The Most Valuable Commodity: Attention

During the past week (as I write this), I came across two articles which focused on the subject of “attention.”

In the first, Toward a Medical “Ecology of Attention” (MJ Kissler et al. NEJM 2021; 384: 299-301), the authors assert that “in the clinical environment, the most important –and most limited–resource is attention.” They note that distraction contributes “to lapses in judgement, insensitivity to changing clinical conditions, and medication errors.” The article delves into modifications that can improve attention in clinical settings:

  • Prioritizing communications using triaging and batching
  • Designing physical spaces to improve concentration
  • Optimizing electronic health record to minimize attention spent maintaining the record outside vital patient care activities
  • Development measurement tools

The second article, “The Internet Rewired Our Brains. This Man Predicted It Would,” (title online is “I Talked to the Cassandra of the Internet Age”) assesses how the “the attention economy” and the internet are changing the country.

A few excerpts:

  • Most of this came to him in the mid-1980s, when Mr. Goldhaber, a former theoretical physicist, had a revelation. He was obsessed at the time with what he felt was an information glut — that there was simply more access to news, opinion and forms of entertainment than one could handle. His epiphany was this: One of the most finite resources in the world is human attention. To describe its scarcity, he latched onto what was then an obscure term, coined by a psychologist, Herbert A. Simon: “the attention economy“…
  • “Rational discussion of what people stand to gain or lose from policies will be drowned out by the loudest and most ridiculous.”
  • His biggest worry, though, is that we still mostly fail to acknowledge that we live in a roaring attention economy. In other words, we tend to ignore his favorite maxim, from the writer Howard Rheingold: “Attention is a limited resource, so pay attention to where you pay attention.”
  • Perhaps, just by acknowledging its presence [the attention economy], we can begin to direct it toward people, ideas and causes that are worthy of our precious resource.”

My take: I frequently relate a quote from Jim Gaffigan. He stated that his wife is great at multi-tasking but that he is trying just to task. I try to focus on what’s in front of me.

What NOT to say with functional pain

A recent article crossed my desk (from the “G-force”) which I hadn’t seen (or at least remembered).  So, although it is not new, it is a useful reference (Pain 2006; 122: 43-52).

In brief, the authors divided 223 children (n-104 with recurrent pain, n=119 healthy children) between ages 8-16 into 3 groups: attention, distraction, and no instruction.  After the children consumed water until they felt “completely full,” they were observed with their parents.  Parents in the attention and distraction groups had received video and written instructions; whereas the no instruction parents watched a video about the university.

Questions/statements that were typical in the attention group:

  • “I know it hurts now, but you’ll be OK later”
  • “What doe it feel like?”
  • “I can imagine it must feel really uncomfortable”

Questions/statements that were typical in the distraction group:

  • “Let’s talk about something else to get your mind off of it.  Tell me about ____”
  • “What would you like to do this evening?”

Key findings:

  1. Complaints nearly doubled under conditions of parent attention and were reduced by half under conditions of distraction (in comparison to the no instruction group).
  2. Female patients in this study had greater increase in pain complaints in the attention group than male patients.
  3. After water loading, children with a history of pain had significantly more complaints in the attention group than healthy children.
  4. “Unlike parents of well children, no parent of a pain patient rated attention as having any potential for negative impact on their child.”

Take home message (from Oscar Wilde -quoted in article): “While sympathy with joy intensifies the sum of joy in the world, sympathy with pain does not really diminish the amount of pain.”

Related blog post:

Anxiety and Functional Abdominal Pain | gutsandgrowth