Lesson 7: Taking notes in a Way that Writes your Content and Makes you a Better Physician

Here’s the handout (the transcript is coming)<–

Objectives

• Develop a practice the creates notes that build your content from the bottom up.
• Learn to insert that content into a growing newsletter that goes out automatically to every new patient and to everyone who subscribes to your email newsletter on your website–the result is that every person sees every email that you ever wrote.

Tools

• ONTRAPORT
• 3 x 5 index cards
• 4 x 6 index cards
• a box for the cards
• Zotero
• Focus
• Sabbath app

ONTRAPORT assets

• Free ONTRAPORT trial (buy the pro version if this software beats your current software).
• Newsletter (click this with your Ontraport account open on the same computer and it will automatically install)
• Lifetime Customer Asset (click this link with Ontraport open on the same computer and it will automatically install into your Ontraport account).

References

• Smart Notes
• Becoming a Writer
• Pomodoro Techniquef
• A Way of Life
• Stress for Success

Video of Week 4, Lesson 7

Transcript

Thank you very much for being here today. This is the point where it gets really interesting regarding this outrageous idea that, somehow, writing emails can make you a better doctor. It starts to come together, I think, even more plainly today.

DAVID OGILVY TIP

We’ll start with David Ogilvy. I want to make a rule per class with him, and one of his big tips when advertising medical procedures is the following: Do not strain credulity.

To me, that translates to that if you watch the TV ad, you know they’ll spend the last third of the ad talking about all the horrible things that could happen to you.

And you would think that would scare people away. It doesn’t because it actually gives more credibility to what they said. It might be good if you’re willing to say all the bad.

And so I recommend what you do is as follows: on your website itself, you have a link to the actual consent form. This is a way to practice credulity.

If you have a webpage that discusses a procedure, you should include the consent form somewhere on the page. It’s right there; see our main O-Shot page.

When you open that up, there’s a copy, so look at everything we list that might go wrong. If there’s something that I left off of that list that could go wrong with the vagina, tell me because I want to put it on there.

I listed many things that I’m not aware of it ever being caused by an O-Shot, but it might be one day. Nobody’s ever had an embolism. I don’t want anybody to think that we didn’t think of the possibility of something and then blame us for it.

If you gave a million women a Tootsie Roll or an ice cream cone, out of the million, someone might get an embolism the next day. That goes on our consent form. People realize that we have to be careful about things. And so the actual conversation is different in that, well, we haven’t seen this, but we have seen urinary retention in four cases so far that we know about. We don’t know of any infections.

Actually, PRP helps infection, but it’s possible. You have the conversation, but you list everything that could go wrong. Watch the next TV commercial where they advertise a drug and listen to that rapid talking where they make a list that’s that long. They just talk so fast. They do it in about 30 seconds.

So that’s my Ogilvy tip for the day. Let’s go back to our outline.

A Way (of Making Notes) That Writes Your Content

I want to give you a way of making notes that writes your content for you, and then it’s personalized content. Look what’s coming from Medicare. So proposing a 3% pay cut in 2025. When you add to that 3% inflation, that’s a 6% cut in your ability to buy things. And then when you have to pay taxes on that extra 6% of work you have to do, you have work 10% more, one extra patient for every 10 to make the same amount of money.

But if you’re doing an all-cash practice, you can actually make your charges stay in line with your value and with inflation. No one gets to tell you this sort of thing. So, this is just a little reminder about part of the reason we’re doing it. But it’s not just about the amount of money we make.

I want to show you a quick video. I don’t know if you’ve read any of Robert Greene’s books. He wrote Seduction, Power, and the Laws of War. And maybe you don’t know it, but while he was writing those books, he used this guy right here, Ryan Holiday, who was a young kid at the time. Ryan—I think he’s written 12 books now that have been bestsellers—but he was Robert Greene’s research assistant.

Robert Greene was a broke historian, a kind of nerdy guy who wrote multiple huge bestseller books. And I don’t know if you have read any of them, but I’ll give you an example of one.

When I saw him recently, I called him after his lecture, and he is still writing and following this method. And it’s a pencil or a pen and paper and index cards. So these are huge books and he’s made huge amounts of money with them.

Let me just let Ryan Holiday explain the system that Robert Greene taught him. It’s about eight minutes, but it’s worth listening to. So here we go,

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Ryan Holiday on Writing and Reading

A Professional reader, that’s really what authors are.

