Essentialism: Living a Purposeful and Balanced Life

“Live lives true to yourself instead of the one others expect.”

—Greg McKeown, author of Essentialism: The Disciplined Pursuit of Less

— TIM’S THOUGHTS —

I strongly recommend becoming an essentialist and living an essentialist lifestyle before entering your education and training.

What is an essentialist? What is an essentialist lifestyle? Essentialism focuses on identifying the important signals in life and eliminating the noise. The noises are the distractions that add no value to your life and frequently monopolize time and meaning. When you assume the role of an essentialist you will discover that you achieve more with less. You will live by design, not by default. This means living proactively rather than reactively. You will systematically and deliberately distinguish the vital signals from the trivial, meaningless noise, and remove obstacles so you can pursue the important signals in a clear, enlightened, and effortless pathway. Essentialism is a disciplined, purposeful approach that allows you to determine what is important to you and your personal goals, and the best way to achieve these objectives.

Why is it important to become an essentialist if you are pursuing a life in medicine? Let’s answer that question in the alternative by viewing the polar opposite approach: being undisciplined and reactive. The undisciplined and reactive lifestyle leads you to think you can do it all because everything is important. However, ask yourself these two questions:

1. Can you do it all?

2. Is everything important?

The answer to both questions is no. An undisciplined and reactive lifestyle leads you to react impulsively to whatever issue is most pressing at the moment. You say yes to all queries without critical thought and execute tasks at the last minute, unprepared. You take on too much and your work product is suboptimal. You feel out of control and become overwhelmed and exhausted. If you do not prioritize your life, those around you will — at the expense of your own energy, time, and personal growth.

How does this apply to you, the evolving healthcare professional (HCP)? As an emerging HCP, you will be challenged to explore, absorb, and learn a vast array of detailed material across a diverse landscape of topics, such as human anatomy, histology, physiology, biochemistry, and pathophysiology. Each topic is akin to a new language that will take time, energy, and cognitive focus to master. This vast amount of material will be set against a background of maintaining your friendships, your family ties, and your health.

How does this apply to you, the HCP? Your work schedule will be dictated by the program or specialty in which you are training. Your work hours will increase exponentially and you will be challenged to fit in continuing education and independent learning as well as a personal life. Many of you will look back, wistful for those “care-free” days of youth. With the current system of healthcare, you will be expected to see more patients, spend time with each patient to accurately diagnose and manage his or her ailments, and complete copious amounts of electronic paperwork to fulfill the requirements of patient and system demands.

A haphazard approach will not suffice when you attempt to meet all these varied demands. Handling this array of responsibilities with limited time will require a well-defined, systematic strategy to use your time, energy, and available resources efficiently and effectively.

ELIMINATING THE NOISE

You must recognize there is an abundance of noise and few things that are exceptionally valuable. You must take the time to explore what is valuable to meeting the demands of school, work, family, and friends. This means recognizing you can’t have it all and that you must prioritize. Understanding the reality of these trade-offs will allow you to pursue the priorities that are deemed essential to your survival no matter your stage in life. Spend the necessary time to explore, listen, debate, question, and think about how you will identify the signals among the deafening noise. This detailed and essential exploration will separate the vital from the trivial. You have time and energy only for the vital components of your essential life.

Eliminating noise can be challenging, especially when it has been present throughout your life. You have been meeting everyone’s demands for years. Given your new time constraints, that is no longer possible. Saying no is difficult. It takes courage. It goes against the grain of all our present-day social norms. Most of us instinctively want to please family, friends, and even colleagues. So it takes mental fortitude and emotional discipline to say no to what is socially expected. We must choose what direction to go when confronting noise, or we will be pulled in directions we do not want to go, losing time, and physical and emotional energy on our aimless journeys.

SETTING BOUNDARIES

A key component of essentialism is boundaries. These boundaries are constraints that allow you to seek a rich and productive life. Remember, you cannot possibly cope with doing everything for everybody. Despite the mantra spread by the marketing experts, you cannot have it all — and that’s okay. The boundaries you establish will protect your personal, emotional, and mental space and time from being monopolized by others. They will prevent you from having to say no to people who want to enhance their objectives at the expense of your time and energy. They will allow you to eliminate the demands and encumbrances of others that will not only frustrate you but detract you from achieving your own defined essential objectives and goals. They will allow you the time to explore ways to maximize the use of your time and energy toward what you deem to be important. The boundaries you define are actually liberating and empowering.

