What is Deep Work?
I just finished reading Deep Work, a book by Cal Newport. I think deep work is a concept worth exploring. There is a growing scientific literature that suggests that we get optimal brain function when immersed in work that requires intense concentration, focus and attention. When we do deep work, our brain’s creativity centers go into overdrive. In fact, there is growing evidence that deep work is required for creativity. Newport says in his book that without deep work, a very smart individual will not be able to produce much that is novel or creative.
Deep work requires time
Deep work requires a time commitment with uninterrupted continuity, and limited or even no distractions. The best thinkers and innovators of the world describe how they achieve deep work states in many different ways. But they all describe committing to spending substantial time with limited outside stimuli, in a state of almost trance-like intensity. You can probably think of a time when you were intensely working on something that required your absolute attention such that time passed without your noticing. You might have looked up at a clock only to be surprised that hours had passed without your even noticing. Do you remember what you produced during that time? Was it something creative and unique and memorable? That was probably some of your best deep work.
According to Newport, the best evidence suggests that deep work requires minimum blocks of time of approximately 2-3 hours. One reason for this is that the brain requires some on-ramp time. You need to warm up to deep work. Just like an Olympic lifter would never walk up to a bar loaded with weights and pull out a new maximum lift without warming up, most people can’t drop into flow suddenly and abruptly.
What happens when you don’t do deep work?
Sometimes you are just too busy to dedicate time to deep work. Your day gets filled with less meaningful tasks, and meetings, and you scramble to just meet deadlines. When this happens occasionally, we can recover and get some energy back from a nice session of deep work. But, if this is your norm, and it happens day after day, you might find yourself becoming more and more frustrated. And, you might start to feel like you have lost your creativity without the time to do deep thinking. Although there is no specific study to suggest this, I think the loss of deep work probably also contributes to burnout. After all, when we don’t use our creativity and resourcefulness, we may begin to question whether our work is meaningful and if our purpose is aligned with that of our organization.
Physicians in busy, productivity-based practices are probably particularly susceptible to the trappings of losing the time for deep work. They are incredibly busy turning over rooms, seeing too many patients in too little time, writing electronic health record notes, filling out insurance forms, and even dropping their own bills. We all went into medicine to make a difference in individual patient lives, and that is still important even in the busiest practice. But, I bet most of us also crave those stimulating, interesting, deeply challenging cases that pushed us to the limits of our knowledge. And, if our time is completely and 100% occupied with tasks, where is the time to let our creative brain run through scenarios and differentials, look up ancient literature or novel techniques, and really THINK for our patients? I know I see this myself, as a pathologist. When I occasionally come across a very interesting, challenging and unusual case, if I have the luxury of time for deep work, I come up with better, more creative and more medically useful diagnoses. In my worst over-programmed and over-scheduled and rat-race moments, these cases are an annoyance instead of a challenge. Sometimes, we just need some brain-quiet time to read, study, and deeply think about differential diagnoses in order to arrive at the best answer for our patients.
How can you re-introduce deep work?
Cal Newport suggests that there are three formulae for deep work. Some people have schedules and work that can be done in spurts. For example, a college professor he describes takes a block of time off from teaching where all he does is deep work. The rest of the year, he doubles up his teaching load in order to maximize his deep work time. Other people have found that they can intermix deep work sessions with regular life. In other words, take a few days here and a few days there, and do deep work between the days that look like regular life. To be frank, neither of these two models probably works very well in medicine. With busy clinics, operating room schedules, budget cycles and the constant demand of “emergencies” that seem to arise every other day, blocking parts or all of weeks is nearly impossible. So, the third method is probably the most practical for us. And that is interspersing deep work in chunks of several hours, here and there in our busy schedules.
Deep work at the fringes
A strategy that a lot of academic physicians that I know use is to either stay up late or to get up very early for their deep work. I like to call this “finding time for deep work in the fringes,” These times tend to be quiet, uninterrupted, and distraction-free, even if your home is with a hustle and bustle busy family. Personally, this is a strategy that I have always used myself. My best deep work time is between 3 and 6 am. I have my coffee, my computer, and the peace and quiet of a sleeping household. Sometimes, when I am deeply immersed in creative deep work, I can look up and 3 hours have gone by; they are almost like lost hours, but evidenced by substantial progress on writing, problem-solving, or algorithms.
Another way to capture deep work in the fringes is the concept of taking a mini-vacation. I have some faculty that take a day of vacation, a “staycation,” where they hide away guilt-free, for unscheduled deep work time. The out of office email is set, they don’t answer texts or emails, and they get a deep-work injection that can keep them going for another period of time. I do not advocate skipping real vacations though. And, I actually do sometimes reject requests for to use vacation like this, strictly on the premise that they are still WORKING! Still, the mental release that comes from taking a vacation day can be liberating and has been shown to contribute to resiliency, especially if it is spent doing something meaningful.
The saddest situation is when we become resigned. Maybe we just give up on finding time for meaningful deep work, as we try to balance the demands of work, home, family, volunteer activities, other commitments and relationships. Maybe we figure if we can just plug away at the not-so-deep work day after day things may eventually get better. But, it doesn’t magically happen. As we trudge, we instead become more and more disenchanted, frustrated, disengaged and disappointed. You might find yourself saying “This is not what I signed up for in medical school. This is not what I wanted from my life.”
I know I haven’t been able to eliminate or de-intensify the extreme productivity pressures of medicine today. Even with time management strategies, I haven’t been able to gain total control of my calendar and email inbox. But, there are some things we can do to instill deep work time back into over-scheduled and ridiculously busy days, even if we can’t chunk off the the requisite blocks of time that Newport talks about. If you can train yourself, with grounding and centering exercises, to maximize your ability to live in the present moment, you can actually start to experience deep work moments. This does require moving away from thinking about past moments, or future moments, and spending time savoring and experiencing present moments. This activity alone can free up the mind to gain precious moments for creative deep thinking. Let’s call these micro-vacations. Let’s call these micro-vacations. It’s like entering into the mindset of vacation time, right in the middle of an otherwise normal workday!
You can try a micro-vacation right now. Sit quietly, feet firmly planted on the floor beneath you, chest open, and breathing deeply. Close your eyes and then, with your eyes still closed, lift your eyebrows and keep them lifted. Let your mind wander naturally to any problem that you have been worried about. Just see the problem, as if written on a white board with a dry erase marker, and then ask yourself to imagine any creative and new solutions that might have been escaping you. You can spend as little as 3-5 minutes in this meditative state, and come back to your day feeling rejuvenated and fresh, with some new and creative ideas. It is not a perfect substitute for true, continuous, and dedicated deep work or for a real vacation, but it is a great way to mix a little deep work into an otherwise shallow day.
The Bottom Line
So my bottom line message is to seek out and find your opportunities for deep work, even if it means looking at the fringes. You don’t have to find deep work in all areas of your life and your deep work doesn’t even have to be at work. Do you love to cook? Try a new challenging recipe that pushes you just beyond your comfort zone and requires intense concentration. Do you love to work out? Take a new class that requires you to really pay attention and challenges you mentally as well as physically. Do you love to read? Read a new type of book, something that makes you work to find the meaning. Purposefully finding opportunities for deep work can give you the satisfaction, purpose and meaning that you need.