Having written 11 books now, I’ve read a lot of books.

So what I thought I’d do today is explain my method for reading, for organizing what I read, and keeping what they call a commonplace book [what the Smart Notes Book calls a “slip box”] that organizes all that information in a system that I can refer to in the course of my actual life and do on an almost daily basis.

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How to Integrate William Osler with Ryan Holiday

Before I finish the Ryan Holiday tips, let me just tell you what William Osler said in his lecture, A Way of Life.

William Osler as you know, he was the physician. He was like the Tinsley Harrison of his day. He attended Walt Whitman; we’ve talked about him before. You can’t really be around me much without me talking about William Osler. A Way of Life was published in a book, but it was originally a lecture. And I think I mentioned last time incorrectly that it was a lecture at Johns Hopkins, but it was actually a lecture at Yale, even though he started internal medicine at Johns Hopkins. He was lecturing the graduating class of the Yale Medical School. And by this time he was in his prime. I recommend you read this lecture once a year.

Someone gave me a copy of this lecture when I was still a resident.

I think it’s one of the most valuable gifts anyone gave me. He wrote it on the train, and then he finished it the night before in the “graduates club” on campus just before giving the lecture. He worked on it up until he went to bed the night before the lecture. So, the last part of it was actually written on the stationery where he was going to give the lecture.

But he was brain-dumping how he lived his life.

So, the following contains private ideas about how I took what he wrote and applied it in my life, It’s almost like dropping my pants, but I don’t know how to do this course without exposing how I do my life.

And so what Osler said was that you should devote four to five hours, four to five hours a day to reading, day, after day, after day, after day, four to five hours. And, of course, no doctor really has time to do that.

Or at least we think that.

Devote 4 to 5 hours per day to reading.
                                                            – William Olser

As a compromise, what I’m recommending that you do is what Dorothea Brande wrote in a book called Wake Up and Live! and in another one called How to Be a Writer: devote 30 minutes a day, every day, where you just think about one subject.

Eventually, what you make from this knowledge can become so profitable that you can carve out more and more of your morning (because you no longer need to see as many of the patients who bring you less soul satisfaction and take up much of your day) until, if you want, you can spend those four to five hours a day in the morning thinking and writing and save the afternoon for your patients, your family, and your staff, and paying the bills and whatever, going to a movie.

But how do you get that much time in?

4-5 hours a day? Or even 30 minutes a day?

30 Minutes Every Morning, First Thing, Thinking about the Thing about Which You Want to be an Expert

Practically speaking, I use an app called Focus F-O-C-U-S.

You can download it. This idea came from two different places. It came from what the software people do. They call it Pomodoros, where you can sometimes be working on software, and you get so busy you forget what time it is. It’s been three hours, but you’ve quit working on the thing you want to work on.

So they set themselves 30-minute timers to stop and think, “Okay, is this the right thing? Am I still working on the right thing?” They get a glass of water and then get hooked back in.

I first encountered the idea of 30-minute runs followed by a break in a book called Stress for Success. I know I’m jumping around, but these ideas have been huge for me.

Stress for Success was written by a man whose claim to fame was helping… That’s the original book that I got back in the day. His idea was that stress makes you healthier, not less healthy. Stress is what you do when you lift weights and when you go running, and no stress is an astronaut. You go long enough without any stress, and you can’t even walk.

And so he was a big consultant to high-end athletes. I don’t know if you remember years ago, the guy fell as a speed skater because his sister died and he was distracted. This was the man they hired to get his brain back in the game, and then he came back and won the gold medal.

But his idea when he wrote this book is if you’re a pitcher for a big league baseball team and you bomb out, you really, nothing bad happens. You just open a car lot dealership and you still do well. But if you are an ER doctor and you do something wrong, somebody dies, or you’re a surgeon. Or even if you’re just working in business and performing, you don’t have the fallback. And so, in many ways, we “average” people have more stress than the guy who’s pitching in the World Series. That’s the truth.

So he took those ideas and talked about how to thrive on stress. And you are already thriving on stress. You’re a surgeon, or you’re an ER doctor, and you make life-and-death decisions before lunch every day. If you are a family practitioner, you’ve lived on stress your whole life, but then how do you practically bring that into your life?

