Transcript
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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills
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to build their own research program, whether or not they have a mentor.
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As clinicians, we spend a decade or more as trainees learning to take care of patients.
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When we finally start our careers, we want to build research programs, but then we find
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that our years of clinical training did not adequately prepare us to lead our research
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program.
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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.
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However, clinicians hold the keys to the greatest research breakthroughs.
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For this reason, the Clinician Researcher podcast exists to give academic clinicians
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the tools to build their own research program, whether or not they have a mentor.
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Now introducing your host, Toyosi Onwuemene.
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Welcome to the Clinician Researcher podcast.
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I'm your host, Toyosi Onwuemene, and what an absolute pleasure it is to be talking with
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you today.
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Thank you for tuning in.
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Today I'm talking about lessons learned from being too busy.
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Lessons learned from being too busy.
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And I'm so excited to share this episode as a learning lesson for myself in my life right
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now.
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Okay, so why do I bring you this episode?
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I bring you this episode because recently I've gotten into a place where I can say,
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you know what, I'm too busy right now.
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I'm doing too much, right, this moment.
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And why do I say that?
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Well, so in general, I want to take a step back and say in general, I tend to stay on
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the side of, err, on the side of busy.
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I have a strategic plan I made at the beginning of a quarter, of the quarter, and I say these
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are the main things I want to accomplish.
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And these are usually my research and writing goals, not counting the things that are already
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on my schedule.
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So I said yes to a webinar a few months ago that's going to be happening.
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I said yes to this.
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So, so there are other things that are already on the schedule.
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And then I say, well, with all those things that are happening on the schedule, these
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are the things I want to accomplish.
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Okay, great.
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And then that's, that's usually not my usual schedule.
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So it tends to, it's busy.
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I always have things to do.
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And my strategic plan, contrary to the way I was taught to do it, I'm supposed to just
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put a few things on there and then accomplish those few things and then celebrate the few
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things I accomplished.
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But I tend to do this, but a lot of things and just see how much time I got done exactly.
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And I'm not saying that should be our strategy.
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I'm just saying that I really love that game of saying, well, I said I would do seven things
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and I accomplished five.
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And in reality, I should have done three.
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I'm so excited that I got five done.
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So I really do enjoy that.
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But anyway, that's my usual schedule.
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So a couple of weeks ago, we had a conversation with a program officer.
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It was a great conversation.
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And the program officer said, ah, your ESI status is running out.
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You should put in a grant for this next cycle.
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So we have a grant that's already under review and we're thinking, we're thinking it's going
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to be funded.
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And so this person recommended that we actually submit a grant, an R01, before the next funding
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cycle.
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I mean, before the next submission cycle.
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So here's the thing, though.
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It was five weeks from the deadline when the person said, or five weeks from when we would
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have to turn in the grant from when the person made the recommendation.
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And so my co-investigator and I are looking at each other saying, we're going to take
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up this opportunity.
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It is an opportunity.
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Should we do it?
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And we also knew it was like, well, when it comes to grant writing, you create space for
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grant writing.
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You clear the table to be able to write grants.
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At least that's been my experience.
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And I had not cleared the table.
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I don't know if she had either.
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But we decided we were going to take up this opportunity.
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We thought it was a great opportunity that we shouldn't miss.
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It was not on our radar.
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And we were going to take advantage of it.
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But at first, though, we needed to try to get some other loose ends tied up so that
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we could move this work forward because I tend to be a person who always has a project
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on hand.
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And it's important, again, one of the reasons it's important to me is because when people
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come with their projects that they want me to work on, I want to be clear about the projects
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I want to move forward.
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So I don't let somebody else's great ideas, which are always great, get in the way of
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the work I actually want to accomplish.
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So this is why I keep a running list of work to do so that I'm not confused about the
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fact that my schedule is already full.
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OK.
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But then if there's a greater priority thing that comes up, usually there isn't.
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But if there is, then I can say, OK, well, why don't I move my work so that I can get
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this other work accomplished?
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But this was one of those situations where this grant was a real opportunity.
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And let me share the real opportunity.
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So although I have other funding, as a clinician, it takes time really to build up.
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And your ESI status is your ESI status.
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That's 10 years from your terminal degree.
