When I look at my day there are 2 spaces that occupy my time.

The first is my creative space. This is where I shape things that didn’t exist before. Ideas, programs, writing, new presentations and initiatives.

Next is my reactive space. This is the operational part of my day. Most of this time is centered on problems or emerging issues. Something arises and I react to it. This includes emails, meetings, phone calls, medical license renewal, administrative crises and other practical concerns. Reactive work isn’t trivial or less important, it’s just different.

Clinical medicine is fundamentally reactive. Patients have signs, symptoms and deviations in their health. I respond to right, or help manage, what appears to be wrong. Medicine can and should involve creative work, however.

I’m always in one of these two spaces. Never in between. Every day’s a struggle between the two. If I’m inefficient in my reactive space then I effectively lose the capacity to make things.

For those looking to make a mark or move the chains, the challenge is managing and containing the reactive space to make time for the hard work.

Image via Flickr | University of Liverpool | Upper skeleton from Andrew Bell’s Anatomia Britannica (1770s-1780s)