So he’s big into morning routines.

Part of the morning routine is to think for 30 minutes and schedule your time for when you’ll take care of yourself. I think you do it before anybody gets to you.

Please watch the following video…

So if you spend at least 30 minutes thinking about your thing and then go for your walk or whatever you’re going to do to prevent a heart attack, now you’re invincible. Your brain is developed, you have new ideas, you’ve done what it takes for you to be healthy, and you can go be invincible.

More about Note-taking

So back to this note-taking idea and how this works together with William Osler.
So you’re taking, you’re reading, you’re thinking about your thing for 30 minutes. How do you turn that into your email? Let’s finish this video. I know it’s eight minutes. Sounds like forever, but let’s get through it.

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More from Ryan Holiday

When I read, I read with a pen, and I read physical books. I know that other mediums are easier. But to me, too many screens in our life, you’re watching this on a screen, reading should take you away from screens ideally. I take the time and I sit down with a physical book.

As I’m reading, I’m either highlighting or writing in the margins.

I’m breaking it apart.

I beat the crap out of it.

When I meet people who have read my books, and they show me all the dogeared copies, and they beat the crap out of it, I take that as praise.

You’re supposed to be in an argument in a discussion.

It’s a two-way street with you and the author. So when I read, I fold the pages. S

ometimes I use these highlighter flags.

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Ryan Holiday and Robert Greene Applied to Doctors

Let me back up a second, or just add to what he’s saying.

So there’s one book I highly recommend you get. I know I talk about a lot of different books, but this one is a game changer, and it’s called How to Take Smart Notes.

It’s a study of a German PhD who was so prolific in writing in their area of sociology that people have studied how he got so much done.

So my method of applying his teaching is as follows (and it is in synchrony with most of what Ryan Holiday and William Osler teach):

I’m reading,

I’m observing patients, I’m thinking, and I make notes.

And it’s not complicated. It’s in a notebook. Usually, I just carry around either my Moleskine or a clipboard with notebook paper, college rule notebook paper.

If I’m out walking, I used to carry a notebook. It’s just too nerdy and harder to keep up with, so I stick three-by-five cards in my pocket.

Then, when I have an idea, it goes on those pieces of paper.

This can happen all day long, while I’m seeing patients, reading, and living my day. Then in that morning,

Osler did recommend four to five hours, but I’m saying at least 30 minutes.

Then I take out my notes, and I think. I

might read some more, but thinking may mean I’m looking and I’m just organizing my notes.

Why just read other people’s books or why wait to read the book that you wrote, it’s okay just to read the notes you made.

Not only is it okay, but it’s desirable to read the notes you made, go back, and see what you wrote yesterday.

Then, you take those notes and make permanent notes.

You’re about to see Ryan Holiday talk about what Robert Greene does when he makes notes on four by six cards.

And then those get organized in a box.

This may sound complicated.

It’s not.

You live your life, you have an idea, a patient tells you something, you read something in a book, you make a note.

I don’t really like marking up books. I used to do that a lot, but I wound up with a lot of marked-up books. But they’re on my shelf again, and they’re not helpful to me because the notes in the books are hidden in the books. I must remember I wrote that on the back of that book, but the book is on the shelf.

So what this guy did and what Smart Notes tells you how to do is that instead of putting it in your book, you just write it in your notebook, whatever, a brief note.

Content Evolves from the Bottom UP

But then, that 30 minutes a day, you think about your notes, and you make something that’s more permanent, and it gets filed on a four by five card because it gives you more to write on in a box that’s organized, however, it makes sense to you.

But what happens as those four-by-five notes start to accumulate is that subject matter evolves from the bottom up instead of the top down. And this is a huge point.

The Opposite of Smart Notes (your teacher was wrong)

So what most people do, you’re assigned the topic in school, or you’re trying to come up with your PhD thesis, or just write a book report, and you decide what the topic’s going to be, and you say, “Okay, I’m going to write about the etiology of breast cancer.”

So that’s your title.

And then you have these different causes of breast cancer. Maybe it’s hormonal, maybe it’s inflammation, maybe it’s genetic. And then you branch it off from that. You mind map it and you write the thing.

The Flow of the Smart Notes Way

But the other way to think about it is if you’re making notes, you don’t have a predetermined thing.

You just have maybe a problem; it’s just breast cancer.

