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Welcome to the Five Codes Podcast, where we discuss evidence-based methods to elevate yourself to the next level through optimizing the way you look, move, perform, feel, and connect.
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On today's deep focus, I want to go into making your workspace as perfect for focus and concentration as you can get, optimizing your workspace.
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My best example of this is my operating room.
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It is my absolute dojo.
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It's my place, it's where I get into my flow state.
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And I got to purpose build my operating room with all of the things that we're going to talk about today to help my focus, help my creativity, help my attention.
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Basically, all of those things that I would want if I was having surgery in a space, I want my surgeon to have those too.
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I got to build them into the space.
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The cool part for you is being able to pull the aspects out of this, whether your workspace is an office, whether it's at home, whether you're at a library working, whether you're setting up at a coffee shop, there are elements of all of these things that you can take.
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Simple tools, simple strategies, things you can do to make wherever you're working as optimized as possible.
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I happen to be in the same place every time, doing my thing, my passion, my craft.
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And so I got to really build this workspace around it.
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But there's a lot illustrated in here that can be very important to you from lights to positioning to sounds, all kinds of things we're going to talk about today.
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And the first of those is lighting.
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And this gets beyond just what I do for lighting when I wake up in the morning on a surgical day.
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I live in the northern hemisphere in Cordlean, Idaho.
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And so different times of year, I have different amounts of light.
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I'm focused a little bit more.
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I've done a whole podcast episode on just that, actually, on the five codes that talks all about how to use light, especially with changing seasons.
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This is a little bit more around the structure inside of the operating room.
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Inside of my operating room, I'm starting in the morning with my surgeries, and so there's changes throughout the day, but the light is optimized not just for myself, but for my entire team as well, to be focused and at attention, but not overly fatiguing, because the different types of light can do these types of things.
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You've heard me talk about stimulating these very specific receptors in our eyes called melanopsin receptors that are part of these intrinsically photosensitive retinal ganglion cells and very specific wavelengths of light, specifically around 480 nanometers, heavily stimulate those to get our attention at its greatest.
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This is like mimicking a very bright sunlight, but we don't want to do that for too long or the wrong times of the day because it can be fatiguing.
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So I sort of use that in the morning for myself and for my team.
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And then I'm really thoughtful about the types of light that I'm using throughout the day, using the light when I need it, but also not trying to overfatigue everybody.
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So a prime example of this that's very unique and rare is that in my actual operating lights that I'm using for in the field that I'm working in, I will change the temperature and the intensity, the brightness of those lights throughout my surgery throughout various parts of the day, throughout various tasks.
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Sometimes I'm at a really focused task.
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I want great visual differentiation.
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I will make the temperature cooler, if you will.
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That is changing the Kelvin temperature of the light so that I have better visual differentiation and more stimulation of my melanopsin receptors.
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At other times, when I'm working, say on the skin surface instead of in a space or I'm not dissecting, whatever it may be, I may make it a little bit warmer of a temperature, which is a little bit more relaxing for everybody, gives us a bit of a chance to visually recover, and I don't need as much differentiation in those situations.
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So how this would apply to you is what time of day are you working?
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Is it early in the morning?
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Is it the afternoon?
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Is it the evening?
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If it's early in the morning, you want bright, stimulating light.
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That's also going to help your entire cortisol curve and your cortisol response, which is a side note of things that I think about in surgery.
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But you want to make sure that you are getting bright, stimulating light early in the day.
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And then as things get going in the afternoon, you might want to think about calming down the intensity of the light from a color standpoint, from a wavelength, that is, and also from a brightness or an intensity standpoint.
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So you might want to be calming those down, even thinking about the positioning of your lights.
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Overhead lights are very stimulating.
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They hit different parts
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of our retina than when lights are lower, physically, structurally lower in our visual field.
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So these are all things that I'm thinking about in surgery.
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And I very, very uniquely have lights set in a way that is able to be adjusted for the task that I'm doing at hand.
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I'm in the operating room sometimes for 10 plus hours, so is my entire team, and we want to make that as optimized as we can.
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Sticking with the theme of how our eyes are important to our focus and attention, the direction that our eyes are facing or gazing is also very uniquely important.
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So we all know that we can move our eyes up, down, left, right, things like that.
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And there's clusters of neurons in our brain that help control this, but very interestingly, the positioning of our eyes, the muscles that control that are tied to different clusters of neurons in our brains that have different effects depending on what is happening with our eyes as far as where our gaze direction is.
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So, for example, the clusters of neurons that help us down gaze, that means physically look down below our nose, those clusters of neurons also help to stimulate sleepiness and relaxation, right?
