INTRODUCTION
‘Merry Christmas, Ali. Try not to kill anyone.’
With these words, my consultant breezily hung up the phone, leaving me to handle an entire ward of patients alone. I was a newly qualified junior doctor, and three weeks previously I’d made a rookie error: forgetting to fill out a form to request the holidays off. Now, here I was, managing a hospital ward, on my own, on Christmas Day.
Things had started badly and rapidly got worse. When I arrived at the hospital, I was met by an avalanche of patient histories, diagnostic reports and cryptic scan requests that would’ve made more sense to a seasoned archaeologist than our on-call radiologist. Within minutes, I was confronted by the day’s first emergency: a man in his fifties who had collapsed from a severe cardiac arrest. And then one of the nurses informed me that a patient urgently needed a manual evacuation (if you know, you know).
At 10:30am, I looked around the ward. Nurse Janice was sprinting up and down corridor A in a panic, her arms overflowing with IV drips and medication charts. On corridor B, a stubborn elderly patient was loudly demanding his misplaced dentures. Corridor C had been taken over by a drunken exile from the emergency department, wandering the corridor and shouting ‘Olive! Olive!’ (I never learned who Olive was.) And every minute, somebody was making a new demand: ‘Dr Ali, can you check on Mrs Johnson’s fever?’ ‘Dr Ali, can you help with Mr Singh’s elevated potassium?’
I soon found myself starting to panic. Medical school hadn’t prepared me for anything like this. Until then, I’d always been quite an effective student. Whenever the going got tough, my strategy was simple: work harder. It was a method that had got me into medical school seven years previously. It had allowed me to secure a handful of publications in academic journals. It had even allowed me to launch a business while I studied. Discipline was the only productivity system I knew. And it worked.
Except now it wasn’t working. Since starting as a doctor a few months previously I’d felt like I was drowning. Even when I worked late into the night, I couldn’t see the number of patients or finish the paperwork that I needed to. My mood was suffering, too; I’d enjoyed my medical training to be a doctor, but I was finding the actual job utterly depressing, constantly worrying that I might make a mistake that would kill someone. I stopped sleeping, friendships faded, my family stopped hearing from me. And I just kept working harder.
And now this. Christmas Day, alone on a hospital ward, failing to get through my shift.
Everything came to a head when I dropped a tray of medical supplies, sending syringes flying across the linoleum floor. As I forlornly looked down at my damp scrubs, I realised I had to figure things out – or my dream of becoming a surgeon would slip through my fingers.
That night, I hung up my stethoscope, grabbed a mince pie, and opened my laptop. I’d once been so productive, I thought. What had I forgotten? During my first year at medical school, I’d become obsessed with the secrets of productivity. I’d stayed up night after night making notes on hundreds of articles, blog posts and videos promising the key to optimal performance. All the gurus emphasised the importance of hard slog. A Muhammad Ali quote came up a lot: ‘I hated every minute of training, but I said, “Don’t quit. Suffer now and live the rest of your life as a champion.”’
As Christmas turned to Boxing Day, I stayed up poring over my old notes and wondered whether that was where I was going wrong. Did I just need to regain my old work ethic? But when I returned to work the next day resolving to just do more, it made no difference. Even though I stayed on the ward until midnight – and even though I was reciting Muhammad Ali’s line to myself during my toilet breaks – I wasn’t getting through my paperwork any quicker. My patients were still getting a tired, ineffective version of Ali. And I was still displaying a conspicuous lack of Christmas cheer.
At the end of my hardest day yet, I felt completely underwater. And then from nowhere, I remembered some words of wisdom from my old tutor, Dr Barclay. ‘If the treatment isn’t working, question the diagnosis.’
Slowly, and then all at once, I started to doubt all the productivity advice I had absorbed. Did success really require suffering? What was ‘success’ anyway? Was suffering even sustainable? Did it make sense that feeling overwhelmed would be good for getting things done? Did I have to trade my health and happiness for, well, anything?
It would take me a few months. But I was stumbling my way to a revelation: that everything I’d been told about success was wrong. I couldn’t hustle my way to becoming a good doctor. Working harder wasn’t going to bring me happiness. And there was another path to fulfilment: one that wasn’t lined with constant anxiety, sleepless nights, and a concerning dependence on caffeine.
I didn’t have all the answers, not by a long shot. But for the first time, I could make out the beginnings of an alternative approach. An approach that didn’t hinge on exhaustingly hard work, but on understanding what made hard work feel better. An approach that focused on my wellbeing first, and used that wellbeing to drive my focus and motivation second. An approach I would come to refer to as feel-good productivity.
THE SURPRISING SECRETS OF FEEL-GOOD PRODUCTIVITY
Back in medical school, my obsession with productivity had led me to tack on an extra year to earn a psychology degree. As I started putting together the pieces of feel-good productivity, I remembered a study I’d been tested on – one that involved a candle, a book of matches and a box of thumbtacks.
Picture yourself with these three objects before you. Your task is to stick the candle to the corkboard on the wall so that, when it’s lit, the candle wax won’t drip onto the table below. You find yourself puzzling over the items, turning them over in your hands. Can you think of the solution?
When presented with this problem, most people only consider the candle, the matches and the thumbtacks. But more innovative minds recognise the potential of the thumbtack box. The optimal solution to the puzzle involves viewing the thumbtack box not just as a container, but as a candle holder.
This is the ‘candle problem’, a classic test of creative thinking. First developed by Karl Duncker, and published posthumously in 1945, it has since been used in countless studies testing everything from cognitive flexibility to the psychological fallout of stress. In the late 1970s, psychologist Alice Isen used it as the basis for an influential experiment to study how mood affects people’s creativity.
Isen began by dividing her volunteers into two groups. One group was given a small gift – a bag of candy – before facing the candle problem. The other group started the task with no such incentive. The theory went that those who were given the sweets would have a more positive mood when they tried to solve the puzzle. Isen found something interesting: those whose moods were subtly improved by the gift were significantly more successful in solving the candle problem.
When I first read about Isen’s experiment during my psychology degree, I found it interesting but not exactly transformative. Personally, I’d never felt the overwhelming urge to stick a candle to a wall. But coming back to it as a junior doctor, I realised that Isen’s insight was quite profound. It suggested that feeling good doesn’t just end with feeling good. It actually changes our patterns of thought and behaviour.
Copyright © 2023 by Ali Abdaal.