Proclamations 

I walked into the Starbucks and ordered an Americano and a breakfast sandwich. 

I sat down at the small table and arranged my food, my small black Moleskine, a pen, and my iPhone. I was ready to write the day’s blog post before work. 

He was setting up at the table next to me, in the corner. An obese middle-aged man wearing glasses, baggy shorts, a striped polo, and white socks pulled up to his knees, he reminded me of a cross between Steve Urkle and a panda bear. Or maybe think Charlie Brown at age fifty-five after a fifty year love affair with Krispy Kreme. 

On his small table, same size as mine, but spilling off into the chair, he had a large black backpack, a fifteen inch black PC, a couple of brick chargers and long cords, a pair of wired headphones, a few more cords, and a purple mouse. (I’ll give him style points for the color of the mouse, and it was cordless) 

He was bustling and attaching and unwinding and de-tangling and powering up this rat’s nest of 1990s technology. He would drop the end of one cord, then grunt and huff and puff as he laboriously dropped to his knees to retrieve the plug and then reached under the table to plug in the device attached on the other end. He would get back to his feet, bustle some more, sigh heavily and loudly, then move to the next device.

(150 words of the blog post done)

After ten minutes, he went to pick up his coffee at the bar, came back to the station and took another five minutes to fix it just right, slurping loudly. 

As he passed, he said hello, followed by, “So many moving parts to a nice, quiet cup of coffee.” I smiled. He smiled. 

Having for most of his rig at least connected to power, he began to talk into his cell phone, making a recording telling someone that he was at Starbucks and was having trouble getting connected to….something…..somewhere. He then played the recording back, loudly, sans headphones, to check it. The quality, also very 1990s, was scratchy and hard to understand. He did this three times. I’m not sure if he ever sent it to anyone. 

(350 words of the blog post written)

He looked over at me, exasperated, and exclaimed, “I’m very envious of you. You’re already making proclamations, and I’m still forming committees!”

Ten minutes later, he got up again, packed up everything into his backpack except for the PC, the cell phone, the cable between them and the purple mouse. He continued to try to record messages, but other than that, I could not see that one thing had been accomplished so far while drinking his quiet cup of coffee. Not for lack of trying, of course. 

Sometimes, less really is more!

(750 words and done for the morning’s post)

The world is a crazy place right now.

Think, prepare and plan as much as you feel you need to, but then stop preparing.

Start doing.

Have a great week, all. 

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Time Out

We are all caught on a treadmill of expectations. 

We have obligations to work, spouse, kids, church, friends. 

We love to watch TV, listen to music, read books and magazines, surf the Internet, email, text, talk, write, paint, remodel, clean, shop, eat, and socialize.

We sometimes even need to sleep. 

Add it all up. Numbers don’t lie, do they?

Most of our waking and sleeping hours are spoken for. We make some of these choices about how those hours are spent. Others are made for us, usually with our tacit approval. 

I would submit to you that we also need time to learn, think, train, assimilate, absorb, plan, assess, dream, commit, network and care. 

The main problem is, if we don’t schedule the time for this, and I mean hard schedule it, on your calendar, taking up a block of time, it will never happen. 

You must put yourself in time out. 

I mean it. 

Go into the corner (whatever that space is for you) and put your nose to the wall and block everything else out. Give yourself time for yourself. 

Think. Dream. Plan. Scheme. 

Because if you don’t take the time to do this, and you’re never sure where you’re headed, any old road will take you there. 

Don’t let the treadmill win. 

Get off. 

Today. 

I Don’t Always Daydream, But When I Do…

So, I’m eight days and 3 1/2 books into 2015, and I’ve already learned (been reminded of?) several very important things.

Please allow me to share them with you now.

Successful and interesting people:

Actively engage their surroundings.
They do not wait for things to happen to them. They go after things. They take the bull by the horns and wrestle that sucker to the ground.

Have varied and extensive social networks.
They know lots of people. They talk with people. Not to them (that would be the narcissists). They learn from them. They genuinely like them. The go out of their way to engage them.

Read a tremendous amount.
They love books. They read and learn and share and journal and write and read some more. Then they read some more. Then they take a break and read a little.

Have very specific goals.
They know what they want and how they’re going to get there. There is no pussyfooting around. I think most of them have a very keen sense of how much time they have to accomplish their agendas, and they do not intend to waste a minute of the time they’ve been given to make their mark on the world.

Have well-defined interests.
They waste no time on trivialities. They fully immerse themselves not just in their vocation and projects, but in their avocations as well. They know what they like and what holds their attention, and they doggedly pursue it.

Have figured out how they want to impact the world and what their legacy will be.
See above. They figure it out. They plan. They execute. Boom.

Know how to play.
I think every serious, world -changing adult has never fully lost contact with his or her child mind. We are all the richer for that fact.

Give themselves adequate time to think, plan, and dream.
No one can work all the time. We kid ourselves if we think that scheduling every moment of every day makes us more productive. It does not.