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The opposite of that being the clusters of neurons that help us look upwards, that stimulate those extraocular muscles to help us look upwards, help us with focus and creativity.
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So something as simple as the direction that your eyes are gazing can control these things.
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So this is how I leverage this in my workspace.
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I use a very specific type of what's called loops.
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These are the funny glasses that you see me wearing that have the little uh let's call the loop on there that controls the magnification and the direction.
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I have a very special loop that allows me to look forwards in my gaze.
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That means at the level of my nose or above, but the reflection of that allows me to see what's happening in my lower visual fields.
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So this is very specific and purposeful.
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This allows me to maintain the stimulation of the clusters of neurons that allow that stimulate up gaze.
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This is my focus and my creativity.
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These are really important things that you would want your surgeon primed on in surgery.
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They allow me to keep those engaged while I'm working in an actual visual field that is below that.
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It's very interesting.
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If you've ever seen me working, it looks like I'm looking out the window or looking forward on the horizon, but I'm really working in a space below.
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That is very purposeful to take advantage of my eye gaze positions.
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Now, that gets magnified to an even greater degree when you look at the physical space that I'm working in.
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My operating rooms have very high vaulted ceilings, like abnormally high.
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It's really cool, actually.
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It was a very attractive aspect.
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And there's this really cool phenomenon called the cathedral effect.
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And the cathedral effect is very well described when you are in an open space like a cathedral and you are stimulated to look up into the air, up into the space above you.
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And these higher ceiling environments are very well described to stimulate more creative, abstract, higher levels of thinking.
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Which is crazy for me to think that the height of a ceiling has such profound effects on the types of cognitive states that we're able to access.
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But I leverage that in my operating room.
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Very uniquely, the photographs that I'm referring to hundreds of times in every surgery are very strategically placed up in the cathedral, if you will, of my operating room, so that when I'm operating and I'm looking, I'm stimulated to look up at this cathedral, up at this very large TV that has all of the photos that I need of the patient that I'm working on, which I reference quite often during surgery.
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I'm very, very much getting into that space to think.
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And literally looking up allows that creativity that I'm looking for.
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So it's very stimulated.
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It's not just the visual field that I'm looking in, which we just described with eye position, but it's actually taking advantage of this very creative, high-seiling, larger types of thinking by using the cathedral effect, which again is very, very well described.
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I also think it's fascinating that the opposite of this is true, where the cathedral effect is stimulating this creative, larger types of thinking.
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If we want more analytical thinking, think the type of process that you're in when there is one distinct right answer.
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For me, I think of studying for a test or taking a test.
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The opposite of this is also true.
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And when I really think back to my formative years of taking hundreds of tests, including some really, really important ones, I was doing the opposite of the cathedral effect, unbeknownst to me.
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I didn't even know what I was doing, but I knew that I had
blinders on, blinders on my desk, maybe I had a hat and a hood at a very narrow area that I was working in.
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I was not working in this vast, wide open space metaphorically.
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I was working in the tightest space that I could.
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And that was stimulating these more analytical parts of my brains, the black and white yeses and no's, memorizing correct answers.
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And so that's not a space I want to be working in when I'm in the operating room because everything is very creative, very flowing.
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And you definitely want your surgeon in problem-solving mode when that's happening.
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It's not all just black and white analytical.
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But I do think it's really funny that I sort of gravitated towards that in these other, completely other types of situations.
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So for you, this could vary with the task that you're doing.
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Are you working on something large, expansive thinking that's creative?
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Maybe you do want to be in a big vaulted open area, a big coffee shop with high ceilings, something like that.
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If you're working on something that is very like get this done, black and white, um, you know, hard numbers, things like that, you might want to be in a smaller space where there's not as sort of this vast landscape around you in quite the same way, uh, which I again I think is a really actionable item.
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What are you working on?
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Where do you want to be doing it?
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So beyond just our eyes positioned in space, whether they're looking down or looking up, the relation of our eyes and what they're focusing on together is also really important.
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There's a couple of channels or names for this.
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One of them is called a parvocellular channel, the other one's called a magnocellular channel.
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And so we don't need to remember that necessarily as much as in a parvocellular channel.
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In that type of vision, our eyes are invergence.
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They're converging on one thing, they're looking at something together, sort of in close range, if you will.
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And that's really important because that narrows our visual field, it helps us focus in, and it's very activating, stimulating, and helps us be focused.
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It makes sense.
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When our eyes are focused on something nearby and close to us, we are locked in, if you will, quite literally and figuratively.
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That takes energy and focus, kind of pun intended.
