# How to manage your stress like an ER doctor: TedTalk <iframe width="390" height="230" src="https://www.youtube.com/embed/by5oCr8bQ5E" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" allowfullscreen></iframe> ### Notes - stop using the term Crazy Busy - when we are in Crazy Busy Mode we are less capable of handling the busy - we all process stress in the same way but how we react to it is up to us - Ready Mode means knowing that whatever happens, we can handle it - we need to relentlessly triage the things we have to do - individuals who cannot differentiate threat from non-threat and react to everything with the same response - individuals who cannot differentiate threat from non-threat have double the level of stress hormones - we can't do everything but we can triage - when we are Crazy Busy Mode we react to everything as if it is life threatening - we need to separate the noise from what's essential - some tasks need taking off your list - design to make tasks easier to do - the more options we have the longer each decision takes - planning can help with decision fatigue - never leave anything to remember that you could automate - colocate to save energy - participants eat 70 percent less when food is out of reach - design to make the choices you wish to make easier - problems come when we let our inner thoughts take over - get out of your own head by actively putting your focus on someone or something else - compassion can help us get out of our own way - own the busy but stop calling it crazy %% ### [[stop using the term Crazy Busy]] > if you've used the phrase "crazy busy" to describe your day, your week, your month ^jxwyv > I'm an emergency-room doctor, and "crazy busy" is a phrase you will never hear me use. And after today, I hope you'll stop using it, too. ^rl9pc [View Highlight](https://read.readwise.io/read/01gw1zm54qe2h0b7e0bn9fjpnp) ### [[when we are in Crazy Busy Mode we are less capable of handling the busy]] > Because when we are in what I refer to as Crazy Busy Mode, we are simply less capable of handling the busy ^zjo-2 > Here's what happens. Your stress hormones rise and stay there, your executive function in the prefrontal cortex declines. That means your memory, your judgment, your impulse control deteriorate, and the brain areas for anger and anxiety are activated. [View Highlight](https://read.readwise.io/read/01gw1zmp0gs1dnhydeppd556s6) ### [[we all process stress in the same way but how we react to it is up to us]] > Our brains all process stress in similar fundamental ways. But how we react to it has been shown by research to be modifiable, whether it's emergencies or just daily, day-in, day-out stress ^3o2x0 [View Highlight](https://read.readwise.io/read/01gw1zngy5vnvvdyq0nnjp9mkn) ### [[Ready Mode means knowing that whatever happens, we can handle it]] > Now contrast Crazy Busy Mode with how I think of us in the ER -- Ready Mode. Ready Mode means whatever comes in through those doors, whether it's a multiple-car pileup, or a patient having chest pain while stuck in an elevator, or another patient with an item stuck where it shouldn't be. When you're know you're dying to ask. Even on those days when you would swear you were being punked, we're not afraid of it. Because we know that whatever comes in through those ER double doors, that we can handle it. That we're ready. That's Ready Mode. We've trained for it, and you can, too. Here's how. ^mo99c [View Highlight](https://read.readwise.io/read/01gw1zq1xd8wyhm82ej1vnrcyv) ### [[we need to relentlessly triage the things we have to do]] > Step one to go from Crazy Mode to Ready Mode is to relentlessly triage. In Crazy Mode, you're always busy, always stressed, because you're reacting to every challenge with the same response. Contrast that with Ready Mode, where we triage, which means we prioritize by degree of urgency. This isn't just a nice way to get your to-do list done. ^zuxn0 [View Highlight](https://read.readwise.io/read/01gw1zqqef0rq9cqpmw9ymwm1b) ### [[individuals who cannot differentiate threat from non-threat and react to everything with the same response]] ### [[individuals who cannot differentiate threat from non-threat have double the level of stress hormones]] > Work by Dr. Robert Sapolsky shows that individuals who cannot differentiate threat from non-threat and react to everything with the same response have double the level of stress hormones. ^6yo9u [View Highlight](https://read.readwise.io/read/01gw1zr26dq029n52wk41h3szv) ### [[we can't do everything but we can triage]] > You can't take care of them all at once, but you don't have to. Because we triage ^8tcl8 > Red -- immediately life-threatening. Yellow -- serious, but not immediately life-threatening. Green -- minor. And we focus our efforts first on the reds. ^lgqkl [View Highlight](https://read.readwise.io/read/01gw1zrnht3zjj4cqy61p7zy37) ### [[when we are Crazy Busy Mode we react to everything as if it is life threatening]] > Part of the problem in Crazy Mode is that you are reacting to everything as if it is red ^y-f2l [View Highlight](https://read.readwise.io/read/01gw1zrxsbdbfyeb5chdjffkc7) ### [[we need to separate the noise from what's essential]] > Now it's easy to be confused by noise, but