So.

I wonder what I’ll learn the last fifty -one weeks of this year?

After I read some more,

And visit with friends and family,

And travel,

And do my best to save a patient’s life,

And daydream a few hours away?

I wonder.

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Gregorian Calendar

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Sometimes things just get so hectic I can’t believe it. Ever have those days/weeks/months? I’m sure you have. 

I’m smack dab in the middle of one of those stretches of work, travel, visits, and obligations that feels like I got tethered to the back of a 747 and was asked to run fast enough to keep up as the plane barrels down the runway for takeoff. You know you can’t just stand still, but you also know that things are going to speed up beyond your control pretty quickly. 

As I’ve told you before, I’m a purist. I use the applications and programs that come standard with my Apple kit unless I find something better. For that reason, I use Calendar on the iMac and the corresponding app on the iPhone. I have nine separate calendars within the program. These help me to keep track of personal time, actions that need to be taken on a specific date and at a specific time, Facebook events that I have been invited to, meetings I must attend, my professional schedule including telepsychiatry and clinic work schedules, arts events I have tickets to and of course, the 2013 football schedule for the UGA Dawgs. 

All of these calendars sync with my iPhone. Make a change on the phone and it shows up on the iMac at home, and vice versa. Cool. All are color coded. I can look down at my calendar and instantly know if I have to work that day or if I have a meeting later in the day just by scanning colors. 

I also have alarms and reminders enabled via Mac OS-X and iOS 6, so this adds another layer of help to keep me on track. Things will pop up, ding and boing when I’m supposed to be somewhere, write something, or take action on a project. These alarms may come a week before an event, or thirty minutes before a meeting. 

On the iMac, I keep the weekly calendar open, and I have it set to show the entire twenty hour hours of each day. I can get a better sense of what my day or week looks like if I can see color-coded events spread over the entire time period. This lets me know just how busy I will be that week, but it also let me quickly and easily see where there are gaps that might serve as times to meet someone for coffee or plan a dinner with my daughter. 

Still and all, there are periods like this when all I can do is trust that my carefully crafted system will get me where I need to be on time. I trust that I have set alarms, put up reminders and blocked off enough time to accomplish what needs to be done today. I check the calendar one last time at home, grab my iPhone, and head out the door. Then, all I can do is show up and do what I’m told at the appointed hour and hope I make it until midnight, ready to slide into the next day. 

The good thing?

In eight days, there’s a green entry starting at 4:30 PM that says “Trip to Monticello”. It stretches out for three days. The green color tells me that this time will be set aside for personal travel, activities, fun and recharging.

Now that’s the kind of personal obligation I won’t have any problem meeting. 

Tools of the Trade

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I have had some of you ask me what I use day-to-day to get my job done. In other words, what are the tools of the trade for a psychiatrist as he goes about the business of seeing patients in the clinic and the emergency room?

Although the personal interview and personal attention to patients is my stock-in-trade, I could not survive nowadays without technology.

I use a new twenty-one inch iMac in my home office, the machine I use to do most of these posts. I have two 4 TB hard drives attached to it for extra storage of music, video, and other items, as well as to back up my data. Everything is backed up three times, twice on my desktop on two different drives and once in a cloud service off site.

I have a set of harman-kardon speakers as well as a DVD drive attached to this machine for enjoyment of music, as well as for viewing videos, doing continuing medical education and the like.

There is a copier/scanner, a stand alone printer and a Fujitsu ScanSnap iX 500 on another desk adjacent to my main workspace. A shredder lets me securely get rid of paper that needs to be destroyed. I am transitioning to a completely paperless home office, so the last two remaining piles of charts and supporting documents on the floor will find their way into the ScanSnap and from there to my iMac as soon as time permits. 

My iPhone has been my primary go-to computing device on the road since 2007. When I leave home, the iPhone goes with me. Everywhere. Everything that I do on the iMac syncs wirelessly at home and through the cloud without me thinking about it. When I pick up the phone, I can get right back to a post, a project or anything else I was doing on the main machine at home before I walked out the door. Believe me, I have tried more configurations of more machines than you can shake a stick at, including desktops, laptops, phones and tablets. For me, having one main machine at home and one device to take with me just works better overall. 

Of course, you have seen me post about the setup at work, including the Polycom system, an HP laptop, a Dell desktop, fax machine, printers and the like. This is in my telepsychiatry office and is a static configuration that I leave on and operational all the time. As you know, I am an Apple guy, I use PCs and supporting peripherals to do my day job by default, trying not to whine too much about it! Another Dell desktop lives at the clinic office and is tied into the department network, so I can access all databases and notes for either job from either site. 