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It takes energy
because our eyes have to do something called accommodating, which is changing physical, physically changing shape to be able to do that together.
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So what that means is that act, that activation energy that it requires to be in this parvocellular channel means that it's fatiguing.
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And this is, we've all experienced this.
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This is why your eyes physically feel fatigued when you focus on something for a long period of time.
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And you can imagine in a 10-hour surgery that you're spending a lot of time in this parvocellular type of vision where things are convergence and you're locked in and you're focused.
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Takes a lot of energy, literally, for your eyes to do that, in addition to just the energy to be locked in.
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So this magna cellular vision is different.
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That's like a wider space, think like panoramic views.
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That's important to let us go into for a few reasons.
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Uh it helps relax our eyes, helps them kind of get their strength back over time.
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Uh it helps us relax that heavy, heavy locked-in focus that we're in.
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And I'm using this in my operating room, broken into naturally broken into breaks that exist throughout my procedure.
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Sometimes I do these as like what we call a movement snack where I'm physically moving my body, because on a side note, there's research that inside of the operating room, taking small physical breaks improves your performance and your outcomes and doesn't add any time onto the procedure to do that as long as they're relatively reasonable times.
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So I'm not just moving my body, refocusing my brain.
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I'm also letting my eyes relax in those times.
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I'm very fortunate that my operating room looks out at water, mountains, and trees.
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So I'm getting these beautiful views of fractal patterns, watching the sun rise or the sunset over the mountains.
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It's frankly beautiful, and it's hard to not be distracted by that, right?
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Um, but this is so when I get this magna cellular relaxation view, it is it's something else.
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It's really pretty to see.
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Um I'm very fortunate for that.
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And again, I chose my operating rooms for a good reason.
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Um but when you are locked in working on something very focused, again, in that vergence eye type of position where everything is like on a narrow space right in front of you, you do want to take breaks.
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The general recommendation is like five minutes of break for every 45 minutes of work or something along those lines.
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And that's just for your eyes.
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There's of course other types of focus and techniques that have to do with your attention span and things like that.
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But in general, I don't know that you need to get too into the numbers of this, but just knowing that you do want to change your gaze pattern, not just up and down, but how what you're focusing on from a distance standpoint into close parvocellular, virgence type of eye movements and faraway magnocellular thinking, broad landscape types of views to relax your brain and your eyes a little bit.
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The second I talk about working in a coffee shop, it makes me think of the background noises that exist as well.
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This is also very purposeful in my operating room.
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These background noises, whether they're white noise, pink noise, brown noise, you can look up the difference between those types of noises, has to do with frequencies.
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They can be certainly deleterious to your cognitive space, to your cognitive abilities, meaning white noise, pink noise, brown noise can take away from your overall cognitive capacity, especially as time goes on.
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And there have been studies of this showing whether it's like HVAC noises from, you know, the heating and cooling system, whatever it may be.
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Those types of noises take away from our capacity.
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Anyone who's been in the operating room knows that these sounds are notorious.
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Uh, one of the main ones would be like the suction that's on.
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Suction is a little tool that we use that is aptly named suction.
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Um, but when it's on, it creates this sort of background noise that is insidious.
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It just sort of like say eats at your soul a little bit.
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And the second that it gets turned off in the room, everybody who's been in an operating room has experienced this.
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It's this immediate sense of quiet relief.
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Like I didn't even realize that that was sort of rotting my brain a little bit in the background, what was happening.
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So that was something I was very cognizant of and immediately found the most quiet suction that I could.
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So this is something that is not running in the background, it's not eating into my cognitive space, it's not taking away from my reserve.
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I have it available when I need it, but it's also not something that is sort of running in the background, taking away.
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So that's a
really unique and interesting way to go about it.
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I think a lot of people think of the music in the operating room that's getting used.
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And that's something that I actually am not really tuned into, to be honest, because it's not white noise, pink noise, brown noise, it's nothing like that.
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It's it there'll be times that I'm tuned in and times that I'm not.
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It sort of depends on where I'm at in my surgery and the cognitive space that I'm in and whether I'm even paying attention to it or not.
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So certainly types of music I enjoy versus I'm not listening to things I don't enjoy, but I'm actually not as into that as you might think one might be because I am not tuned in.
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Now, here's an area where you can use sound to be helpful to your cognitive space.
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There, for me, the one way that I really get to do this is there's these types of frequencies or sounds called isochronic sounds.
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This would be like the, for me, it's the the heart rate of the of my patient.
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The the beep, beep, beep, beep, beep, beep, beep, beep, kind of that sort of rhythmic thing.
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That can interestingly enhance focus when you get tuned into those.
