How Physicians Can Manage Unexpected Free Time

I was taking a medical history on one of my young male patients. In his mid 20s, married, with two young children, he struggles to find enough hours in his day to sleep. We discussed the short and long-term importance of adequate rest, to which he readily agreed.  He reported it was hard to manage the time between kids’ bedtime and his own bedtime.  Even as I advised him of the tantamount importance of sleep and rest, I chided myself inwardly for my own misuse of this evening time in my own home.

I am not sure of the underlying physiologic principle in which I am dragging by 7:30 p.m., ready to put myself to bed shortly after the kids go to bed, only to be hit with a burst of productive energy after the last little head hits the pillow.  I jump up, my mind already racing through the to-do list. Do I do the ironing that’s been sitting there for months? Should I make a cup of tea and start the new novel I just checked out from the library? Or, maybe it’s time to tackle a huge project like organizing all four kids' school projects from kindergarten until 5^th grade in a compact, visually-appealing way. 

Of course, the right answer is to get to bed. That’s usually not what I select, though.  Sometimes, even when I’m being good and go get ready for bed, I end up taking 20 trips up and down the stairs before I finally turn the light out. I just need to finish “one more thing” before bedtime. It is difficult to put this time - really, the only uncluttered two or three hours most working parents get - to good use. 

I face the same challenge at work. If I have a patient no-show, I should gain at least 20 minutes of time to finish my charts, make a phone call, sign the stacks on my desk.  Instead that time seems to evaporate and I am not sure what happens to it. Why is it so difficult to use unexpected free time wisely - either going to bed or getting needed work done? I wish I had an answer.

Even though I struggle with this as much as anyone else, I have a hypothesis why this occurs in my home and office and yours as well. It is a two-part theory.  The first part is that the list of things to do is simply too overwhelming.  I plan to go to sleep after the last kid is in bed but when faced with a surge of energy to last another two hours, I am paralyzed by the long list of things I could or should or want to do and don’t know where to start. Instead of having a plan as to what I’m going to do, I wander aimlessly through a few different things. The second part is decision fatigue. I must make about 30,000 decisions each day.  When unexpected time comes up, I simply cannot make another decision about how to triage that time and end up doing whatever is easiest - whether that’s catching up on Facebook nonsense or reorganizing the pen container on my desk.

So now, I'd like some answers. Readers, how do you use unexpected free time wisely?