time-block fifteen minutes out at the slots when I think I’ll most need it. And whenever I’m tempted to push through it, I remember the science of self-regulation and that the harder you work, the more overexerted you become. And I remind myself of the importance of rest – even when you don’t think you need it.

[P19] ⚙️ 𝘽𝙧𝙚𝙖𝙠𝙨 𝙖𝙧𝙚𝙣’𝙩 𝙖 𝙨𝙥𝙚𝙘𝙞𝙖𝙡 𝙩𝙧𝙚𝙖𝙩. 𝙏𝙝𝙚𝙮’𝙧𝙚 𝙖𝙣 𝙖𝙗𝙨𝙤𝙡𝙪𝙩𝙚 𝙣𝙚𝙘𝙚𝙨𝙨𝙞𝙩𝙮. Remember Dr Adcock. Even if you’re in the business of saving lives, breaks aren’t a special treat. They’re an absolute necessity. ⚗️ 𝗘𝗫𝗣𝗘𝗥𝗜𝗠𝗘𝗡𝗧 𝟲: 𝗘𝗺𝗯𝗿𝗮𝗰𝗲 𝗘𝗻𝗲𝗿𝗴𝗶𝘀𝗶𝗻𝗴 𝗗𝗶𝘀𝘁𝗿𝗮𝗰𝘁𝗶𝗼𝗻𝘀. Not every small break must be scheduled into your calendar, though. Sometimes, unplanned rests can be beneficial. I call these ‘energising distractions’. I first got to thinking about the power of energising distractions when I came across the work of the Vietnamese Zen master Thich Nhat Hanh. Often described as the ‘father of mindfulness’, Nhat Hanh never actually used the term himself. Instead he viewed his work as introducing the world to the ancient wisdom of Buddhist teaching; something he began doing after he was exiled from South Vietnam in the 1960s for refusing to support the Vietnam War. To me, the most powerful of Nhat Hanh’s ideas is the ‘awakening bell’. In Nhat Hanh’s Buddhist tradition, known as Plum Village after the Plum Village Monastery he founded in France in 1982, bells are used to mark the beginning of a meditation session. But they’re often also sounded at random through the day. The unexpected ‘ding’ of the bell would cause people to stop what they were doing and realise where they were. It would encourage them to be present. When I first encountered Nhat Hanh’s teachings, it made me realise that not all distractions are created equal. Sure, some distractions stop you achieving the thing you want to – Twitter notifications, urgent administrative emails and so on. But some distractions can bring positive energy into our lives, forcing us to pause, reflect and take things at a more reasonable pace.

[P20] Once I started thinking about some distractions as energising distractions, I realised I’d been using them for years – without having realised that’s what they were. When I was at university, I’d decided that friends were always going to be welcome distractions from work. Instead of closing my door while studying, I’d prop it open with a doorstop, which meant that any time a friend would walk past on their way to their own room, they could stick their head in for a quick (or not-so-quick) conversation. Yes, this probably did ‘waste’ some energy and so reduced my effectiveness while studying. But it gave me something far more energising – quality time with friends. When I think back to my university days, I don’t wish that I’d worked harder or more efficiently. I’m glad I made the time to have these serendipitous interactions with my friends. There’s a joy to some distractions. Think of them as short, sharp invitations to pause – like Nhat Hanh’s awakening bell. Life isn’t about maintaining focus all the time. It’s about allowing space for little moments of serendipity and joy.

[P21] In Summary • The greatest cause of burnout isn’t exhaustion. It’s low mood. If you can make yourself feel better, you won’t just achieve more – you’ll last longer, too. • Our first kind of burnout arises from overexertion. The solution: do less. • There are three ways to do less in practice. The first is to stop yourself from overcommitting. Limit the list of projects you’re working on and get comfortable with saying ‘no’. Ask yourself: if I had to pick only one project to put all my energy into, what would that be? • The second way is to resist distraction. Ask yourself: can I uninstall social media apps on my phone so that I can access them only through my web browser? How can I correct course and restart if (or, more realistically, when) I get distracted? • The third way is to find moments in your working day to do nothing. Ask yourself: am I treating breaks as a special event rather than a necessity? And what could I do to take more of them?