S03E60 Flow State in Surgery and in Life for Peak Performance

Wikipedia describes it as being in the zone where you are fully absorbed by what you are doing , engaged in full but effortless concentration . You lose track of time and the flow is the melting together of action and consciousness . It is a feeling of energized focus , full involvement and complete immersion in a challenging situation .

It is definitely a positive and rewarding feeling . There are some famous instances described where people have entered flow state while doing certain tasks . For example , sir Isaac Newton supposedly forgot to eat and sleep for several days while writing Principia Mathematica , the foundation of classical physics and the law of universal gravitation .

Other activities in which people often describe being in a flow state include playing music , sports or even certain games such as chess or video games . Don't get me wrong seeing patients in the office is great .

Focusing on patient care outcomes has always been my goal , as in attending , but when I had a moment of crisis during my third year of general surgery residency when I thought about leaving medicine completely and taking the GMAT to apply to business schools to become a junior analyst or a consultant .

The single most important factor that made me decide to stay in surgery was a fact that I knew of no other job where I could have that feeling of flow state while I was operating . Most people can probably describe being in flow state in their lives , sometimes a lot In addition to surgery . I feel that flow state doing other activities in my life as well .

Let's talk about what conditions can activate flow state and how that might apply to our everyday lives . First of all , you probably don't want to be in flow state all the time . Even if you could , for example , would you really want to be in flow state while brushing your teeth every day ?

But recognizing the conditions and components that help us enter flow state might help us in many of our tasks for our everyday life . So what is the actual definition of flow state ? How do you know for sure that you're in the zone ?

According to Jean Nakamura and someone with a really complicated name I can't pronounce but go something like Chexsah Zenta Mi Halle there are six attributes that , if present , would indicate you are experiencing flow state . The first attribute of flow state is one intense and focused concentration on the present moment .

Number two merging of action and awareness , ie the doer and the doing becomes one and the actions feel automatic . A lot of actions we do in life are very deliberate . We are consciously controlling our actions . In flow state , there is no deliberation . Our movements don't require thought .

Number three another attribute of flow state is a loss of reflective self consciousness . That is the mind's mirror that reflects back to us about what we are thinking and doing . Flow state eliminates that feeling of self awareness .

Number four a sense of personal control or agency over the situation or activity , where we feel in complete command of what we are doing . Number five a distortion of temporal experience , as one's subjective experience of time is altered so oftentimes what may take hours can feel like minutes . This is the one characteristic that I feel most strongly .

In surgery , I'll look up at the end of a case and it felt like 15 minutes , but it was actually three hours . Unfortunately , if you are a medical student doing nothing but standing and watching the case , you probably were in in flow state and those three hours probably felt like 12 .

And the sixth and last attribute of a flow state is that the experience of the activity feels intrinsically rewarding . This is referred to as an auto-telec experience , where you are enjoying the activity for its own sake . You just love being involved in the activity itself . So now maybe you're thinking about activities where you feel like you're in that flow state .

Some people actually say the purpose of our lives is to engage in flow state activities as much as possible . But not everything can be done in flow state , even if we may want to . What are the factors that can prevent us from achieving flow state in an activity ? Number one lack of clear goals .

You need activities with a clear goal , such as chess or a sport , which can allow attention to be focused solely on achieving that objective . Another factor that can stop us from entering flow state is lack of challenge . Flow state generally requires doing something which is not too easy and not overly difficult .

Some flow researchers have suggested that the optimal challenge for flow state is when the activity is 4% more difficult than your skill level . I honestly do not know what that means , but yes , I do agree that flow state requires something that is not boring nor impossible to do . Number three distractions .

There are some activities where you can enter a flow state so strongly the roof could fall down on your head and you might not notice . However , for most of us , in most activities , distractions can take us out of that flow state .

I have seen surgeons get enraged when they are operating and there are distractions such as beepers , people talking , machine alarms all of which can take you out of flow state .

Just talk to a surgeon about how frustrating it can be to be operating during shift change when all the personnel are all talking and moving in and out of the OR , and you'll get a sense of the emotion behind the frustration . The fourth barrier to flow state can be self-doubt or internal criticism .

Nothing can impede flow state more than our inner voice constantly questioning us Am I doing this right or is this going to work ? Obviously , these are important questions , but they shouldn't be done during the activity , especially surgery . Planning and setup are 90% of surgical success , just like they are for most other activities .

Of course , unexpected issues and detours can always occur , but the hesitation and pauses should never come from within . There's an old saying about surgeons frequently wrong but never in doubt . Confidence , or at least a sure sense of what you need to do for the task at hand , is critical for focus and for flow state In regards to other activities in life .

I think that one of the reasons I love CrossFit is that on my best workout days , I can enter a high level of flow state . During a workout , when you're performing well , you can definitely feel like you're in a zone . There aren't too many feelings that are better than being fully immersed during a wad , executing well and losing yourself in that moment .

Of course , not every workout works this way for me . Some days I'm fighting self-doubt , that inner voice that looms large in my head . I may be wondering if the weight I chose was too heavy , or if my shoulder is up to the task today , or if I should just go a little slower or rest a little more , because I have a really busy day later on .

Sometimes I worry about being the last to finish or whether people are going to be looking at me . Working to shrug off these inner voices and focus at the task at hand has gotten easier for me over the years , but it is always a challenge .

I do know that I continue to improve at entering at least some degree of flow state for many of my workouts and that it has helped me outside of the gym on other activities , the ones where flow state could help me achieve more if I can clear my mind and pay full attention to the task at hand .

It is always a challenge in our everyday lives to find an enter flow state for many of our activities that could benefit .

One of the reasons I'm glad I didn't leave surgery is because I can almost always enter flow state while operating and in fact you almost have no choice to do so in order to achieve your desired result , and usually that can make for a quick day . Surgery days are always the days that go by fastest for me .

So what instances of flow state have been memorable for you ? What activities have a high degree of flow state in your daily

life ? Let me know my weekly thankful is our nation's highways . I know that most people would not necessarily think to be thankful for roads , but having had to drive for over eight hours twice and four days back and forth on a long trip recently , I realized , even with traffic , the road system in the United States allowed us to move pretty quickly .

The roads were mostly of good quality , no major potholes or other problems and , having been in countries where you share the roads with motorbikes , people walking rickshaws , even cows and goats . Our nation's highways allow us to travel long distances , driving efficiently even when you don't fly or take a train .

Plus , driving out of the state of New Jersey always reminds me how other people live where they have to fill up their own cars at gas stations . Let me know your thoughts about flow , state highways or anything else . Please DM me at Botox and Burpees podcast on Instagram or leave a comment at youtubecom . Slash at signbotoxandburpees . Thank you .