February 2017

“Do not be sunk by the weight of history and do not let inertia impede your improvement.”

 

TASK AT HAND: This week I’m thinking about two stumbling blocks that can insidiously creep into our perceptions and influence our strategies.

1. The weight of history. The weight of history is the concept that our personal and collective historical baggage can be so heavy that it limits our progress. This can strain relationships and hinder decision making.

Now, it is imperative that you live with the correct – i.e., true – facts and conclusions from your history. However, it does not mean you must be weighed down by them. History is an ocean of knowledge, but it can also drown you. If you shackle yourself to the portrait of who you were yesterday, you may bind yourself to painting the same picture again today.

“If you shackle yourself to the portrait of who you were yesterday, you may bind yourself to painting the same picture again today.”

I want you to let go of this weight! How? Find an action or outcome from the past that you felt delivered underwhelming results. Look for the root cause; for example, a tendency to rush decisions. Now, find a tentative solution; like being cognizant of the time available for each decision. Then, institute a change as a means of unburdening yourself of a negative historical weight.

 

2. Law of inertia. This concept is from Newton’s First Law of Motion which reads:

“An object at rest stays at rest and an object in motion stays in motion with the same speed and in the same direction unless acted upon by an unbalanced force.” Newton’s First Law of Motion

I want to surmise this law into a simple statement: “objects tend to do what they do”.

What’s the relevance for us? Where the weight of history limits our progress, the inertia in our lives – the stereotypical rhythms of our actions and strategies – can keep us from findings new directions to grow, learn, and discover.

How do you curate the change to overcome inertia? Newton answers this for us: “unless acted by an unbalanced force”. Find an unbalanced force – spontaneity, travel, a rewarding relationship – and invest time and energy in it to overcome the inertia and resistance blowing against you.

 

MEDICINE & MACULA: Check out our newest publication, Efficacy of the Intravitreal Sustained-Release Dexamethasone Implant for Diabetic Macular Edema Refractory to Anti-Vascular Endothelial Growth Factor Therapy: Meta-Analysis and Clinical Implications (Khan, Kuriakose, Khan, Chin & Almeida) published in Ophthalmic Surgery, Lasers and Imaging Retina (February 2017, Volume 48, Issue 2, pages 160-166, DOI: 10.3928/23258160-20170130-10).


In this meta-analysis, we examined a total of 3,859 patients among 15 studies and found that treatment with Ozurdex is associated with significant mean improvement in visual acuity in patients with diabetic macular edema who have a sub-optimal response to anti-vascular endothelial growth factor therapy. This is further support to a multimodality approach to treating diabetic macular edema.

You can find the study here.

GRATIS: “The reason men oppose progress is not that they hate progress, but that they love inertia.” -Elbert Hubbard

 

My best to you,

David Almeida

david@davidalmeidamd.com

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“Panic causes tunnel vision. Calm acceptance of danger allows us to more easily assess the situation and see the options.” -Simon Sinek

 

TASK AT HAND: This week I’m thinking about the pitfall of cognitive tunneling. Cognitive tunneling, also known as cognitive capture, is an inattentional blindness phenomenon where one becomes hyper-focused on some variable other than the present environment. When this occurs, as the old axiom states, you “can’t see the forest for the trees”; or in other words, you become obsessed in some sentence that you lose perspective of the story.

“Cognitive tunneling is an inattentional blindness phenomenon where one can’t see the forest for the trees.”

When cognitive tunneling occurs, the individual may become lost in internal thought or instrumentation and lose focus on the present action or environment. An example would be a pilot focused on an altimeter rather than the runway ahead. More commonly, we tend to become entrenched in inner negative thought rather than executing effective strategies for the conflicts we face in our lives.

Inattentional blindness is primarily caused by our unconscious minds, particularly when we are overwhelmed with information or options, fatigued, inebriated or panicked (Caroline Beaton, Millennial Cognitive Tunnel Syndrome: Why We Miss The Solutions To Our Career Crises, Forbes July 2016). Realizing that our unconscious minds aren’t always the best at determining what’s important, cognitive tunneling helps explains why we tend to react to failures in counterproductive ways. Instead of remaining focused on the conflict, we lose awareness and move farther away from resolving the issue.

As mentioned above, under stress, this cognitive capture is exacerbated into the error of tunnel vision where the range of cue utilization is reduced (Dirkin GR, Cognitive tunneling: use of visual information under stress, Percept Mot Skills 1983;56(1):191-8). Simply put, tunnel vision limits our ability to process peripheral information because we are over-committed to some central issue.

“Under stress, this cognitive capture is exacerbated into the error of tunnel vision.”

Why is this important?

The crux here is awareness! You are at your best with maximal awareness for the task at hand, but also by being cognizant of the variables that influence it. Awareness is akin to context and, minimizing cognitive tunneling, aids you in the processing of relevant information. One step further, improved contextual awareness allows you to filter out the relevant from the irrelevant which minimizes your chances of becoming trapped by unimportant details.

“Awareness is akin to context and, minimizing cognitive tunneling, aids you in the processing of relevant information.”

 

MEDICINE & MACULA: Thanks again for all the interest in my new book, Decision Diagnosis: Seven Antidotes to Decision Procrastination, and for making it an Amazon best seller in multiple categories and countries!

Both paperback and Kindle versions are now available here.