TRADE-OFFS

To underscore the necessity of essentialism, let’s explore the reality of trade-offs. In the perfect world, we can have all the options in life we desire. Realistically, we often are faced with two choices we really want, but choosing one results in cognitive conflict with the other. For example, you want all A’s in your didactic work, yet you want more leisure time. Typically there are few times we can have both the grades and the leisure time. This underlies the principle of trade-offs.

Although having to make a choice between two covetable options may be unpleasant, it may also represent a huge opportunity. How? By forcing us to explore and weigh the options systematically and strategically to select the one that will give us the best chance of achieving the desired outcome. Trade-offs should be embraced to make choices deliberately, strategically, and thoughtfully. These deliberate choices create time and space to think and identify what really matters. You may decide to be okay with Bs in exchange for more leisure time. The process of trade-offs allows you to experience addition through subtraction.

In summary, it is important to establish boundaries and utilize trade-offs as opportunities to clarify these boundaries if you haven’t already done so. This cognitive process leads to clarity and control of your journey — your journey. This essentialist lifestyle will allow you to enjoy your education and training, as well as your family and friends.

— ELIZABETH’S THOUGHTS —

Essentialism, from a cursory analysis, seems like a selfish lifestyle in conflict with the altruistic principles assumed to be inherent in a career path involving the care of others. Prior to learning about the breadth of essentialism, I followed a few maxims, such as:

• Know your own limitations.

• Everything in moderation.

• Logic goes a long way.

On closer inspection of the concepts of essentialism, I realized it has the components listed above, but is a more succinct philosophy that further delineates the excessive clutter that must be eliminated to streamline your life.

By trying to be a little bit of everything and pleasing as many people in my life as possible, I quickly burned out, suffering from physical, emotional, and mental exhaustion. Ironically, I saw the same weary expression in the faces of colleagues, as well as caregivers of my chronically ill patients, and I advised them to “Please go home and take care of yourself, because you can only give others optimal care if you’re not sick or physically or emotionally drained yourself.” I preached but did not practice this, and in the end, had to deal with the consequences.

In fact, essentialism does not equate to selfishness. Essentialism does not mean putting yourself first among all others at all times. It does not mean being inconsiderate of others around you, nor does it mean carrying out a life of such complete practicality that you lose sight of sentimentality. Essentialism, when practiced appropriately, is a manner of life that allows you to become a stronger and more efficient person — physically, emotionally, and mentally — so you can be there for the important people in your life while achieving your own personal goals.

Let’s be realistic: As much as we would like to say our happiness is derived solely from helping others, we are human and have our own personal needs and desires. We would be doing a disservice to ourselves and others around us if we were in a perpetual state of denial about this reality. As contradictory as it sounds, you have to be a little selfish in order to be the optimal giver.

For example, after doing a 24-hour shift on call during one Christmas, I was tired beyond words. I wanted to take a long nap and show up just before Christmas dinner, but I knew my family was waiting for me to come early and help prepare the holiday meal. Not wanting to disappoint them, I showed up early to help. However, due to my extreme fatigue, I was disengaged and ended up falling asleep on the couch shortly after dinner rather than participating in the traditional family games. My mom told me she simply was happy to see me and did not expect anything else. It actually made her sad to see me so withdrawn and weary and caused her to worry about me. I should have been “selfish,” taken my nap, and shown up to the gathering a much more refreshed, engaged, and cheerful person.

Personally, I think the toughest mental hurdles when embarking on the practice of essentialism are learning to 1) accept that you cannot please everyone and 2) to be a little selfish to be more generous with your time and energy. Many people who enter into the healthcare field have a genuine sense of giving and a desire to please others. They probably will find the above-stated notions difficult to implement. However, once you accept the above concepts, establish boundaries, and prioritize, you can start to experience more balance and peace in your life, which leads to enhanced performance in your service to your patients, family, and friends.

Excerpted from Physician - Time to Invest in Yourself: Work-Life Balance, the Needs of the Patient, and Medical-Legal Risk Management by Timothy E. Paterick, MD, JD, MBA, and Elizabeth Ngo, MD.