Instead of branching it out like that, you start reading and curating. And as you make your notes and file them, you’ll see one area of it just starts to get pregnant, and that pregnant area grows and it becomes a topic that you may not have anticipated. I’ll give you an example of how that has happened with me.

I decided that once I had completed my workshop, I got distracted by other questions and events, and I failed to teach the one—or two-hour cram course I usually take on cosmetic botulinum toxin.

So I told my wife, “Let’s go make some videos.” And it turned into 40 videos. I thought, “Well, since I’m not restricted by time, let me just brain-dump everything I can think about that seems relevant without going too far overboard about what I know about the use of cosmetic botulinum toxin.” And it took me 40 videos to get that done.

So then I thought, “Well, let me just turn that into,” and we’ll learn how to do this in the next week, how I’ll turn this into a book and a course. But one area of it, as I was collecting notes for one area, I was curating, not trying to think of anything new, just curating the notes of how botulinum toxin is used to treat migraines.

This one area started to build up about how it’s not about relaxing muscles; it’s attenuating the pain signals, the trigeminal ganglion, the caudate nucleus, and how it’s traveling along the axon.

Before I knew it, I was reading research and ordering books from the 1950s that explained how that happened—old neurology books from the 1950s and sixties that I couldn’t even find—and reading references, to references, to references. So I read a paper and then read the relevant references to that paper, and then followed that.

Then, I realized this is becoming its own topic about the changes in the autonomic nervous system secondary to injecting botulinum toxin. And that pregnancy turned into becoming more aware of how that research had spilled over into erectile dysfunction, which became pregnant.

From the bottom up, the idea of Clitoxin and changing female sexual function by injecting the clitoris with botulinum toxin came out. It wasn’t top down, it was bottom up starting from just curating information about botulinum toxin, which turned into how it affects the autonomic nervous system, which turns into, “This might help women.”

Faraday Math and Smart Notes and Getting Motivated

Go back to what Faraday said. Faraday said, and remember, he’s a physics guy.

He’s a mathematician. He said, “I hold it as a great point in self-education.” He wasn’t talking about just students. Edison was self-educated. I think that we’re all self-educated. College teaches you to read whatever subject matter it is, but it doesn’t really teach you the subject matter. When you finish a degree in chemistry, which I did, you can read a chemistry book, but you’re really not ready to go be a chemist. Now you go work as a chemist, and eventually, you know enough that you’re a chemist.

Same way as you guys know in medical school. You do four years of medical school and can read a medical book, but you’re not ready to be a doctor until you do your residency. And then you don’t become a wizard until some point after that, that’s maybe a decade later.

So Faraday wasn’t talking to high school kids; he was talking to us. Physicians who want to be not just a hack, not be satisfied with what they know, but to understand one part of medicine on a deep level and do miracles because of what they understand, and use the internet to let people know that they have this understanding.

So, we’re coming back to your emails.

I think this quote is worth putting on your wall: “I hold it as a great point in self-education that the student should be continually engaged in forming exact ideas and expressing them in language.”

“I hold it as a great point in self-education that the student should be continually engaged in forming exact ideas and expressing them in language.”
–Faraday

Look at that.

He’s talking about words (and he was a mathematician). I’m going to read you the rest of that quote. I didn’t put it all in here, but this is also Faraday.

“Accustom ourselves to clear and definite language, especially in physical matters, giving to a word its true and full, but measured meaning that we may be able to convey our ideas clearly to the minds of others.”

He’s not talking about being a teacher. He’s talking about teaching yourself.

And in the process of teaching yourself, you should express what you’re thinking. And if you can’t in the process of expressing it, you learn it. You truly learn it.

So there’s writing to teach. But in writing to teach, it becomes learning for the writer.

So, in my effort to write a book about botulinum toxin, I discovered how little I actually knew and wound up learning.

It is cliche; the more you study something, the more you realize how little you know, and it turns into writing to learn instead… But as a side effect, you might teach somebody something. And this is a mathematician.

So when you say, “Well, how does writing an email make you a better physician?” That’s it.

And that is really the heart of it: We’re eventually going to get back to what buttons you push, and there are no new buttons.

There are two automations I’m going to show you how to put into your ONTRAPORT account in the next lesson, but I’m showing you how to use those automations to change your life.