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Most of us in medicine, our terminal degree, if it's a residency, it takes a long time
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to get to your faculty position, to build up your faculty position, to learn to be able
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to do the research, to then get to submit the R01.
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And there are benefits that come from your early stage investigator status.
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So there is this clock that's ticking from a perspective of NIH that gives you an advantage.
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You get a couple of points towards your score.
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It gives you an advantage in peer review because you're an ESI.
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For physicians, it takes you longer to get to your first R01 or to get your first R100
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relative to, say, our PhD college.
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So let's just say that it is important and it does help to be able to have this ESI status.
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But for physicians, the clock tends to run out a little bit sooner.
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Anyway, so I say that to say that my clock was running out, but I wasn't too worried
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about it because to be honest, I like not to be bothered by these kinds of things.
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I'm like, yeah, I know that's important.
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Is it going to kill me to get there?
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Not going to do it.
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Okay, so this came up where the program officer said, well, you should submit anyway.
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And here's the benefit of submitting.
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Even if you are not funded, you still have a window to be able to turn around and resubmit
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and still keep your ESI status.
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Now that was really, really helpful counsel.
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And we knew that we needed to take advantage of it.
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So for this particular situation, we're submitting a grant as two ESIs.
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And so at least at the time at which we were submitting two ESIs, they get a special consideration
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as opposed to one ESI and the other person's not an ESI.
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So because we knew we were going to submit this application, at least in the future as
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co-PIs who are both ESIs, we knew it was important to take care of this.
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Okay, so that meant that on top of my very busy schedule, I added now an R01 grant, which
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takes a lot of time.
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And maybe if you've been writing R01s for 20 years, maybe it doesn't take you as much
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time, and you have a whole team that writes it for you.
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Not there yet.
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So let's just say it definitely took time.
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Okay, so on top of that, I'm also rounding on service the week it's due.
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Okay, so that means busy, busy, busy time and not really realistic for getting a bunch
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of grant writing done.
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Oh, and in the midst of that, I'm moving.
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So I hope it's coming together to help you understand how busy a season it is.
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I should say has been, but it's not over yet.
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It has been and it still is right now.
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And it's been one of those seasons where I am literally just moving from one space to
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the next, trying to like cut corners to make things happen.
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For example, when I say cut corners, hopefully it's not terrible cutting corners.
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But for example, I went around at...
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Oh, and okay, so the other thing that comes up is that it's the end of the semester for
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kids who are going to school.
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So I have kids in elementary and middle school.
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And this was the time of year where it's like, oh, this is the band end of year band party.
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And this is the end of year celebration.
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There were a lot of end of year things.
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And I was determined to attend all of them.
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Yeah, yeah, it's getting crazy and crazier as I talk about it.
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But so this particular day, I'm trying to explain to you the shortcut and I need to
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get to the points of this particular episode shortly, but let me just set it up.
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I go to the end of the year party because my daughter wants me to be there and I do
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want to honor her and be there.
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So I go and then I go and continue my writing and then I go round.
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And then instead of seeing the patients after rounds, I stop and I do my writing and then
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I go see patients.
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So I actually am the person who is going around at 8 p.m. still seeing patients.
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And I run into a couple of my anesthesia colleagues or one anesthesia colleague who was finishing
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a cardiac surgery.
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He was like, are you here at 8 p.m. seeing patients?
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And I'm like, yes, I am.
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But it's that kind of season.
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Okay, so busy, busy, busy.
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And I want to just share learnings from being super busy.
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I don't want to say too busy because at the end of the day, who defines what's too busy?
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I certainly feel as if right now it's a little busy.
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But I want to share learnings from being super busy.
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And you know, sometimes people we talk about how, you know, you shouldn't be and all the
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things you shouldn't do.
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But I want to talk about what is important from seasons of being too busy, what you learn.
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It's five things.
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So the first thing I want to share is that it tells you very quickly what you prioritize,
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very quickly, because a lot of things, the fact that you have so much on your plate means
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that there are things that are not getting done.
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It's just the reality.
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You have so many things on your plate.
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There's things that are not there, things not getting done.
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But the things you prioritize are clear in your priority list.
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So clear.
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So looking back on this week, and all the channel or I should say it was last week,
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because this is the beginning of a new week at the time I'm recording this.
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But when I look back, I see the things I did get done all through last week.