what it noisiest is not always what is most red. In fact, my severe asthmatic patient is most at risk when he's quiet. But my patient over here, demanding that I bring her flavored coffee creamer, she's noisy, but she's not red. ^qs17z [View Highlight](https://read.readwise.io/read/01gw1zsmb7f8aa67q2avf5q8q4) ### [[some tasks need taking off your list]] > Now there's one last triage level that we use in the worst scenarios. And that is black. Those patients for whom there is nothing we can do. Where we must move on. And although it is gut-wrenching, I mention it, because you each have your own equivalent black tasks in your life. These are items that you must take off your list. And I think many of you know what I'm talking about. For me, this was the fundraiser. I had to step down. Because as we in the ER know, if you try to do everything, you have no hope of saving your reds. ^gl7ct [View Highlight](https://read.readwise.io/read/01gw1zvpzwx2rsc9kzq9j564nk) ### [[design to make tasks easier to do]] > Step two to go from Crazy Mode into Ready Mode is to expect and design for crazy. Half of handling crazy is how you prepare for it. So if step one we triage, step two, we design to make those tasks easier to do. ^3hit4 [View Highlight](https://read.readwise.io/read/01gw1zwr3r7mp5zkxqzphbwzy3) ### [[the more options we have the longer each decision takes]] > Science shows us that the more options we have, then the longer each decision takes. And the more decisions we have to make, the more exhausted our brain gets and the less it is capable of making good decisions. Which is why this step two is about finding ways to reduce your daily decisions. ^njlzw [View Highlight](https://read.readwise.io/read/01gw1zx2bq64zv7t2ryyradkjd) ### [[planning can help with decision fatigue ]] > Plan. Plan your entire week's meals on the weekend, so that when it's Wednesday at 6pm and everyone's hangry and requesting pizza, you have no decisions to make to get a healthy meal on the table. ^i5raa [View Highlight](https://read.readwise.io/read/01gw1zxstsbjw1vqdxb5xgs6ed) ### [[never leave anything to remember that you could automate]] > Automate. Never leave anything to remember that you could automate, whether it's scheduling it as recurring or saved list, or recurrent purchases ^q7ezo [View Highlight](https://read.readwise.io/read/01gw1zy1hzmx88tjkrq05654ja) ### [[colocate to save energy]] > Colocate. When it comes to exercise, store all the equipment that you need for a certain activity together, charged and ready, so you don't spend energy looking for it ^i8oih [View Highlight](https://read.readwise.io/read/01gw1zy8g4nx7dgsjcgqjyg6yb) ### [[participants eat 70 percent less when food is out of reach]] > Design differently. If a food is out of immediate reach, such that you have to use a stool to reach it, even when it's chocolate, study participants ate 70 percent less without thinking about it. I know. Let that sit for a second. ^yalgf [View Highlight](https://read.readwise.io/read/01gw1zz6pt6k6qwwwhc5tt2gx0) ### [[design to make the choices you wish to make easier]] > Design to make the choices you wish to make easier. ^7vi7b [View Highlight](https://read.readwise.io/read/01gw1zzhnfnjnc5m5xaa787s57) ### [[problems come when we let our inner thoughts take over]] > Which bring us to the third step to go from Crazy Mode to Ready Mode, and that is to get out of your head. ^cgl2t > Because, you see, we all get nervous. We all get scared, but it's what you do next that matters. That first feeling isn't the problem. It can be an important sign. The problem comes when we let it derail us. When that internal monologue starts and we catastrophize and we start to get that tunnel vision. That's how you think when you're in Crazy Mode, and you cannot solve anything that way. ^5ors6 [View Highlight](https://read.readwise.io/read/01gw200k73f7my92qz99n9557a) ### [[get out of your own head by actively putting your focus on someone or something else]] > how do I get out of my own head? There are many tactics that you may hear, but for me, I find it best in the moment to actively put my focus on someone else. To deliberately make myself see the person in front of me, see myself in the arena with them -- what do they need, what do they fear and how can I help? This may sound like a whole lot of warm and fuzzy to you, but it's not. ^v0i35 [View Highlight](https://read.readwise.io/read/01gw201k9kdxyzzqq0my69yd94) ### [[compassion can help us get out of our own way]] > In fact, research shows that when you prime your brain with what is, essentially, compassion, we disrupt that tunnel vision and internal monologue. You widen your perception, so your brain can actually take in broader information, so you see more possibilities and can make better decisions. Try it. Know that your internal monologue can derail you. And realize that when you get out of your own head, you get out of your own way. ^47nzx [View Highlight](https://read.readwise.io/read/01gw2027wgq2vsheg6ns4g7x7r) ### [[own the busy but stop calling it crazy]] > Own the busy. But stop calling it crazy. You've always had that ability. But now ... you're ready. ^tchu4 [View Highlight](https://read.readwise.io/read/01gw203651n21xdtdvyefzy7r1)