So Faraday says, in the process of teaching yourself, well, think about it. 30 years ago, you were just writing to yourself. And I remember back in the ’70s in high school buying…

There’s a book, you can still buy it. The Writer’s Digest publishes it, but it’s the directory of where to get published. And until you got a magazine, a journal, or a book publisher to agree that what you said was worthwhile, you were writing to yourself, which is harder to get motivated to do.

So if I just woke up today and said, “I’m going to talk about what we’re talking about today,” it would be harder for me to be as motivated.

But since I know I have very smart people who want to apply something that might’ve worked for me; then I’m at a different level. Even if you have two people on your email list, three people, four people, or five people, even if your list is just beginning, people are still going to read what you have to say.

So, it motivates you to think more clearly about how to say what it is you’re learning.

All right, so back to Osler. These were his ideas. We’ll come back to the note-taking techniques of Ryan Holiday and Robert Greene.

More Ideas from William Osler (which supports the practices of the 5-Notes System)…and who trained to be not smart

Day-tight compartments, four to five hours a day. He was big on connecting your mind to, he called it great literature, and he read the Bible 15 to 20 minutes a day. He said, “You don’t have to think about it, maybe the way your father thought about it.” That’s his quote. But you should read it, and it will change the way you think by rubbing minds with the great minds.”

So yeah, I’ve read the Gita, and Thoreau, and Emerson, and Shakespeare, and the things I would never admit to reading on the high school bus because it might’ve gotten me beaten up back in North Birmingham in the ’70s, because I’d be looking like I’m a smart ass.

And I find doctors still have that in them; you’re so smart. It was dangerous for people to see how smart you were.
When you’re among laypeople, I tell you to be as smart as you are. The world needs you to make things. The world needs smart people to be smart.

Also, as a resident, you were taught that if you spoke one of your thoughts, you were out of line. Until you publish fifty papers and are the head of a department at a medical school, you should only speak out loud when behind a closed door with one patient.

You were not allowed to be as smart as you are.

And by the way, Osler said his brains were of the most mediocre type.

And I’m with him there. I don’t think I have a superior brain. But he attributed his contribution to medicine to these habits—not just the four or five hours a day of reading, but thinking about his life one day at a time, rubbing his brain against great literature and scripture.

So, even with a “mediocre” brain, the practice of reading, thinking, making notes, and then making something with those notes turns you into the transcriptionist…and things fall out on the page that are unexpected and beyond what you thought possible.

This was a daily habit for Olser, too. Reading the Bible every day and other great literature to connect his mind with the great thoughts.

He also did not drink alcohol. He recommended no smoking. He also warned people about sex taking you away from your main purposes.

Sex energy is good. Harnessing sexuality in a transmutation sort of way is a whole different topic, but sex is one of the greatest motivators if it’s used properly as a motivator, the way Ben Franklin talked about it, rather than to the point of denervation, and being thrown in jail, and being worthless.

So now, to put that into practice, we just talked about smart notes, reading, observing, spinning 30 minutes a day, putting your notes. Sometimes, I just spend 30 minutes looking at a diagram in a book.

Sometimes, the notes are drawing a picture. I would add to what Faraday said: when you really understand it, you should practice expressing it in language and drawing it.

I know we did that in the third grade—draw a picture of the heart or whatever. But I’ve spent hours now looking at anatomy books, trying to draw the pelvic floor.

I’m not sure anybody really understands the pelvic floor. And maybe some people do, but when I read, the deeper I go into the literature, I realize, yeah, they understand it better than I do in many points. But there’s a certain point where it becomes very mysterious, to how even when you read the lead investigators, there are still big questions about how the pelvic floor and urinary continence work.

It’s like the layperson who thinks we’ve got everything figured out because we know that gravity is proportional to mass and the distance that two objects are from each other. But then you can make any physicist look stupid by asking three questions in a row. Well, that’s true. You described it, but have you really explained it? That’s a mathematical description, but it’s not an explanation. And Einstein died looking for an explanation.

He said, “God doesn’t play dice with the world.”

So yes, this describes it, but it doesn’t explain why two bodies are attracted by the laws of gravity.

And in the same way as you dive deeper into the literature, you all know this, you start to dive deep into one subject, and you realize that there are more questions than answers.

So, this is a huge point in how you practice this morning ritual.

