Monthly Rounds (March 2021) - Incrementalism, Toughness, and Why Zoom Fatigue is Real

Hi friends,

Below is my favorite content from March. I skipped February because I did not have enough good content worth sharing. Going forward, I’ll aim to structure this list from shortest to longest reads.

(1) (Length: Short)

I’m a “video off” type-of-person during meetings for two main reasons: (1) I prefer walking aimlessly (aka pacing) during conversation, and (2) because I find “video on” to be mildly exhausting. This article helps explain why I’m not alone.

“Bailenson says the constant barrage of complex non-verbal cues, both being sent and received, during a Zoom interaction can be a major influence on the novel sense of fatigue generated by the technology. He suggests long Zoom meetings should require audio-only breaks, to help relieve the cognitive load of video interactions.

“This is not simply you turning off your camera to take a break from having to be nonverbally active, but also turning your body away from the screen,” explains Bailenson, “so that for a few minutes you are not smothered with gestures that are perceptually realistic but socially meaningless.”

(1) (Length: Medium)

Great article by Dr. Sachin Jain on incrementalism in healthcare and death by pilot -- an attitude that is largely responsible for legacy healthcare's snail-like pace of innovation and also why the new cohort of tech-enabled healthcare players are poised to take over (e.g. Livongo, Ro, Hims, and others). The anecdote with which he starts the article sums it up perfectly.

“True story: When I was a medical student, many of the patients I saw on rounds each morning had a lot of questions for me. Inevitably, however, they forgot to ask some of them. In the afternoons, I’d often pass a nurse in the hallway who would say something like, “Patient X says she’d like you to come back to her room because she forgot to ask you something.” 

Often, when I went back to visit Patient X, she’d say something like, “Oh, yes, I had a question about what you said this morning…But I forgot what it was.” 

I totally got it. These patients were in a hospital, often quite ill, and surrounded by strangers and odd machines. Meanwhile, we’d come in every morning and feed them a barrage of unfamiliar medical terms. Of course they had questions! And of course they forgot to ask some of them!

So I got an idea. “Let’s get our patients notebooks,” I said to an attending I had been shadowing. “That way they can write down their questions and never forget to ask them.”

“Good idea,” the attending said, hoping to encourage my idea for a quality improvement project. “Let’s take it to the division chief.”

So I proposed my idea to the division chief. “Good idea,” the chief said. “Let’s take it to the division all-staff meeting.”

“Good idea,” resoundingly said members of the divisions. “Let’s take it to the nursing steering committee.”

No doubt you can see where this is heading.

I’ll admit it. 

They wore me down. 

I gave up.”

(2) (Length: Medium)

This article contains a nice array of mini-profiles of mentally tough individuals including the skills, traits, and tactics they use to maintain a mental edge.

"There's a reason why even though most people hit a wall at mile 16 during a marathon, they’re still able to finish. Goggins explains it through his "40% rule: When your mind is telling you that you’re done, that you’re exhausted, that you cannot possibly go any further, you’re only actually 40% done.

"Your brain is wired to protect you," Johnson says. "Most of the time our brain will show up to protect us when we don't need protecting." If you do one difficult task per day, you can increase your threshold for discomfort.”

(4) (Length: Medium)

I've recently aimed to learn more about charitable giving -- specifically when is it best to give and what is it best to give to. There are tons of interesting arguments in this realm, e.g. the financial rationale of waiting to donate till you die vs the contrasting argument of giving while you live, or the debate between giving cash vs giving physical items. This piece provides a helpful introduction to some of these questions.

“Generally, you should only give something other than cash if you are confident you know the recipients' needs better than they do. With the exception of bednets — which really do seem underprovided when they're just put up for sale rather than given away for free — I'm not confident of that. So I gave cash.

As the World Bank's Jishnu Das once put it, "'Does giving cash work well' is a well-defined question only if you are willing to say that 'well' is something that WE, the donors, want to define for families whom we have never met and whose living circumstances we have probably never spent a day, let alone a lifetime, in." If you're not willing to say that, then you should strongly consider giving cash.”

(5) (Length: Long)

It's always a pleasure to hear world-class performers discuss their craft, whether it's Lebron James talking basketball, Magnus Carlsen talking chess, or Tobi Lutke (Shopify's CEO) talking entrepreneurship. We're lucky to be alive in a time when this type of insight is so accessible. I highly recommend this read (and the broader series by Sriram Krishnan called The Observer Effect).

“One of my biggest beefs with engineers, in general, is that they love determinism. I think there's very little determinism in engineering left that's of value. An individual computer is deterministic; once you introduce even just a network connection into the mix, everything becomes unpredictable and you have to write code that's resilient to the unknown. Most interesting things come from non-deterministic behaviors. People have a love for the predictable, but there is value in being able to build systems that can absorb whatever is being thrown at them and still have good outcomes. 

So, I love Antifragile, and I make everyone read it. It finally put a name to an important concept that we practiced. Before this, I would just log in and shut down various servers to teach the team what’s now called chaos engineering.”


As always, I would love to hear updates about your life and what you have enjoyed reading, watching, and engaging with over the last month. If you are free to catch up or reconnect, please reach out. And if you know anyone who else would enjoy receiving these content, feel free to direct them here.