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Crazy week lessons
My most recent week at work was stupidly hard. By Tuesday morning, I’d worked more than twenty-four hours, looking after several critically ill patients, and the week had only just begun. But it was a week that contained several Great Work lessons for coping with crazy workloads. And, in this email, I’m distilling them for you.
First, though, I need to be honest: I don’t write these emails because I’m naturally good at serenity and success doing work that matters. I’m not. I’ve often been stressed, wrung out, exhausted, sometimes close to burnout. Less nowadays: what I have figured out, and now write about here, is how to get better at this. We’re always learning.
So, my last week at work. I’m currently a GP and emergency room doctor at a tiny hospital and clinic in a remote part of Canada. Our medical team was short-staffed. This time of year we’re wading through a miasma of respiratory viruses. Everyone’s sick, some kids and elders seriously so. So we’re working harder than usual, and some of us get sick too. I ended up covering the ER overnight four nights in seven days, on top of working during the days. I was pushing through exhaustion. And that week, in this tiny, warm-hearted Indigenous community that had already suffered so much loss, there was a tragedy.
(I mention this because I was involved and it weighed heavily on me. I’m not going to say more about it: it is not my story. But my heart goes out to those whose story it is.)
So I worked around eighty hours that week, often in the middle of the night, and many more hours on call.
Earlier in my career, I might not have made it through. If I had, I’d have been a wreck within a couple of days—exhausted, anxious, irritable with colleagues, pissed off with the job, and working slowly and ineffectively. This work—like the work of teachers and sewage workers and social workers and nurses and bus drivers and farmers and managers and carers and musicians and honest politicians and everyone else who keeps the tiny cogs of the world turning—matters. But sometimes it’s barely doable.
This time, though, I wasn’t anxious, irritable, or pissed off. I was exhausted, and saddened, and relieved when the week ended—but I felt on top of it, and even, much of the time, fulfilled by a job that means something to me.
What got me through this week?
(1) It’s the reaction, not the stuff.
This is a core Great Work idea (drawn from cognitive-behavioral therapy, the most evidence-based of all psychological therapies1). It’s this: you can often choose how you respond to challenges, and doing so well can turn an ordeal into exhilaration.
Of course, some situations, including some work situations, are objectively awful. As for my week, it wasn’t a week I’d want to have again. And no one should ever work eighty hours a week. That’s a failure of workforce management and culture, of health care systems, of political leadership. But none of that could I solve, or solve that week. My concerns were to keep my patients and colleagues safe and for the week not to be horrible.
And commonly, at least in the moment, the thing that makes the biggest difference is not changing the circumstances but changing how we react to them—deliberately choosing a mindset that’s going to make it easier. This was one of those weeks.
What did I do? At the first sensation of stress or overwhelm, I reminded myself that I could do this, that I’d handled harder things before without catastrophe. I took time to ponder these thoughts. I kept in mind that it wasn’t just me—that I was part of a great team, which I could count on to support me if things got bad. I considered the worst that was realistically likely to happen—that I’d get ill, or not be able to cope—and how bad that would actually be (not so bad: I’m not that important, and, if our whole team really couldn’t cope, there’s a health authority behind us to manage the situation). I remembered that I’d be doing interesting medicine for people I care about, and that, when I’m doing that, I enjoy it.
And then I decided to take quiet pleasure in being able to handle something I couldn’t have done earlier in my career. I focused on the exhilaration of proficiency, the feeling that some call ‘flow.’
It worked. As the week ended I was exhausted, and a little heartbroken by the tragedy, and relieved the week was over. But I wasn’t wrung out, and I’d done a week of work I care about, and I’d felt fulfilled doing it. I was even a little proud of myself. (Don’t tell anyone.) I’d kept the old irritation, the anxiety, the stress at bay. And, if a week like that comes around again—well, I hope it doesn’t. But each time I do something like this, I get a little better at it.
Here’s the Great Work article on It’s the reaction, not the stuff.
(2) It’s not a crisis.
A serious flood, fire, or earthquake would have been a crisis. The week’s tragedy, for those whose story that is, is a tragedy. But my own working situation? It was a challenge. But it wasn’t a crisis.
It’s taken me a while to learn that, if you call it a crisis when it doesn’t have to be, it’ll start to feel like a crisis. And, worse, you’ll crank up the stress of those around you. I was leading the medical team, and making my colleagues’ weeks worse would have been terrible leadership. Nor did I want to crank up my own stress. This is a facet of It’s the reaction, not the stuff, above.
So I cultivated a good-natured “Bring it on” mindset, found opportunities for fun with my colleagues, and didn’t create a crisis out of a challenge. And it was so much easier.
Here’s the Great Work article on Almost nothing is a crisis.
(3) Do less. Say no.
The harder you work, the more you’ll get done—up to a point. After that point, working harder will result in you getting less done overall, than if you’d gone easier on yourself. This is another core Great Work idea.
This week I was far beyond that effort optimum. So, to be effective and to get through the week, I knew I had to be brutal about protecting myself. After a busy night in the emergency room, when I’d snuck away to catch a couple of hours’ rest, several people started calling and texting me about a problem that wasn’t my responsibility and that others were better-placed to solve. I did something that doesn’t come naturally: I said a firm “No.” And, to keep my head above water, I looked for other opportunities to say no to things.
