Time

It is disappointing and humbling to wonder how much time gets wasted in the day. We spend a good deal of effort, energy, and thought on activities with very little yield in meaning or productivity. How much of one's time is spent reading news articles that have no lasting impact, surfing the web mindlessly, shopping for things one doesn't need, or writing blogs for the sake of doing so? We whittle our lives away on Facebook or driving a car or waiting for elevators. Some of these activities are necessary and some may be worthwhile even if their worth cannot be measured. But perhaps others, the things we do selfishly, the things we do without knowing why, those things, can and should be discarded.

This thought occurred to me as I was pre-rounding on patients, faithfully copying down lab values. Indeed, that itself should be questioned. What laboratory tests are relevant to psychiatry? Certainly, some are vital on the consult service such as B12 levels or TSH or RPR. Some may be occasionally relevant like WBC or electrolytes or liver function tests. But a lot of what I was looking up and copying down never got used and never contributed to patient care.

The Pareto or 80/20 rule states that for many events, 80% of the results come from 20% of the efforts. Most of what we do contributes very little to our productivity. Our best successes can be attributed to a small percentage of our time. This has been empirically shown in many arenas: most of the wear on our carpet occurs on a fraction of the surface area; most of the profits for a business come from a minority of customers; most of the money in a society concentrates within a limited number of people; most our time is spent with only a few of our friends. Not all of our time is equally useful; not all of our work is equally productive. This has been widely applied in business and quality management, but I think it could be used in everyday life.

We should accept that some of what we do will be "waste" and as long as the fleeting pleasures or necessity of doing those things justifies them, that's fine. But we should wean ourselves off other pursuits that just don't seem time-efficient. We should spend less time with useless pre-rounding, more time with the patient; less time with online social networking, more time talking to those we care about.

Image is Rene Magritte's "La Trahison des Images," owned by and exhibited at LACMA, shown under fair use, image from Wikipedia.