Sunday Surgical Scrub: 12 June 2016

blurry

“The focused mind only picks up on those aspects of a situation that are needed to accomplish the task at hand. It is not distracted by other thoughts or external events.” The Inner Game of Tennis by Timothy Gallwey

 

Task at hand: This week I’m thinking about the concept of cognitive burden. We know from cognitive psychology that cognitive load refers to the total amount of mental effort being used in the working memory. Cognitive burden can be thought of as an excess load on our mental effort – I attribute this undue burden to mostly meaningless or inconsequential items. We all want the personal freedom to choose: to choose a place to call home, to choose a partner, to choose a career. However, do we want to make every possible decision and have every choice? Personally, I don’t want to have to choose when to breathe, when to take the next walking step.

Do we want to burden ourselves with the construct of every action? Yet, our lives are increasingly filled with inconsequential decisions – from cell phone plans to social media posts – it’s easy to lose clarity. Thus, we arrive at the point of today’s scrub: remain focused on what is important to you and minimize cognitive burden. There are two main strategies I use for this.

The first one applies to extrinsic inconsequential items. You have to strip these decisions away. Einstein had multiples of the same suit and shirt so he never wasted any time on this trivial matter. He was right – you shouldn’t waste any of your mental energy on this! I’m a believer of the morning routine: wake up, exercise, nutrition and don’t burden your brain until executive functions are actually required. For these inconsequential items, try to create as many possible routines as possible. I really don’t want to use any of my processing power for these mundane musings; I want to save them for creativity and problem solving.

 
The second item is related to intrinsic cognitive burden. This is a major component, and the one I find hardest to minimize. First, you have to realize that there are two parts to your being: a physical part that executes movements and actions and a cerebral part that perceives and processes. Unfortunately, these two seem to be in constant battle with each other. Your cerebral part is constantly burdening you – the voice ruminating and contemplating – eliminate it so that it does not undermine what you desire.

 

Minimize your cognitive burden – both the extrinsic inconsequential happenings and the intrinsic personal trappings – so that in clarity you can fulfill your potential.

 

Medicine & Macula: Interesting article in JAMA on the resurgence of syphilis in the United States. Syphilis is caused by infection with the Treponema pallidum pathogen and can cause a myriad of systemic and ocular manifestations. While there were fewer than 4 cases per 100 000 by the year 2000, this has been increasing every year since that historic low.

The task force finds that there is net benefit of screening for syphilis infection in nonpregnant persons who are at increased risk for infection. Screening allows for identification of infected individuals which can then be treated. Treatment of early syphilis with single-dose intramuscular administration of penicillin G is highly effective and has the advantage of assured adherence and can prevent significant morbidity of untreated disease. After seeing multiple patients this week with syphilis, I am reminded of the need to increase awareness of this great masquerade!

Check out the study here

US Preventive Services Task Force.  Screening for syphilis infection in nonpregnant adults and adolescents: US Preventive Services Task Force Recommendation Statement. JAMA. doi:10.1001/jama.2016.5824.

 

Gratis: Check out Timothy Gallwey’s The Inner Game of Tennis: The Classic Guide to the Mental Side of Peak Performance (where the opening quote comes from). This book is about much more than tennis and is a wonderful short read on cognitive clarity and enhancing your ability to reach your potential in any situation.

 

My best to you,

David Almeida

4 Comments, RSS

  1. Maria Thompson June 12, 2016 @ 7:41 pm

    Hi David,
    thank you so much for the information,
    Very proud of see a Portuguese Person getting ahead …Making a beautiful life and be of Service to others in such capacity…
    Congratulations
    Best for You and Yours
    Maria Helena

    • David Almeida June 12, 2016 @ 9:04 pm

      Muinto obrigado Maria!

  2. Lalaine July 12, 2016 @ 3:02 pm

    Your posting is absolutely on the point!

  3. Time For A Routine – David Almeida MD March 26, 2017 @ 7:01 am

    […] Routines minimize cognitive burden. I have talked about cognitive burden before (Sunday Surgical Scrub from 12 June 2016, you can find the original post here). Cognitive load refers to the total amount of mental effort being used in the working memory. […]

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