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And I'll tell you, one thing I did get done is we got the grant submitted.
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We did.
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And what does it tell me?
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It tells me that I prioritize my research and writing.
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I absolutely do.
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I got the grants that we got the grant submitted.
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And you know, it might be to you like, oh, okay, great.
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So you prioritize the grant application.
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Whoop-de-doo.
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It's not a big deal.
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I'm not saying it's a big deal.
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I'm just telling you that I learned a lesson of what I prioritize.
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If I go beyond the fact that it was a grant submission I prioritized, I think what is
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clear to me is that I prioritize the academic things I'm supposed to do.
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So let me tell you why I do prioritize grant writing.
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I really enjoy creating the future through my writing.
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And that's how I see grant writing.
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It's a creation of a future that does not exist.
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And it's built on the potential.
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It's built on reality.
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I hope it is.
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But to some extent, I'm making some stuff up.
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I'm like, yeah, if we do this and we do this, then we're going to discover this and then
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we're going to move on.
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We're going to do this.
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And I'm creating a future that's not yet.
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So I really, really, really, especially in my area of interest, I love grant writing
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because I'm well aware that I'm creating a future that does not yet exist, that will
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not exist unless I declare its existence.
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And the grant may not get me to, I may not get the funding from the grant, but what it's
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doing, it's laying for me a very clear understanding of how I move forward to make this future
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possible.
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I really enjoy that.
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I enjoy the benefits that come from that, enjoy the fruit that come from that.
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Now, do I love all the other parts of the grant that are not like the background and
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significance and the approach?
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Not necessarily.
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They're the things that get me to where I want to be.
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And the grant deadline is a forcing function.
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It's like, well, you can think about the future when you have time or there's this deadline
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and why don't you create the future right now?
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And so I do prioritize that because I love the idea of creating a future that does not
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yet exist.
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So you learn about the things that you prioritize when you're super busy because these are the
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things you do not let fall even when other things fall.
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The other thing I didn't share that I prioritize that I maybe have came through in the story
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is that I prioritize being there with the children.
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I did.
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I absolutely went to the end of year party.
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Now was I required to be there?
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No.
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But I enjoy being there because the skits that they put on are so funny and it's a great
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laugh and to be honest, it's so lovely in my life to be able to sit and do something
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that has nothing to do with my work.
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And so I prioritize family time and I prioritize the rest that comes from doing things that
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are so unrelated to my work.
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So yes, I have more than one priority because I can and you can too.
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But I recognize that as I look back on the week and how I spent my very busy week, I
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definitely had those two things rise to the four things that I prioritize.
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Okay.
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Number two is that it shows you the things that you do not prioritize.
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So I know that that feels a little circular like, okay, great.
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It shows you the things you prioritize or the things you don't prioritize.
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How great is that?
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But what I'm saying is that there are things that are at the bottom of your list that tells
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you that you actually don't care for.
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You're like, you know what?
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The skin fall and I don't care.
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This is important because remember we always talk about, I talk a lot about the 80-20 rule,
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but it's the 20% of things you do that really move you forward versus the things that you
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do that don't move you forward.
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And very quickly, when you get into a season where it's super busy, you recognize the things
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that you let fall to the bottom and you're not even bothered that they fell to the bottom.
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Now here's the thing.
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They may be important things, but you're letting them fall to the bottom.
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It shows you that you don't value them at least to the level that you say you value
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them.
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And so this particular scenario helps you recognize, well, so should I care about those
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things and what can I change in my life so that those things rise to the core?
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For example, maybe what you let fall to the bottom was your family and you're like, oh,
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well, yeah, I guess I don't prioritize them at all.
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And you can decide that's okay for you or you can decide, well, I don't want that to
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be the case.
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I want a scenario in which I prioritize family.
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And then you can choose.
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Right?
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So it shows you things.
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It doesn't judge you.
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This is not a judgment.
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It just shows you things.
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It's like, oh, when you were super busy, you let X, Y, Z fall to the bottom of your list.
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What does that say?
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What would you like it to say?
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How would you like your priorities to look like to you?
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So what it helps you do, it just helps you level set.
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It's not to judge you.
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It's not to say you're a bad parent or it's not to say you're a bad this or that's not
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about good or bad.
