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Getting Our House In Order

Hey friends, Last week, I made a mistake at work. My consultant asked me to check the dosing instruct
Getting Our House In Order
By Ali Abdaal • Issue #63 • View online
Hey friends,
Last week, I made a mistake at work. My consultant asked me to check the dosing instructions of two anti-psychotic medications that a patient (“Harry”) had been given while he was in Intensive Care, and that he needed to be weaned off now that he was on our normal ward. I said ‘no problem’, noted the task on my patient list (a piece of paper with patient data on it) and intended to get to it later that day. 
When I came to doing the task, I got Harry mixed up with another patient (“Ron”) and spent 10 minutes figuring out Ron’s antipsychotic medication weaning scheme instead. I thought it was a bit strange that Ron was only on 1 antipsychotic drug rather than 2, but I assumed the consultant hadn’t realised this and went on with my life. 
Later that afternoon, the consultant happened to see me on the ward and asked “Have we figured out the weaning doses for Harry’s meds?”. I was very confused for a few seconds until everything clicked in my head. “Ah crap I’m sorry, I got Harry and Ron mixed up in my head, I’ll check Harry’s dosing now”. 
Everything worked out okay in the end, but I was annoyed at myself for getting the patients mixed up. I thought about why it happened, and figured out pretty quickly what the problem was.
The Problem
See, that morning I’d forgotten to pack my pen in my bag. I’d arrived on the ward, picked up a printed patient list, and found some random thick pencil lying around. I thought ‘it’s not a big deal, I’ll just use this pencil today’. 
By mid-morning, my sheet (which is usually quite tidy) was a mess of pencil scrawls. Because I couldn’t clearly keep track of my list on paper, I ended up juggling stuff in my head, using my brain as a storage device rather than a thinking device. When the new information about these anti-psychotic medications came in, I wrote it down correctly on the piece of paper (“Harry - check weaning doses”) but because the whole sheet was a mess, my brain had to take on the extra cognitive burden of keeping things organised, and mismatched the task to Ron.
The Solution - GOHIO
The following day, I made sure to pack my pen and kept my to-do list neat throughout the day. I even spent 5 minutes transferring my annotations from one sheet to the next when we updated and printed a new list in the afternoon. That day, everything felt more manageable, less manic and nothing slipped through the net. 
In the early days of Amazon, in the year before they first hit $1 billion in revenue, Jeff Bezos instigated a year-long policy of “Getting Our House In Order” (“GOHIO”). He knew that at the $1bn mark, companies often struggled, partly because the systems that worked well when they were smaller became bloated and less fit-for-purpose. Spending a year focusing on GOHIO, on updating their internal systems so that they worked better, on organising their structure and products to be more streamlined, worked wonders, and allowed Amazon to grow into the behemoth that it is today. 
I came across the story of GOHIO in a podcast the same week that I made the anti-psychotic dosing mixup. Now, whenever I find myself getting even slightly overwhelmed by the amount of stuff I need to do, or if I realise that my list isn’t as organised as it should be, I spend a few minutes on GOHIO - Getting our house in order. 
Have a great week!
Ali 

This week’s podcast
Stuff I enjoyed this week
1 - Podcast - I recently discovered the Rad Awakenings podcast, and found my favourite productivity guru Tiago Forte on two episodes of it! If you’re into the productivity / creator thing you’ll love listening to episode 1 and episode 52.
2 - Book - I started reading The Third Door by Alex Banayan. The tagline is the wild quest to uncover how the world’s most successful people launched their careers. It definitely passes the ‘made me stay up till 4am reading’ test.
3 - Notebook - I’ve continued to enjoy my purchase of the Leuchtterm 1917 A5 dotted notebook. I write in it almost every day, and I find that my ideas are much more free-flowing on paper than they are even on an iPad Pro + Apple Pencil combo.
Kindle Highlight of the Week
Scott helped me refocus, to use his language, on “systems” instead of “goals.” This involves choosing projects and habits that, even if they result in “failures” in the eyes of the outside world, give you transferable skills or relationships. In other words, you choose options that allow you to inevitably “succeed” over time, as you build assets that carry over to subsequent projects.“
From Tools of Titans by Tim Ferriss.
This week's video
My 3 Favourite Fiction Books (2019)
My 3 Favourite Fiction Books (2019)
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Ali Abdaal

Hey friends, I'm Ali, a Cambridge medicine graduate now working as an FY1 junior doctor. I spend most of my spare time making YouTube videos, but every Sunday I send out an email 'newsletter' with some thoughts, life lessons and interesting articles I discover on the internet.

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Ali Abdaal, Emmanuel College, Cambridge, CB2 8RP