Triaging Your Life

When everything seems like a crisis, Dr. Lila Pereira shares tips for taking a step back and prioritizing what’s important.
Dr. Lila Pereira

In medicine we have a term we call “triage” which essentially means multi-tasking in a prioritized way. We take the patients who are in crisis and see them first. It can be applied to an emergency room setting, a patient waitlist, or the day to day juggling of patient calls and other tasks. Because of my background I often view life as one big triage. Talking to my grandmother on the phone while cooking dinner, and hearing “Mom, hey Mom, Mommy look at this” and a cat puking in the next room. If that’s not the definition of triage I don’t know what is.

While moms often have the reputation of being super multi-taskers, one thing people often overlook about us is our ability to prioritize within the midst of chaos to consider the best way to get stuff done in an efficient and effective way. Unfortunately, the one way in which we fail this is when it comes to our own needs. Life shouldn’t be one big contest to see who can go the longest without eating a warm meal or holding in their pee. But somehow, that seems to go hand in hand with motherhood. And here’s the real kicker. While women have often be praised at having brains more capable at handling multi-tasking, there is conflicting evidence to support that this is true. At the most basic level, society just expects women to be good at this so we have to learn how to triage to make it so. The consequences of this are dire as it can leave us feeling overwhelmed, underappreciated, and burnt out.

So the next question becomes “what do I do about this?” And most importantly, “what do I do about this if I have no support system?” First and foremost, I think being aware of how your brain works is one of the most important things you can do as a human. This form of mindfulness is not practiced enough. I’ll note, this isn’t about saying “I am not able to…” but instead saying “how can I capitalize on my strengths so I can work around my weaknesses.” Ask yourself these questions:

1) Am I a morning, afternoon, or evening person? (i.e. when I am most productive, NOT when do I like to be awake))

2) What situations cause me to feel overwhelmed?

3) Am I a visual or auditory person?

4) What’s my cleaning process? (I know this is a funny one, but I’ll explain in a moment)

To take you through this, I’ll tell you my answers.

First up, I’m actually a late morning person. I have ADHD and I find that the time I am most productive is usually around 10am. I need to get into work, settle in and build up momentum and then I can get really focused on a task. If I ever have a hard time getting focused by that time I know something is off and I need to find a way to either switch to different tasks that don’t require deep focus or compensate with one of the coping skills I’ve learned over time. This way I can still be productive instead of spacing out for the next 6 hours and getting nothing done. When my husband first went to residency we were renting a house and I lived there on my own for a few months with our toddler before moving in with my parents. By knowing my “early” bird nature I came to the realization that while I hate waking up when it’s dark, I had to do it. At night most of us are exhausted anyway. So why burn yourself and trudge through chores then if that’s not your brain’s style? When I adjusted my schedule, I got most household things done and exercised before my son was awake. Once he went to bed I had nothing I had to do that I didn’t want to save until the morning and I could relax or go to bed too.

My answers to 2 and 3 are actually really related. I’m a visual person. For a variety of reasons processing what someone says to me when I’m being flashed a sparkly object just don’t compute. When there are too many auditory things going on at once, I start to shut down. As a result, when I really need to focus and get things done I stop talking. If I need to give out directions to get my team going (even if it’s to just tell people to get out of the way), I say it first and then get to work. Or I make it a point to tell people to wait to talk to me until I’m done so I can maximize my ability to triage and blast through my to do list.

And lastly, as I said, I have ADHD. I’m totally that person who moves from room to room cleaning multiple things at a time while then remembering I wanted to water my plants, and playing Words with Friends for 20 minutes mid-way through (don’t ask me how many times I have played that game since I started writing this blog!). I also move super quickly and have full expectation I will turn into my father some day and physically move people who are in my way while running around getting ready for a family event. What that ends up meaning is that unless I become hyper focused on a task, it is absolute torture to focus on any one thing for too long. I recently painted the doors to our house purple and I apparently did a horrible job because my style was to basically be ADHD and not be systematic about combing through the entire door looking for potential missed spots. I’m not allowed to paint anything anymore (score because I hate painting). If I don’t have the option to bounce around a task and avoid systematic completion steps 1-100, I reward myself with brief breaks. Sometimes this actually does turns into multi-tasking. I’ll get the mail and sort it, move along laundry, take the chicken out of the freezer for dinner late, or some other quick task I can do in 5-10 minutes before returning back to the task at hand. Whatever it is, I make sure it’s something I feel good about doing or getting done, and rarely do these tasks involve talking to people.

Whatever it is, I make sure it’s something I feel good about doing or getting done, and rarely do these tasks involve talking to people.

By maximizing my brain, I am not engaging in tasks that will exhaust it or do in an order that does not make sense to it. I’m able to feel good enough about being highly productive that I have guilt free time for myself when I’m done. Because I’m lucky enough to have help, I also know how to ask for it when I need it, while playing to my husband’s strengths (read: future painting projects, he also irons for the same reason) and abilities of my 6 year old. If I didn’t have help I’d also know what will take me more time and how to best take care of myself cognitively and emotionally on those days.

Now that you know how your brain works, let’s get back to how I started this whole blog. Triaging. These answers should now be simple:

  • Does this need to get done now?
  • How long will this take?
  • Does this REALLY need to get done now?
  • Will I remember this if I don’t do it right away and is it easy to do it quickly?
  • Does this really need to get done now?

I hope you read the side eye with that last one. Unless it’s cleaning up the cat puke before the dog eats it—and then throws it up again in a few minutes—or burning your house down because you burned dinner. I don’t think it really needs to get done right now and you can do things your way. Everything else can get written down in your planner of choice (Google calendar? Phone alert system? Handwritten to-do list?).

And moms, to be really clear about everything I just said. This is not about getting through everything. This is not about taking on more work (wait until my next blog when I talk about how “the reward for success should not be more work”). The medical world hates having to triage, but we also recognizes that it takes away the guess work of what to do moment to moment (Decision fatigue is real!) while helping us make sense of a stressful world around us. I hope that this blog helps you to recognize those things in your own life so you can make sure your brain is not so tired at the end of the day you don’t crash and feel guilty about taking care of yourself. I want you to be able to say: I did what I can, I feel good about this plan, now let me sit outside and ENJOY this glass of pinot on the porch while my kids play, instead of drowning in it.

Dr. Lila Pereira is a licensed Pediatric Psychologist and Assistant Professor of Pediatrics and Psychiatry. She works and sees patients with a history of cancer or blood disorders in the suburbs of New York City at a large Academic Medical Center. Her research explores the importance of different forms of peer support in families facing pediatric and young adult cancer. She is also a board member of Families in Psychology Project, a research and advocacy group supporting psychologists in their quest to become parents while progressing through the academic pipeline. She has conducted research examining the barriers trainees and early career psychologists face when starting a family of their own.

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