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It's just about, hey, when it gets super busy, we can see what you bring or what you prioritize
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and we can see the things that you let fall.
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Is this how you want it to be?
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Now I will tell you just in case I'm making it up or it's appearing as if I'm great at
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prioritizing family and my grant in the same week.
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I did not exercise.
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I exercise daily.
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I let exercise fall to the wayside.
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Until your second thing, I let fall to the wayside.
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I did not sleep well.
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So I'm not doing great in those two areas.
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I want exercise to be one of my highest priorities.
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I want sleep to be one of my highest priorities.
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And what it showed me in this past week is that I let sleep fall to the wayside.
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Now some of that is that I'm on call and if they call me at night, here I go.
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I get up and I make that happen.
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But I said that's not a priority.
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Whether that is that my work made sleep not a priority or that I made sleep not a priority.
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It was not a priority on my list last week.
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The other thing that was not a priority on my list last week that showed is that I did
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not, I did not, I took out sleep.
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Oh, exercise, my goodness, I let it fall to the wayside.
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I've said, and when I look at my list, I've said exercise is optional.
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And it's not optional.
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I don't want it to be optional.
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I want exercise to be one of my highest priority items daily because it makes me feel good.
305
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And I love the benefits that come from exercise, all the health benefits and the good feeling
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benefits too.
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So it's at the bottom of my list this week.
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I can tell because I see what I did, but I don't want it to be there.
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So it's just telling me that, KLC, you want exercise to be a priority, but it's clearly
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not.
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How can you change that?
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That's the gift that being super busy gives you is that you're able to align the things
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that maybe you do want to be higher priority list, but they're not.
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And what do you want to do about them?
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All right.
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Number three is that you discover the limits of your sanity.
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What do I mean by that?
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You discover what triggers you a little bit more easily than in scenarios where everything
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is cool and calm and not so busy.
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And I want to bring this up because to be honest, I'm talking to an audience that gets
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really busy and you've had your busy weeks.
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And it's funny, you've had busy weeks where you're like, it could never get busier than
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this.
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And then of course next week comes and it's like, oh, this is crazy busy.
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Oh my gosh.
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Right?
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So you, you've had busy needs, sir.
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This is applicable to you, I hope.
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There are times where you are so busy that it does not take much to push you over the
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edge and it will happen a lot more when you're so busy.
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So you recognize that, okay, this is how I behave when I'm triggered.
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This is how mad I get.
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Or maybe you're not triggered.
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And that's important to say, wow, the work you've been doing is paying off.
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This didn't trigger you even when you were super busy.
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And why is that important to understand the limits of your sanity?
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Okay.
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You know, you work with people who, if you're in academic medicine, you work with trainees
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and it may be okay for you to get super mad around your college and you probably know
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better about, you know better not to do that.
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Or it may be okay to get, it probably isn't okay to get mad when any significant amount
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of weight around your division chief or your mentors, right, you know, better.
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But sometimes you feel like your guard is let down and you might get mad in front of
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a trainee and now that's the problem, right?
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That's a problem.
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Maybe the trainee does something and you suddenly snap.
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Oh, that's a problem, right?
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That's a problem.
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And you want to be aware of the limits to which being so busy pushes you so that you
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can decide that number one, you're either going to dial it back or, you know, do what
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it takes to exercise the kind of self-control that no matter how busy you get, you're still
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pleasant and kind and respectful to everybody around you.
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And so this is very important because then you learn very quickly what your limits are
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and then you can choose in a non-judgmental way how you're going to respond to that.
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And maybe you find that, hey, no matter how busy I get, I'm still kind of courteous to
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everybody.
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That's beautiful.
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So you're doing the work that helps you continue to show up as your best self even when things
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get super busy.
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But if you're finding out that you're snapping, you're yelling at people, people think you're
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a monster, okay, maybe dial the busy list down.
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That's hard to do in that lesson.
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Or do the work, the internal work that's needed to show up in a way that's respectful and
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honorable to the people around you even when you get super busy.
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So you learn when you're super busy the limits of your sanity and the things that trigger
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you.
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Okay, number four, you learn what it is you still need to learn.
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Now that's how it came back to me in my example where I cut out exercise and I certainly was
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not getting enough sleep.
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I want those things to be a priority.
