One Bin, One Queue

Classic scheduling theory: it is most efficient having a single queue for all outstanding items: think bank queues, airline queues as opposed to supermarket queues where people have to choose between multiple queues and switching has high costs.

 

Single bin means that most things need be handled only twice: classic GTD: once to decide what to do about it and once to do it. The decision is a queue decision: now/soon/sometime/never and a quadrant decision: urgency vs. importance.

 

With everything in one bin there are no places for things to get lost and nothing else to keep in mind. A single queue means you must always be thinking about how important things are in terms of your ends.

New Year Resolutions

Today I was asked about New Year Resolutions: I said that I had given up on them in favour of new week reviews. Everyday is difficult enough if one has to focus on good habits, balance and small wins.

One Bin, One Queue

I have alluded to my life map before: it is a move towards “one bin, one queue” living. It is one response to TIABIM (Taking Into Account and Bearing In Mind) given our current cognitive deficits and it makes New Year Resolutions obsolete because one is always pruning.

 

I have said that I added “Build Wisdom” with subnodes for knowledge and judgement. Knowledge is overrated and liable to expiry so we need just-in-time knowledge rather than a whole corpus of uncertain utility, but this is a problem that time will solve. Judgement is a bigger problem and I do not know how to design a process that improves it.

 

Any suggestions?

The desert teaches many things:

• That life is constant flux – the landscape is always changing
• That life is both fragile and hardy and that it can persist in the most inhospitable environs
• That preparation and vigilance go hand in hand
• That necessity is a hard teacher
• That basics matter
• That nature is indiscriminate

 

Problems

Newton’s first law is the law of inertia; extended in a simple fashion it is the law of the status quo. Newton’s law of universal gravitation is fundamentally also Coulomb’s law of electrostatic attraction, which is not to say that the macro and the micro necessarily behave in the same way, but rather to remind that different scales and spheres may share fundamental properties that are unnamed and unrecognised.

 

That is perhaps a clear manifesto of a lumper.

 

Problems may be peculiar to their contexts but the experiment seeks to generalise, to abstract rather than make concrete. If the specific can educate to the abstract then that generalisation can be more widely applied specifically: algebra is genie to arithmetic. I am being clumsy and inarticulate. It takes genius to be simple, clear and I am tired and frustrated.

 

Simple problems allow for simple solutions. Even complex problems allow for simple solutions: the Gordian knot was cut.

 

I do not know if my problem is simple or complex; it’s boundaries, it’s density or it’s field. Step one: define the problem. Some problems defy definition. Where disagreement exists and one cannot simply agree to disagree because action is binary and mutually exclusive how does one proceed without insanity?

Type 3 Error?

It is better to solve the right problem the wrong way than to solve the wrong problem the right way.

Richard Hamming

Where should people die?

Should people die at home or in hospices or in acute care hospitals? Who should decide? When should the decision be made? What should inform it? And when should it be reviewed?

Spannungsbogen

Where do you draw the line between maturity and pathology?

Personal Development

Personal Development

Metacognition

Metacognition

Personal development goals

• Think better
• Speak better
• Read faster
• Type faster
• Move better
• Imagine!

 

 

 

Life and Death

All stress, including fatigue, narrows one’s focus. A narrow focus means failing to attend to relevant information and weighting some information too heavily. A narrow focus, then, misdirects sometimes disastrously.

 

Reflection improves performance and reflection in action improves it sooner. In clinical care many events are singular so that reflection after action helps only with process rather than specific actions whereas reflection in action helps with what one is dealing with specifically. Highly dynamic, time critical events do not lend themselves to reflection in action particularly because they are stressful. What is needed is the facility to step back in critical moments, to disengage.

 

The patient is dying; disengage. That, friend, is easier said than done.

 

My belief that I have no control over life and death and that death is destined allows me to disengage. I cannot save those who will die: nothing I do will make a difference. My task then is to see that those who survive do so with the best possible outcomes. There is a central inconsistency here, but inconsistency is human. And I have no wish to debate whether death is destined or not. My conviction is pragmatic: I do not decide life and death so I am free to be as heroic as I choose: I have control of the process, not the outcome.

 

How do you deal with stress? How do you free your stuck cognitive gears when life is on the line?

DO LESS

I have long had a problem doing less. There are so many important things to learn and do that choosing is difficult. I am reminded though that there are an infinite number of things to do and very limited time in which to do them, so ultimately, we all have to choose our “Yes!” carefully.