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So I've always liked to be able to hear that.
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Um, and it kind of keeps me like quite literally in tune, attuned to what's happening with my patient, which is one of my I want to be attuned to what's going on.
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Um, but it also probably has that focus enhancement that I've always gravitated towards as well.
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So the the one thing I wish I could do.
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So this is a I can't do this, but you should take this away into your workspace, has to do with bineural beats, right?
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Bineural beats are where you have a frequency in one ear and in the other, and your brain sort of finds a space between them.
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I use them for my patients, interestingly, before we do anesthesia to help calm down their autonomic nervous system.
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This is stimulating their parasympathetic nervous system, essentially to relax them before they ever go have anesthesia.
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That means we need less anesthesia, less of an induction dose.
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It's a more calm process.
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So I'm using very specifically like delta theta waves.
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This is very unique, by the way, to do this for my patients before they go in.
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It's a very simple way to be calming without pharmacology drugs and to get them in a space that's sort of ready for anesthesia.
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Anyone else who's had anesthesia might know that, like, oh, before you go back into the operating room, they want to give you a relaxing medicine, which is usually a benzodiazepine or something like that.
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Well, I'm not using benzodiazepines at all anywhere in my entire anesthesia process.
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I'm certainly not using them before you go back to relax you when we can use other simple tools that exist, something like binary beats.
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But so my patients are using these.
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I can't use binary beats because you have to have sort of your ears both occluded, if you will, and have to have this sound, you know, it's this idea of like the woo-woo woo-woo woo-woo happening between your ears.
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Um, I have to be able to communicate with my team.
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I want to hear heart rates and things like that that are going on.
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And so I actually have unobstructed hearing during the procedure, which means I can't use the binaural beats, but if I could, or when I'm doing something productive, you can also use binaural beats to beat, enhance your focus and your stimulation.
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This gets to different frequencies than I was just talking about for my patients, something more along the lines of like 40 hertz and like that, you know, more like the alpha ranges of our brain waves are going to be stimulating and help you with your focus during your procedure.
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So if you're sitting at a coffee shop doing some meaningful work or you're doing deep focus at home or wherever it may be, binary beats can be a helpful addition to enhance your focus.
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So that would be something I can't do that I wish I could do, that you could take away and utilize in your own workspace.
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A really interesting aspect of your workspace that almost kind of goes without saying, but is often not thought about enough, is just your positioning and interruptions.
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So for me, just laying this out, it happens with the door entering and exiting the operating room.
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People are throughout a surgery entering and exiting, people are switching shifts, people need to go grab supplies, whatever it may be.
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So the door is getting used during the procedure.
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And you can imagine that you don't want your surgeon actually paying attention to who's coming in and out the door all the time.
00:19:17.759 --> 00:19:18.880
This is the support team.
00:19:18.960 --> 00:19:27.759
They are like busting it, doing their things, they're focused, they're tuned in as well, but you don't want your surgeon really knowing what's happening in and out the door every time.
00:19:27.920 --> 00:19:31.599
So
this is something I've gotten very good at just tuning out at baseline.
00:19:31.680 --> 00:19:40.079
But in my operating room spaces, when I get to control them, like design it, I'm very purposefully set to where my visual fields do not include the door.
00:19:40.240 --> 00:19:47.920
So, like I said, I am focused on the visual field in front of me, and I'm using my ergonomic loops, which means I'm looking forward, working down.
00:19:48.079 --> 00:20:00.640
And then when I am breaking visually, I'm looking up in my taking advantage of my cathedral effect, looking up at the television, getting into that very creative space, looking at the patient, and I'm back into my field.
00:20:00.799 --> 00:20:08.000
I do not have distractions coming in from people entering and exiting through the door, which is again a very important thing.
00:20:08.160 --> 00:20:12.559
But this would be applicable with sometimes just like what part of a desk you sit at.
00:20:12.799 --> 00:20:17.440
You don't want the door entering the room that you're in right in your visual field.
00:20:17.519 --> 00:20:23.839
Or if anybody's ever worked in a coffee shop, you might turn your back to the entrance to the coffee shop to see where people are ordering coffee.
00:20:23.920 --> 00:20:28.480
You'd maybe put your back to that so that you're not being distracted by people entering, people ordering coffee.
00:20:28.559 --> 00:20:32.079
It's it's just a bit of human nature here as far as things to avoid is.
00:20:32.240 --> 00:20:34.880
So it's just positioning yourself to avoid distractions.
00:20:35.119 --> 00:20:39.920
Your physical position in your workspace matters too, meaning whether you are sitting or standing.