GRATIS: “Stress makes us prone to tunnel vision, less likely to take in the information we need. Anxiety makes us more risk-averse than we would be regularly and more deferential.” -Noreena Hertz

 

My best to you,

David Almeida

david@davidalmeidamd.com

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“Man is the only kind of varmint who sets his own trap, baits it, then steps in it.”

-John Steinbeck

TASK AT HAND: This week I’m thinking about the confirmation trap. Confirmation bias, also known as the confirmation trap, occurs when we procure data and information that aligns with our beliefs and ignore that which runs counter to our arguments.

“The confirmation trap occurs when we procure data and information that aligns with our beliefs and ignore that which runs counter to our arguments.”

The ability to recognize bias is essential for survival. To be cognizant that we are strongly attracted to our own beliefs and that these biases, left unchecked, increase our vulnerability for errors needs to be constantly addressed. Bias in opinion is easier to detect and correct; however, confirmation bias – when we actively seek out information to back our preconceived beliefs is dangerous!

“The ability to recognize bias is essential for survival.”

 

How do you avoid the confirmation trap?

How do you escape the fallacy of searching for information that propagates an erroneous echo chamber?

There are three strategies you can employ that are effective at liberating you from this trap.

1. Be a cynic. Act like a doubter. Question as a skeptic. Question both the quality of the data and the validity of the source. Those that know me, come to recognize that engagement by means of doubt is something I value dearly. I believe that the ability to question is essential for the overall health of the individual and the common collective. Worthwhile societal contributions are commonly created by this process of questioning and conflict.

“The ability to question is essential for the overall health of the individual and the common collective.”

2. Plan how you acquire your data or information. This strategy tends to apply more towards your professional tasks but I recommend you plan your data gathering ahead of time. In the medical and scientific literature, we describe this as a priori endpoints and outcome measures. The act of specifying analytical methodology before you start looking at the results minimizes haphazard and scattered conclusions.

3. Two sources are better than one. When in doubt, have multiple sources. Few strategies are as simple, yet as effective, as having multiple trusted sources to ascertain the validity of the information you are analyzing. As I have mentioned here on the Sunday Surgical Scrub before, never rely on just one source for any meaning analysis.

 

MEDICINE & MACULA: My new book, Decision Diagnosis: Seven Antidotes to Decision Procrastination, is now available on both Kindle and as a paperback.

My sincere thanks for making it an Amazon best seller in multiple categories and countries!

 You can find it here.

 

GRATIS: Whenever I’m lucky enough to get the opportunity to drive my kids to school, I always remind them to ask one good new question each day. Then, I ask them to look for holes, fallacies and inconsistencies in the answer they get back. Always be on guard for the confirmation trap!

 

My best to you,

David Almeida

david@davidalmeidamd.com

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“Think outside the box, collapse the box, and take a sharp knife to it.”

–Banksy (Wall & Piece)

TASK AT HAND: This week I’m thinking about the axiom, “think outside the box”. I don’t particularly like clichés but they sometimes are exemplary to illustrate a concept. For example, what does it mean, “think outside the box”? This is one you hear constantly, irrespective of field or expertise.

When I hear, “think outside the box”, I interpret this as the pursuit of original thought, creative discourse, or innovative strategy. These are all worthwhile goals! In fact, I believe these to be crucial to personal growth. As we previously discussed here on the Sunday Surgical Scrub with Constant Change (August 2016) and Agents of Change (January 2017), one must change or pay the heavy price for staying the same.

Banksy, the infamous social artist articulates and extends this concept one step further with our introductory quote. He feels that thinking outside the box is not enough; you need to shred and destroy the box – thereby eliminating boundaries – to appreciate your full creative potential. I like this!

 

But how do we go about getting outside the boxes that constraint our deliberations and decisions? There are two strategies that are central to getting outside the box.

1. Grow your capacity for self-awareness. Pursue self-enquiry and probe the degree of self-awareness you currently occupy. Do you constantly revisit your ability to look inward? This is challenging and difficult but, your ability to get out of the box and escape its boundaries, relies on your ability to be self-aware. Only when you recognize your comforts and conveniences can you eclipse them. The knife you need to cut this box into pieces is your degree of self-awareness. Sharpen it often!

2. Invite conflict. Akin to your degree of self-awareness is your desire to invite conflict in your life. Note, I do not mean to invite melodrama or perfunctory argument. Invite genuine conflict into your ideas. Invite conflict so as to challenge your strategies. You will find the resultant solutions are wonderful elaborations rather than products of simple linear thinking. Having conflict need not create a discordant song but rather allows for a symphony with rich notes and rhythms.

So, next time you are faced with dilemma or decision, get out of the box, stomp on the box, cut up the box, and realize that you need not be confined to its boundaries. Instead, use self-enquiry and self-awareness to invite conflict as a means for the creative expression of innovative solutions and strategies.

 

MEDICINE & MACULA: Thanks to everyone for all the support and interest in my new book, Decision Diagnosis: Seven Antidotes to Decision Procrastination.

It is a now an Amazon best seller in multiple categories and countries!

My sincere thanks!

You can find the book here. 

 

GRATIS: “Instead of thinking outside the box, get rid of the box.” -Deepak Chopra

 

My best to you,

David Almeida

david@davidalmeidamd.com

 

 

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