 

This then is everyone’s essential task: to decide or discover what is important.

 

I searched Google for “what is important” and got 896,000,000 results.

 

“Why?” That is the beginning.

 

I value life. I value life because we have only one life to live. I know nothing of what came before or what comes after. I know that something came before and that something comes after, but I am not convinced that my identity has been continuous. An amnesiac is not the same person as his premorbid self.

 

I value life because the living have agency. I know that I can effect. Control is an illusion; agency is not.

 

My problem is what to effect.

 

 

Longevity Quotient

Proposed:

 

 

LONGEVITY QUOTIENT: RATIO OF PHYSIOLOGICAL AGE TO CHRONOLOGICAL AGE MULTIPLIED BY HUNDRED.

 

 

LQ = PA/CA x 100

 

 

knowledge Ends

Advancing technology makes it easier for individuals to plan, create and develop new products and then to market them. Knowledge is the most important and most valuable product, but knowledge has to serve some other external end.

 

Ends:

 

• Community
• Longevity
• Health
• Education and Training
• Creativity
• Engineering
• Posterity
• Repair
• R&D
• Negotiation
• Transaction fulfilment
• Inventory management
• Recruitment and retention
• Architecting capability
• Enforcement
• Persuasion

 

 

The above list is in no particular other than the order in which they came to mind (How revealing!). Nor is it meant to be exhaustive.

Productive Effort

Productive effort is directed towards improving our tools and improving our tool use. This is captured as improved productivity.

 

Productive effort is also directed towards solving significant problems that could not be solved before due to lack of resources or lack of knowledge.

 

Improving our tool use involves using our tools more skilfully and applying our tools more appropriately in addition to finding creative, uncommon uses for existing tools.

 

As always we have to remember to do the right things before doing things right.

On teaching patients to begin with the end in mind

Patients consult with symptoms = problems. They are often in search of solutions that remove the causes without due regard for what is possible.

 

 

Patients fail to consider that a determination of cause is not always possible and that knowing cause does not necessarily mean effective correction and that even effective treatments are not guaranteed effective in their specific circumstances. And there are always trade-offs, side-effects, costs. These have to be balanced against the anticipated benefits.

 

 

Ironically, in an age when healthcare providers are more effective than ever, patients trust their caregivers less than ever. Expectations are to a large extent misinformed. The essential question given this mismatch is who is responsible for educating patients?

 

 

I do not consider it my responsibility to teach the general public how to think. I have enough difficulty persuading my colleagues that their thinking is a skill that can be improved.

How do you teach a child to begin with the end in mind?

How do you teach a child to begin with the end in mind? Keeping in mind that adults teach what they do, not what they say, and that learning needs feedback and doesn’t happen without it.

For children, beginning with the end in mind means beginning with an unmet desire; needs and drives are the responsibilities of their carers. And those desires are likelier to be impulsive than planned. Frustration is likelier to promote learning than easy and early success. All this suggests that teaching an awareness of ends will be very challenging.

Sometimes it is better to act before you think; most times it is better to think before you act.

So, these are the necessary conditions: an unmet desire that has been frustrated; a proximate non-malevolent desire that can be satisfied given some help and thought and the willingness and patience to teach something that can be taught.

An awareness of ends implies an awareness of ecology: how things fit together, how they relate, what the facilitators and obstructors are or are likely to be.

Friction and inertia are practically ubiquitous. They are easily taught and often forgotten. The motivations of others are difficult to ascertain and confirm and are always changeable. And it is natural and common to ascribe to others degrees of latitude that are greater than we are aware of having ourselves.

Knowing how to teach children would make teaching adults easy.

Decision Technologies and Evaluation

http://www.york.ac.uk/res/iht/events/HTAiRome2005/romepresent/Dowie.pdf

Action

A letter to a junior doctor:

…

The joys, vagaries and risks of A&E are that it is an action driven practice. The rule is “Find it, Fix it.” It is the philosophy underlying the ABCs: First things First & Find it, Fix it. It requires that you make a decision and ACT!

The caveat is act in haste, repent at leisure.

ACS is one of the big six: appendicitis, ectopic pregnancy, aortic aneurysms, acute coronary syndromes, missed fractures, and missed foreign bodies (http://www.emedicine.com/emerg/topic945.htm). Everyone needs to be especially careful of these.

And everything is ultimately a learning experience.

Keep fighting the good fight J.