00:20:40.079 --> 00:20:47.920
Uh, the best, spoiler alert, the best is a mix of sitting and standing, which is very, I'm very grateful that I get to do that in my operating room.
00:20:48.000 --> 00:20:49.519
It's designed around that.
00:20:49.759 --> 00:20:52.640
I stand, I sit, I go back and forth throughout the day.
00:20:52.720 --> 00:20:56.319
It depends on what part of the procedure that I'm doing, but my team has that very dial.
00:20:56.400 --> 00:20:58.480
That's a bit of a dance between getting up and down.
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We know exactly on this portion I'm standing, on this portion I'm sitting, and I get to go back and forth.
00:21:03.440 --> 00:21:07.519
So I get to take advantage of the mix of sitting and standing.
00:21:07.680 --> 00:21:21.359
Um, people in you know workspace environments might know this just from sitting and standing desks, the ability to change your position up or down, uh, depending on your level of fatigue, how central the task is that you're working on.
00:21:21.599 --> 00:21:23.200
So these are things that are known.
00:21:23.359 --> 00:21:25.359
We know that we don't just want to sit.
00:21:25.519 --> 00:21:28.240
Um, that's not great for our health in the long term.
00:21:28.400 --> 00:21:31.680
There are certain tasks that we do really well when we sit and focus.
00:21:31.759 --> 00:21:38.799
Uh at the same time, standing all the time can be fatiguing, and you'll often see, if you really pay attention, this is uh something to tune into.
00:21:38.880 --> 00:21:42.079
You'll often see people that are standing at, they're actually leaning on their desk.
00:21:42.400 --> 00:21:44.640
They're not standing under full power.
00:21:44.799 --> 00:21:46.720
So that's not something I'm able to do.
00:21:46.799 --> 00:21:50.079
I'm truly standing or truly sitting, but these are things to pay attention to.
00:21:50.160 --> 00:21:55.680
If you find yourself leaning on your desk, it might just be time to sit before you can go to a pure standing session again.
00:21:55.759 --> 00:22:00.160
But the best is to be mixing, sitting, and standing when it comes to your physical position.
00:22:00.319 --> 00:22:03.359
So for me, my operating room is my most special place.
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It's privileged, it's unique, it's really cool to get to see it behind the scenes.
00:22:07.279 --> 00:22:14.160
I've got a lot of time in there in my life, and so I got to design exactly what I wanted in the exact way that I wanted it.
00:22:14.319 --> 00:22:17.759
Every detail is curated as you might imagine in there.
00:22:18.000 --> 00:22:19.359
I did it the way that I would do it.
00:22:19.440 --> 00:22:20.960
I did it the way that I would want it done.
00:22:21.039 --> 00:22:27.920
If I was the one having surgery on me, this is how I'd want my surgeon to, this is the environment I would want my surgeon to be in.
00:22:28.079 --> 00:22:40.400
So there's some cool ideas and strategies and techniques and tips and tricks and tools to take into your workspace, wherever that would be, especially if your workspace is variable and changing.
00:22:40.559 --> 00:22:41.839
Uh, I do this all the time.
00:22:42.000 --> 00:22:43.839
I'm not only working in the operating room.
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That's my most special work, but when I'm doing other things, I'm incorporating these techniques and tools and ideas as well with where I'm looking.
00:22:51.200 --> 00:22:59.440
Like I put my computer up when I'm working instead of down, just for the simple visual gaze types of things like at my nose level or above, which is kind of weird sometimes.
00:22:59.759 --> 00:23:00.960
Can't always do that.
00:23:01.119 --> 00:23:04.240
But when available, I'm trying to take advantage of those same things.
00:23:04.400 --> 00:23:18.319
And I guarantee the next time you walk into a big vaulted space, whether you're working in there or not, um, you will have now that you know what the cathedral effect is, you'll have that idea and that visual and you'll be like, oh yeah, I definitely felt that before.
00:23:18.480 --> 00:23:24.799
Um, but now that you're aware of it, it's something you might be able to leverage in your workspace or depending on the type of task you're doing.
00:23:24.960 --> 00:23:26.960
So hope you found this very helpful.
00:23:27.039 --> 00:23:33.039
Uh a little insight into how my brain works, what my operating room looks like, and how you can take those tools into your everyday life.
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If you have any questions or topics you would like me to explore further, please leave them in the comments.
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I read them all and they often help shape the future conversations here.
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I also want to be clear that the views shared on this podcast are my own and are not associated with or representative of my clinical teaching affiliation with the University of Washington School of Medicine, nor should this be taken as individual medical advice.
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Thank you for spending your time with me.
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I appreciate you being here, and I will see you on the next episode.