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So I'm learning in this experience of being super busy what I still need to help myself
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learn as high priorities.
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So what I'm seeing in the way I behaved or the things I didn't prioritize is that I've
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decided that exercise is optional.
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I don't want that to be the case.
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I want it to be fully required.
377
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And so what work do I need to do to tell myself to help myself learn that no, no, no, this
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doesn't fall aside.
379
00:20:30,820 --> 00:20:33,280
So I learned the things that I need to learn.
380
00:20:33,280 --> 00:20:39,560
I'm learning that I need to work hard to prioritize exercise in my mind so that it's something
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I do consistently.
382
00:20:41,760 --> 00:20:42,760
How about sleep?
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One of the things I've learned is that I want to be able to continue to do this work no
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matter the work I have to do in the hospital.
385
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And so maybe this clinical work I do that keeps me up at night is not what I want to
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do.
387
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Right?
388
00:20:58,040 --> 00:21:01,400
So now I have the opportunity to say, well, how do I want to structure my clinical work
389
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so that I'm not waking up in the middle of the night?
390
00:21:03,480 --> 00:21:08,080
And I can do that because I'm building my career as I'm moving forward, building my
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career as I'm living it, and everything I do is optional.
392
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And I need to decide how do I live?
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So I'm doing clinical care.
394
00:21:18,480 --> 00:21:20,640
Clinical care is still part of what I do.
395
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How do I do the clinical care such that it doesn't interfere with my research and writing?
396
00:21:25,700 --> 00:21:30,840
So for example, maybe what I do is I sign up for the Fellows Clinic because I know that
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the Fellows Clinic does not involve overnight call.
398
00:21:33,920 --> 00:21:39,400
So it just shows me different strategies that I can use so that I can prioritize sleep even
399
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when things get super busy.
400
00:21:41,240 --> 00:21:44,040
It's hard to prioritize sleep when you're being paged in the middle of the night.
401
00:21:44,040 --> 00:21:46,640
And I recognize that that's extrinsic to me.
402
00:21:46,640 --> 00:21:51,520
But the choice that I make is whether I continue to show up in the space that limits my ability
403
00:21:51,520 --> 00:21:53,480
to sleep in times of busyness.
404
00:21:53,480 --> 00:21:57,600
So that's one example of the way I'm thinking about it.
405
00:21:57,600 --> 00:22:02,040
So you learn things that you still need to learn or you learn about opportunities to
406
00:22:02,040 --> 00:22:05,880
adjust things in your life so that you can show up the way you want to.
407
00:22:05,880 --> 00:22:06,880
Okay?
408
00:22:06,880 --> 00:22:08,420
All right, wonderful.
409
00:22:08,420 --> 00:22:10,760
You learn that only you can stop the train.
410
00:22:10,760 --> 00:22:15,680
So can I be honest and say that I'm really busy this week where I'm falling asleep while
411
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having conversations with people?
412
00:22:17,680 --> 00:22:19,080
That is really crazy busy.
413
00:22:19,080 --> 00:22:21,160
And I think it's a little too busy.
414
00:22:21,160 --> 00:22:25,240
And in reality, I'm the one.
415
00:22:25,240 --> 00:22:26,680
Is nobody making me busy?
416
00:22:26,680 --> 00:22:28,400
It's not the clinical work.
417
00:22:28,400 --> 00:22:29,400
It's not the grant.
418
00:22:29,400 --> 00:22:30,400
I chose, right?
419
00:22:30,400 --> 00:22:32,920
I chose to keep my schedule the same.
420
00:22:32,920 --> 00:22:35,360
I chose not to take time off in the middle of a move.
421
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I am choosing.
422
00:22:36,360 --> 00:22:39,240
And so the train is mine.
423
00:22:39,240 --> 00:22:43,400
If I'm like, wow, this train is going at a really high speed, that's because I'm driving
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the train.
425
00:22:44,400 --> 00:22:47,960
And if I want the train to slow down, guess who slows the train down?
426
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I do.
427
00:22:48,960 --> 00:22:52,280
And if I want the train to come to a crash and stop, guess who does that?
428
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I do.
429
00:22:53,280 --> 00:22:54,280
I do.
430
00:22:54,280 --> 00:22:55,280
I choose.