So tech is cool, but what about analog tools? Is there still a place for them in the twenty-first century? Of course there is! I also love paper, notebooks, pens and other analog tools almost as much as I do my tech toys. In the home office, I always have a couple of Field Notes notebooks and a large cup full of pens around for jotting down ideas as they come to me, later to be captured in my electronic devices for processing. I have a large whiteboard on an easel right behind my desk, so that I can stand up, think about projects on my feet and jot down outlines or notes as I go. On this board I also note books that I’m reading, places I want to visit, and a working budget for my daughter’s upcoming wedding! There’s something about having a large  white space like that that promotes brainstorming and planning for me, which can be very helpful in a way that a blinking cursor or mouse pointer cannot. 

When interviewing patients, especially new patients I meet for the first time, I’m still a clipboard and template sheet kind of dinosaur. I have an interview template that I’ve used on and off, with multiple modifications, for over twenty-five years. It keeps me on track, helps me to remember overall areas that I want to cover, and is sprinkled with mnemonics for various assessment tools that I might want to use. When I get to the bottom of the stack of papers on that clipboard, I make fifty more copies and keep going. 

I also have Field Notes notebooks in my bag for on the go, plus an assortment of charging cables, batteries, pens, paperwork and other goodies that I grab as I go out the door. I keep this bag stocked all the time, so that I never have to remember whether or not I have a USB cable or a uni ball Vision Elite pen or some other equipment that I might need when I’m away from home. 

Prescription pads, printed schedules, paper projects that need to be top-of-mind and various other stuff take up the remainder of the room in my bag. There is always something to send to someone, process, respond to or to read. 

I haven’t covered absolutely everything, but you get the gist of what I grab and go with almost every day as I go about the business of working, writing, reading, seeing patients and living. 

One day soon, I’ll share with you the applications that I use on my iPhone every day. That little device connects me with the world and keeps me organized and productive in ways that I would never have imagined even five years ago. 

What do you use as you go about your day? Are you a digital or analog person, or do you rely on both to keep you productive? 

I’d love to hear from you. 

You Can’t Go Home Again

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Good morning, good evening, and good night, dear readers, wherever you might be.

So, you know that I have been thinking about working from home. As I have told you previously, the powers that be in our fair state who administer the telepsychiatry program I work in have decided that it is okay for some of us, or all of us as the case may be, to work from our homes. Telepsychiatry is one of those jobs that can really be done from anywhere, as long as the right equipment is available and the internet connection is fast and robust enough to allow for crystal clear, true-to-life video interaction between patient and doctor. 

When I got this news from my supervisor I was giddy at first. How wonderful to be able to get up, make the coffee, take my time getting ready, and then, at the appointed hour, to walk just a few steps to my home office, sit down, and begin to work. Then, at the end of my shift, be it eight or sixteen hours, to get up from my chair, walk out of my office, pour myself a beverage, and sit outside on the porch in my rocker to unwind. Nice, huh? Of course. 

Like tightrope walking, this whole work at home decision is not as easy as it looks. 

The things above are upsides, for sure. There are others.

Being available to cover for a few hours if one of my colleagues falls ill suddenly and coverage is needed. Not having to drive anywhere, saving on gas and time. Preparing lunch or other meals at home, instead of suffering through the usual fast food or other fare. Being able to control the thermostat to maintain comfort throughout the shift. And did I mention making my own coffee? Yeah, I thought I did. 

What are the downsides, some of which you, my readers, friends, and family, have already made me aware of?

Isolation is a huge deal already with a telepsychiatry job. We see hundreds, nay thousands of patients a year, sitting in a chair in front of a high definition monitor and seeing the patient, but blocking out most of the rest of the world in the process. This tends to be great for focusing on what is going on in twenty-five hospitals that are hundreds of miles away from us throughout the state, but terrible for seeing what is happening ten feet from us, right outside our door. 

Social interaction, even for a few minutes out of every hour, is important to my own mental health. At the mental health center, where my current telepsychiatry office is, I can get up, open my office door, step out into the hallway, and speak with colleagues who work on the same hallway or happen to be passing by on their way somewhere else. These little emotional breaks, no matter how small time-wise, mean a lot. 

Another big downside for me is blurring the boundaries between my own space and my work space. Right now, my home office is my sanctuary. I’m sitting in my chair in front of my iMac right now, typing out this missive to you, drinking a glass of grapefruit juice, listening to Chanticleer in the background through my beloved harman/kardon Soundsticks (Best desktop speakers ever. Go buy some right now. I’ll wait) and just enjoying being in this space. It’s the place I think, dream, read, enjoy my music, organize my life, pay my bills, write letters, and sometimes fall asleep in my chair. It’s my space, and I guard it jealousy. Bringing my work into it would violate it in a hard-to-express way that I’m not sure I’m ready for. 

So, the bottom line, dear readers? 

You already know my decision.

For now, home and work will remain separate places with separate feels and separate functions. I will continue to get up, enjoy talking to you in this way in the early morning, drinking juice and listening to the birds wake up outside my window. I will get dressed, take the short six minute drive to my telepsychiatry office, see patients there, and then enjoy the short ride back to the place that is, day by day, becoming my new home.

For now, that’s just the way it should be.