interruptions, focus & mosquito mind

June 15, 2016

The phrase ‘Monkey Mind’ is used to describe the uncontrollable mental wandering that most people (including me) experience when they are meditating.  My Monkey Mind is meandering, inquisitive, and tends to get lost in tangential alleyways.  It is distracted but not unpleasant.

This post is not about that.

I have noticed a far less pleasant mental state that seems to afflict me in certain scenarios:  the Mosquito Mind.  For the record, I cannot stand mosquitos – they give me hideous itchy welts which last for days.  So you can imagine how I feel about the Mosquito Mind state.

 Characteristics of Mosquito Mind:
* flitting rapidly from task to task (example: checking email multiple times during the course of writing a single outpatient note)
* inability to stay in a single mental gear long enough to do anything of substance
* vague irritability for no real reason

Scenarios that tend to bring on MM:
* being interrupted frequently.  I learned recently (on the Note to Self podcast) that outside interruptions actually increase the probability that you will start interrupting yourself.  I have absolutely experienced this phenomenon before
* an uncertainty about what I am supposed to be doing due to a general sense of overwhelm / lack of clear prioritization
* fatigue
* the afternoon hours
* not having exercised
* stress

Things that tend to help prevent MM:
* having a deadline (if I am clear about exactly what needs to happen by XYZ time, I am much more likely to be able to focus)
* meditation (even 5 minutes)

As I am currently on call, I am experiencing plenty of MM.  Yesterday, while trying to finish up notes at my desk, I had what felt like 2837 outside interruptions and then an equal number of self-inflicted ones.  I need to figure out how to block out my day so that I am not constantly getting ‘urgent’ calls about things that are not urgent (important yes, but urgent no!), causing the unpleasant (and unproductive) pinging from task to task.

* consolidating patient slots a little so that there is a dedicated block of time at the end of the day to do patient phone calls / orders / lab result calls / whatever nagging tasks I am being asked to do intermittently all day
* NOT having email open on my desktop (!!!) and sticking to dedicated checking times.  Sadly I have attempted this on so many occasions and failed.  Eliminating digital distractions has been much much harder for me than any other habit!
 * blocking out time for the day in my planner ahead of time so that I know, for example, 4:15 – 5 pm will be devoted to dealing with those kinds of tasks so that they are not bothering me the rest of the day
* establishing daily (or twice daily?) check-in times with staff so that they know when to approach me for questions/issues, or ask them to use the electronic in-box and not show up at my office door / call unless a matter is urgent
* blocking out periods on certain days (when I have time allotted) for focused work on projects such as residency tasks — during which the inboxes will be closed (and perhaps my office door, too, which is currently always open)
* GTD — I think that fully implementing this system will help with this (it is definitely supposed to), and I am on my way, so we will see.

today’s attempt at taming the MM

By the way, this post is about work, but MM can strike at home, too.  Household tasks, time with the kids, texts, flipping through a magazine — often it can all get mixed up into a distracted jumble that is far more unpleasant than the activities themselves actually are.  Although I will say I am far better at ignoring messes than emails/messages.


Has anyone written an article / book / etc on this, especially as applied to the healthcare setting!?  (If not . . . maybe I need to)


  • Reply Laura Vanderkam March 10, 2019 at 7:10 pm

    I don’t know of a book that is like GTD for health care settings, but I think the idea of having dedicated closed-door thinking/working time, paired with dedicated check-in-with-staff time, is smart. If people know they are seeing you at 2pm, for instance, it will be easier to hold requests until then.

  • Reply omdg March 10, 2019 at 7:10 pm

    Yep! This is why it’s impossible to get anything done in a healthcare setting. I heard someplace that "the system" was designed that way intentionally to keep providers from seeing more patients as a way to keep health care costs in check. Cynical? Perhaps.

    • Reply theSHUbox March 10, 2019 at 7:10 pm

      Hmm – I have a feeling it’s less strategic and more a bunch of tech guys putting together a system, dr consultants being too busy to really look at it, and it all evolving in a really non-thoughtful way. and now it’s this behemoth that would be hard to significantly change.

      we need an Apple computer of EMRs to shake things up!

  • Reply Lily March 10, 2019 at 7:10 pm

    Yes! And thank you – mosquito mind is definitely entering my vocab, and is a useful way to think about this problem.
    I don’t have a workplace with lots of interruptions but I am guilty of constantly interrupting myself! As you describe, I’ll be halfway through writing an email and flick over to a different one, or check the news headlines. My summer goal is to beat these bad habits – because that’s the only way any of my other summer goals are going to be achieved!
    One thing that helped my was to realise that as a child, and now as an adult, I read to self-soothe. Grumpy? Book. Cranky? Book. Uncomfortable? Book. This was healthy when I was anxious child getting lost in Narnia. It is not healthy when I am an adult halfway through the tough task of writing a tactful email to my boss, and I switch over to read the news headlines again. I’m trying to be mindful of the trigger, and taking a deep breath and acknowledging the feeling instead.
    Another helpful thing was a lesson I learned from my Whole30 (ahem…Whole15…) which was ‘sugar breeds sugar’ – I haven’t stuck to paleo but I’m mindful that the more sugar and carbs I eat, the more sugar and carbs I want – it’s an unhealthy spiral. My husband always says ‘chaos breeds chaos’ – a messy room just gets messier and then you lose your keys in the mess so you’re running late and you don’t get time to tidy up… Now I’m going to add ‘mozzies breed mozzies’ – trying to really limit distractions so I don’t distract myself. I read for half an hour in the morning before getting up – it used to be news headlines and twitter but now I’m reading books. I do pomodoros in the mornings and have stopped checking headlines in the five minute breaks and instead make tea, do stretches, tidy the desk – anything to avoid digital distractions (which are allowed over lunch).
    Any other tips would be awesome!

  • Reply Bliss March 10, 2019 at 7:10 pm

    Ugh. I just finished an ICU rotation where the physician work station was open for easy patient monitoring – which also meant nurses, patient family members and anyone else could come up to ask you things at any time. It was the worst. It was hard to focus on one task for more than five minutes at a time because of the constant interruptions and I found it very stressful. Plus, if have to constantly recheck my work because I could remember if I had ordered that test or finished that note before getting interrupted. I like your idea of asking staff to come to you at specific times, much like some places do with non-emergent night pages. Please do write something about this, it would be very useful.

  • Reply Brittnie March 10, 2019 at 7:10 pm

    I have been listening to a bunch of productivity podcasts/summits and the one I just finished talked a lot about time blocking and creating a bunker to actually get the work done that you have blocked for specifically. It also touched on the downfalls of multitasking, and the "four thieves" of productivity. I found this interview so so helpful. It is specific to writers, BUT if you can get past that and think beyond writing, I think the ideas overlap to many professions. For what it is worth, here is the link 🙂

  • Reply Brittnie March 10, 2019 at 7:11 pm

    The link is only free to view for 48 hours just fyi.

  • Reply Ana March 10, 2019 at 7:10 pm

    My trigger is absolutely stress/anxiety and fatigue. Like I said above, things just keep entering my head—making me feel slightly anxious about forgetting—and I just decide to tackle them right then and there, which takes me away from my real work so that I’m less efficient & more prone to error. And that in turn stresses me out. So for me "stress breeds stress" is absolutely true!
    And like Lily, I read to self-soothe, so instead of tackling the stressful thing head-on, I start reading blogs/news/etc… to calm myself down, which works while I’m doing it, but doesn’t address the underlying issue so I’m still stressed…so more reading…etc… I like the idea of having a different kind of stress-relief activity (getting up and taking a walk is probably the best, in terms of two birds/one stone)

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