Hemingway would wake up, and first thing, he would write the way I’m suggesting; he wouldn’t even take time to dress. He would go and do his writing. He had a chart that he kept on the wall to keep track of how many words he wrote per day. If he got behind, then that was bad. So that was his motivation to write a certain amount of words per day.

And he, as you guys know, he was a newspaperman at one time. And that’s how you’re paid as a news…

When I wrote for Medscape, I said, “How many words do you need?”

And they said, “They gave me a number.”

And that’s how you get paid. That’s your deal.

But you can’t sit down as a researcher, or a scientist, or a physician and say, “I’m going to write 2,000 smart words today,” because you have to first think of it, which means you have to curate and read the research, and sometimes you write nothing.

But you can always write notes on what you read.

And sometimes, I’ll draw diagrams to help me understand what I’ve read.

So those things that worked as a child that your science teacher got you to do still work. You get out your anatomy book, and you see if you can draw out the neuroanatomy of the pelvis if that’s what you’re studying. Or you read some research about how the pelvic floor muscles work together to cause urinary continence or incontinence, and you see if you can diagram out how it works; what did this paper really mean when they said that?

Then you curate it, and that goes in your box.

I promise we’re getting to the buttons here in a second because what you really want to know is, “Okay, I’ve got this in my brain now; maybe it’s even in my box, but how does it turn into patients coming to see me for exactly the problems I want to take care of to spend my days so that I don’t have to worry about this 3% cut in pay? And I’m doing the miracles I want to do and my bank account is growing.”

So we talked about this, the Robert Greene books. We’ll come back and finish that video in a second. Jack London, we’ve talked about. He lived with his notebook. He said he carried it everywhere. Einstein kept his notebook with him. Leonardo da Vinci kept a notebook.

So make notes.

Whatever your main thing is, sometimes you’ll get rolling, and it’s like having sex the day after you just had all-day vacation sex. You can get so denervated that you lose interest. So I recommend you keep your note-taking and writing about your main area of interest to no more than five hours a day.

I wish I had done this my whole life. You should take a day off. I don’t know why, but it works out. You think better. And I think it should be scheduled.

So, I keep an app that tracks the Sabbath wherever I’m living—an old-school Jewish Sabbath. It tells me when to stop, and so I do. Then I can start back on Saturday night if I want. I’m more productive because I took a day off.

The Jews only make up 2% of the population, but they have 23% of the Nobel Prizes, and no other ethnic group matches that. So I like to do what they do, so hopefully, I can approach being as productive.

If you can’t read and make notes every day, just start off once a week on Saturday morning or whenever you can carve out 30 minutes. But preferably first thing.

Then you’re curating, and you have ideas.

But then, after you get those ideas and put them in your 4 x 6 card file, you can turn them into a message, and we’re getting to that part. Then that message gets broadcasted to your group, and you make it evergreen, stack it, and make it an autoresponder.

Your notes become email messages, web pages, and more.

So that’s what I’m going to show you in a second.

Your Patients Want to be Voyeurs

But I’m telling you right now, let’s say that you read this morning something about the nervous system and how it affects incontinence. And you think, “Well, what patient would be interested in that? “Your patients would be. First of all, even if they don’t understand it, they’re interested that you’re still learning, and they like to be a voyeur.

Some like to see the Kardashians do things, show their cleavage, and balance a champagne glass on their booty, and things that they do. And I’m on vacation with my wife, and I’m looking at teenagers watching some sort of reality show where it’s a kissing game.

Well, some people like that.

But some people, like my grandmother, who subscribed to Prevention Magazine back in the day, there are those people who want to be a voyeur of their doctor getting smart. You may find that hard to believe, but your patients want to be voyeurs of their doctor being smart.

They don’t need you to be funny.

They don’t need you to dance.

They want to see what you learn that day and how you think it might apply to them. And they don’t care if they don’t understand every word of it.

So whatever you read that day, especially if you’re reading about problems which might affect them or their loved ones, which is what you’re going to be doing, then when you write a message about it, even if it’s a few lines with a link to the research, they will be interested and their respect for you will go up. If the thing you wrote about is not even something that you offer for money, it’s okay. Because as we talked about the last lesson, in the PS, you have a link to something that you do.