431
00:22:55,280 --> 00:22:59,960
And nobody can stop the train of busyness except me.
432
00:22:59,960 --> 00:23:04,800
And I have to say that when these kind of scenarios come up where things get super busy,
433
00:23:04,800 --> 00:23:09,960
it really is a great opportunity for rest and reflection and to say, hey, what does
434
00:23:09,960 --> 00:23:11,560
it take to not be so busy?
435
00:23:11,560 --> 00:23:17,360
What does it take to not let things that should be a priority not be a priority?
436
00:23:17,360 --> 00:23:21,320
What does it take to make the priorities, to fix the priorities so that the things you
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00:23:21,320 --> 00:23:24,640
want to prioritize are the things you're prioritizing?
438
00:23:24,640 --> 00:23:32,640
And so I recognize that I fully have the power to make change happen.
439
00:23:32,640 --> 00:23:35,500
And so am I going to exercise my power?
440
00:23:35,500 --> 00:23:38,160
Of course I'm going to because this is crazy.
441
00:23:38,160 --> 00:23:42,280
I also recognize that it's for a very defined period of time because by this time next week,
442
00:23:42,280 --> 00:23:43,680
my life is over.
443
00:23:43,680 --> 00:23:44,680
And so it's gone.
444
00:23:44,680 --> 00:23:50,120
But I also recognize that what I have is a pattern.
445
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What I have also is to some extent, it's a structure for busyness and only me can dismantle
446
00:23:55,640 --> 00:24:02,080
the structure and create a structure for sustainability over time.
447
00:24:02,080 --> 00:24:04,180
So I invite you to think about it for yourself too.
448
00:24:04,180 --> 00:24:08,320
So if I didn't judge me, other people certainly are judging me.
449
00:24:08,320 --> 00:24:13,320
But it is important for me to think about my own experience so that I can change my
450
00:24:13,320 --> 00:24:14,320
experience.
451
00:24:14,320 --> 00:24:15,680
I invite you to do the same.
452
00:24:15,680 --> 00:24:17,040
Or maybe you don't want to.
453
00:24:17,040 --> 00:24:20,680
And it's easier to just sit and judge me about it.
454
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Please do.
455
00:24:21,680 --> 00:24:24,440
Because if it helps you, please do it.
456
00:24:24,440 --> 00:24:28,840
But you could consider maybe sitting down and looking at your own experience and saying,
457
00:24:28,840 --> 00:24:32,560
well, I exercise power and control in my life.
458
00:24:32,560 --> 00:24:34,000
How do I change it for me?
459
00:24:34,000 --> 00:24:35,600
And yes, we have choices.
460
00:24:35,600 --> 00:24:37,400
And yes, we're always making them.
461
00:24:37,400 --> 00:24:40,040
And no other people are not making choices for us.
462
00:24:40,040 --> 00:24:41,320
We're making choices for ourselves.
463
00:24:41,320 --> 00:24:47,200
And I invite you to think about how you can learn yourself from being too busy.
464
00:24:47,200 --> 00:24:48,440
So I talked about five things.
465
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Number one, you learn what you prioritize.
466
00:24:50,160 --> 00:24:53,600
Number two, you learn what you don't care for or what you deprioritize.
467
00:24:53,600 --> 00:24:57,520
Number three, you learn and discover the limits of your sanity.
468
00:24:57,520 --> 00:25:01,560
And before you learn what it is, you still need to learn what opportunities are available
469
00:25:01,560 --> 00:25:05,000
for you to make your life the life you actually want it to be.
470
00:25:05,000 --> 00:25:09,980
And number five, you learn that only you can stop the train and you get to choose whether
471
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you want to or whether you don't.
472
00:25:12,560 --> 00:25:13,560
All right.
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It's been a pleasure talking with you today.
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Thank you so much for tuning in to the Clinician Researcher podcast.
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I look forward to talking with you again next time.
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Thanks for listening to this episode of the Clinician Researcher podcast, where academic
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clinicians learn the skills to build their own research program, whether or not they
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have a mentor.
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If you found the information in this episode to be helpful, don't keep it all to yourself.
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Someone else needs to hear it.
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So take a minute right now and share it.
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As you share this episode, you become part of our mission to help launch a new generation
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of clinician researchers who make transformative discoveries that change the way we do health
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care.