University HealthCare Alliance

June 16, 2017

Dr. Sonia Singh writes about what’s really important, published in the NEJM

Know what matters in life and do those things well.

That sounds like good advice, but all too often what matter in life feels a lot like everything, and you can’t do everything perfectly. You can’t be a star at your job and have time for your loved ones, remember every important birthday, keep the house tidy, exercise as often as you want, pursue that hobby you love, remember where you parked your car last and get enough sleep. It’s just not possible.

Stanford physician Sonia Singh, MD, presents an interesting take on recognizing what matters in a just-published New England Journal of Medicine perspective. Singh, whose medical training has made her acutely aware of the overwhelming number of important details in her professional and personal life, writes:

“You wonder if you left the iron on in your apartment. No matter how often you iron and bleach your white coat, it never looks or feels clean. You never look or feel clean. You wonder how many different strains of staph you’re colonized with. Your best friend just had her first baby, but you’ve avoided visiting for fear of infecting him with some resistant bacteria. You already missed her wedding and baby shower. Trying to be a good doctor has made you a bad friend these days.

It’s 9:55, and you have one patient left — Ms. T. You might actually make it to morning report on time if you keep things brief. You’ve been taught how: walk in and set an agenda (“Good morning, Ms. T., I wanted to check in and see how you’re feeling”), manage expectations (“I only have a few minutes to chat, but I’ll be back later to talk more”), make the patient feel heard (“I’m sorry you’re still feeling nauseated. Did the Zofran help?”), examine while you talk (the patient is alert and oriented, heart rhythm regular, lungs clear, belly soft and non-tender, sclera icteric, unchanged from admission), answer questions (“Your bilirubin is 17 today”), exit courteously. You’re on this last step when you make a critical error.”

Beautiful and candid writing aside, I love this piece because it is offers overachievers a clever way to cull the not-so-important stuff from the things of true value. Singh considers what matters and what doesn’t matter as much. “These are the 60 seconds that will matter,” she writes after allowing herself to spend extra time with a patient in need of comfort. “These are not the 60 seconds that matter,” she writes forgiving herself for an embarrassment she knows will pass.

It’s worth a read.