So if you just read about the neurology of the pelvic floor and how it affects continence, you don’t sell something that you’re not offering them something that directly affects the nerve specifically, but maybe the PS leaks to your EMSELLA machine or it links to your O-Shot as one of the ways that you treat incontinence, which doesn’t directly relate to the research, but it’s the same person.

So I’ll show you how to broadcast it, make it evergreen, and stack it. That will be the button pushing. That’s the part that fits into this whole system, and it’s how your thinking becomes part of your day. It motivates you to produce something. And by the Faraday method, you think about it more clearly, so you become a more thoughtful position about that topic. And then you broadcast it. Your reputation with your patients is elevated, and they call and make an appointment.

Okay. So in the morning, I have my Focus running. I’ll show you what it looks like. I turn it on you, I used it today to get ready for this session. So I click it and you can set it for whatever. When that goes off, I have it set to where my screen just blanks out, and I can only see that because it becomes full screen. And I put a link to this in the handout I’ll give you. I’m just talking now. I don’t even want you to look at the handout. But there’ll be a link, and this goes on my phone. It goes on my iWatch and on my laptop.

If I get up and it’s break time, my iWatch will be synchronized if I have it on. It is better to just use a physical timer and have your electronics off if possible.

So, usually, I take my phone, and I make it where I can’t even get to it, or else I’ll be doing things that are distracting me. So I lock it up with a timed box, which I think I’ve shown you guys. If I haven’t, it’s okay. I’ll put a link to it in the handout. But I put it in a box with a timer where I can’t even get to it. And I like it to be locked up a couple hours a day. My staff knows how to reach me if they have an emergency. Then, because they know where I live, they’ve been told if I have something that’s urgent, just drive to my house, because there’s going to be times in the morning for an hour or two where, don’t expect me to be looking at my phone. But if I stand up, this stays synchronized with my watch, and whatever, if my break goes a little over, whatever.

My goal is to do three 30-minute sessions in the morning. Sometimes, I need a break if I do them back to back.

Sometimes, I’ll just keep clicking this thing, and it’s 1:00 PM, and I’ve peed twice. But usually around the second or third time, my brain needs a break, and then I get up and I go for a walk, and then I’m invincible. That’s my day. No matter what happens, if I’ve done that and I’ve exercised, you can’t hurt me after that. My brain’s the better. I’ve made something, or at least I’ve approached making something.

My body’s healthy, and I’m ready to go.

What comes first?

Now, what about your spiritual practices?

Again, I don’t want to go too deep into this. However, I found that if I spend a lot of time doing spiritual practices, I can feel closer spiritually, but I’ve lost some of the energy for creating something.

So, to me, this is like a prayer. If you are praying without ceasing in the truest sense of the word, you’re not praying so that you can now go to work. You are connected to Something while you are working.

Again, I told you I was going to tell you everything. If that bothers you, I’m sorry, but that’s how I think about it.

After this exercise, I might take a moment, and then that’s when I might read my scripture or sit, pray, or meditate, but I get this part done. Every now and then, I’ll just feel disconnected, and I’ll move the prayer and the meditation to the front side of this. But most of the time, I don’t get my writing done if I do that.

I don’t want to be broke. And maybe I have less mental reserve, but I don’t think so because even the young Hemingway did it first thing in the morning. Charles Dickens, first thing in the morning. It’s just when your brain is best.

You are not composing literature; you are writing letters

Last thing. When you write these emails, it’s a letter to someone you love. Don’t take it too seriously. That’s the bottom line. In the end, we’re all dirt. We do our best, but the world keeps going without us. And I just do my best, put it out there, and I care deeply while I’m doing it.

Right now, while I’m doing this, there is nothing more important unless someone that I love is in some sort of physical danger, at which point I’ll be interrupted. Otherwise, nobody gets to approach me right now.

People have been told, “You don’t get to talk to me during this time,” and it needs to be that strict with you.

Here are some of the tools I use. I’ll get to the buttons here in a second. Actually, you know what? I’ll go ahead and let’s finish that video. Let me show you some buttons, and then we’ll get to how I use some of these tools. Let’s go back to that video. Let’s see, how are we on time? Oh wow, we’re coming up on the 50-minute mark.
So, let’s finish this video.

When we come back, I’ll show you the tools and buttons to push to create it as you’re practicing the system now that you’ve got these notes. How do you put it out there in a very easy, effective way?
So when I send an email, it gets broadcast.