That week, it would have been irresponsible not to.
Here’s the Great Work article on Getting more done and doing better work by working less hard.
(4) Rest and reading.
There weren’t many hours for rest that week, but there are always a few. My instinct’s to disappear into my phone: it’s so easy, distracting, and addictive. But I know how unrested it leaves me, how unsatisfactory it feels. And I was reading a wonderful book, Intermezzo, by Sally Rooney, an astonishing author a Great Work reader had introduced me to. It was so good that, when I needed to unwind before my relatively few nights in bed that week, what I most wanted was to find out what happened next.
In one large international survey participants said that, of all the many forms of rest, reading was what they found the most restful. That’s me, too, when it’s good fiction. So, when I really need rest, I’m trying to put the phone down and pick up a good novel. I’m aiming to keep one with me always.
It transformed the week.
Here’s the Great Work article on Prioritizing rest.
And here’s the Great Work article on Containing your internet time.
(5) Sleep.
We’re living in a pandemic of inadequate slumber. Sleep is astonishing, wonderful, and precious. It’s an essential, active, life-sustaining maintenance and repair process.
So, when that week’s crazy schedule allowed it, I made myself leave my phone charging in another room, put the bookmark in the book, and aimed for seven to eight hours of sleep—or as many as were on offer.
Look out for a future article about sleep and work.
(6) Exercise.
You don’t need me to preach to you about this. You know it unwinds you, helps you sleep, and protects your mental health. As the musician, comedian, and actor Tim Minchin put it, addressing philosophy graduates at his own university, “You think, therefore you are—but you also jog therefore you sleep therefore you’re not overwhelmed by existential angst.”
So, even in this overwhelming week, I found a couple of opportunities to get outside and get a bit of exercise, and I know it helped me get through the week, and to sleep.
(7) Work part-time, if you can.
Not something you’re likely to be able to arrange in the moment, and this isn’t a luxury that everyone has. But, once more, there’s good evidence that most of us would get more done and do it better if we worked less hard. Teams and organizations that experiment with a four-day working week usually stick with it: people paid the same to work four days instead of five achieve more.
I’m an advocate for low-frequency part-time work: not (say) three days a week but (for example) two or three weeks a month. The rest of the time could be another, different job, or a project, or caring responsibilities, or learning, or leisure, or a mix.
Teachers work during school breaks, but they all appreciate the relief of not being in the classroom. I couldn’t do my main job full-time, even though most weeks are easier than my last one: it’s just too many hours. So I do it for two-week stretches and, when it’s tough, the next break is never more than two weeks away. The rest of the time, I do other, less taxing things.
Of course, not everyone’s work is flexible and not everyone can work part-time. But, if you could do something like this, it’s worth considering. Low-frequency part-time work has transformed my life.
(8) If you can’t fix it, move on, if you can.
Another bigger-picture one, this. Day-to-day, it’s often the reaction, not the stuff (see above). But some jobs can’t be made right. If you’re in a job like that, and if you’ve done everything you can to fix it (and, usually more importantly, to fix yourself, to learn how to handle it more skillfully), and if the grass truly is greener on the other side of the fence, leap the fence. I love my job, and some jobs have to be done at night, but the nights become harder as I get older, and I know I won’t be able to keep doing them forever.
This is your life. You won’t get to live these years again.
Could I have done better?
Yes, I could have. I was working crazy hours and there was a clinic I could and should have canceled. A colleague even told me, when there was still time, that I should cancel it. It would have given me a little more time for rest and recovery, a little respite from the relentless decision-making of medicine. But I didn’t. I knew I’d have little other clinic time that week, and that there were patients who’d been waiting to see me. And, if I’m honest, there was a bit of machismo there, a little too much pride in my “Bring it on.” That decision could easily have backfired. And it set a bad example for my colleagues. It was a mistake.
I’m no good at this (but I’m getting better)
But I got through that week unscarred. I didn’t bite anyone’s head off. I didn’t experience the stress or anxiety that used to be regular features of my working life. For much of it, I was tired, but I was enjoying my work.
This handling of a crazy week or a crazy day still doesn’t come naturally to me. I really was making myself focus on the things I’ve written about here, reminding myself of their importance and figuring out how to do them. And they worked. In fact, I had a better, more fulfilling week than I’d had during many lighter weeks before I’d learned these strategies.
They can do that for you too.
PS Thank you to Jess Housty for her wise advice about this one. All faults are mine.
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Its roots are older, though, in the Stoic philosophies of Ancient Greek slave-turned-philosopher Epictetus and Roman emperor-philosopher Marcus Aurelius, and the words of Siddhartha Gautama, better known as the Buddha.
Great article Adam. Thank you. I have been ‘reframing’ some difficult challenges recently and your article made me realise I am been using CBT techniques. I wish you and the community a calming and healing time ahead.
Lovely Adam:)
So much sage advice
One thing I am finding helpful these days and you alluded to it is recognizing the things I cannot change no matter how much I may want to and then focusing my energy on the things I can do/change.
L