But then it gets stacked. After a short time, that same email will eventually go to every one of my patients, so I’ll show you how I’m building that out.

But let’s finish this video by R. Holiday, and then we’ll take a break.

Transcript of Video by Ryan Holiday

I’m having a conversation. This is Cicero’s On the Good Life, which I bought 15-plus years ago when I read, and I took these notes. But I was actually just rereading it yesterday for a project I’m researching. So you’ll see there’s different, some of it’s in highlighter, some of it’s in pen, and as I was reading it, I thought I’d read it another time about five or six years ago looking at a project.

You’ll see things in the margins. Sometimes, it’s a word that I want to look up. Sometimes, it’s a story that I like. Sometimes, it’s an example, a moment in history that I know nothing about that catches my attention. So I’m folding the pages as I read often as well.

This is David McCullough’s biography of Truman. Truman famously said, “Not all readers are leaders, but all leaders have to be readers.” Again, you’re reading to get information that will improve your work.

So this is a short 1,100-page book. Probably took me a week or so to read. I spend a lot of time with it. I don’t read fast. Speed reading is bullshit.

But as I went through and read, I’m folding the pages that I like. I’m marking things that I think are of value to me. So you’ll see I probably did 100 pages here. This is a practice that readers have been doing forever. You read, you fold the pages, you write down, you argue in the margins. You’re noting what’s important to you.

And then what?

So when I finish a book like this, I let it sit. I put it on the shelf behind my desk, and I just let it sit, a couple weeks, a month. And then now’s the hard part, especially on a book like this. I know my hand is going to ache by the time I finish.

But what I do is I sit down with it and I break it apart, and I take all the things that I like, and I put it on note cards. So here’s a little story that I’m going to use in an email for Daily Dad. I’m writing a book right now about courage, and I actually use this exact quote here in the book. He said, “What made Mr. Truman great is that he decided.” This idea of not equivocating, of making hard decisions, making them quickly, owning them. This is an example of him living that idea and living up to it.

These are all things I’m going to write down on note cards. Let’s say I do this book. I might get this many note cards on it. So I’m taking the note cards. Where do they go? They’re not in a black hole. I keep what is called a commonplace book.

So, historically, commonplace books were published in journals. You can see Thomas Jefferson’s commonplace book. There’s commonplace book of Montaigne. They would just write down things that they like.

I do it on note cards, because this is what I learned from Robert Greene. Robert Greene famously builds his books about note cards. So this is my commonplace book. These are note cards on all different topics, things that have resonated with me that I’m going to use in one of my books. So I have different themes, themes about stoicism. I have themes about strategy, education. You can see in my book The Obstacle Is the Way began as just one little section of note cards in this box, and then eventually it spreads out to its own box. So in the corner of each card, I’m writing the theme of why that resonated with me, how I’m going to use it.

Eventually, if I’m going to use them as writing, they spin off, I take them out, and I collect them. A single book might be one or two of these boxes. So each one of my books is a collection of note cards that I make.
Part of the process of writing this stuff down, and there’s a reason I do it longhand, is that it’s helping you create kind of a muscle memory. And I could just read these on Kindle, highlight them, and send them to my Evernote.
But it’s actually reading it once, going back through it, writing it by hand, organizing it. This forces me to go through the material over and over and over again until it’s locked in my brain. I’ve now interacted with the material so many times, that I have kind of a fingertip feel for what it is, what it means, and how I might use it.

Really, what a commonplace book, it is kind of like a backup hard drive of your brain. It’s things you couldn’t possibly remember, but you kind of have a vague sense of them, but that you think might be usable in the future. The Obstacle is the Way for me, as I said, began as just a single note card. First, I read meditations. So I read the quote there, “The impediment to action advances action. What stands in the way it becomes the way.”

So I first read the quote there, then I read Pierre Haddo’s The Inner Citadel, and it’s in this that he calls that exercise turning obstacles upside down.

So I went through it, I marked it, turned it into a note card, started a new category here in the commonplace book. This book leads me to this book, which leads me to note cards, which leads me eventually to write this book.
So again, it starts with the raw material and it’s about the refining, and the organizing, and the checking, and finding patterns that eventually culminates into some usable idea. This isn’t just a tool for writers. It doesn’t matter who you are or what you do. Chances are you’re coming across wisdom or information in the course of your life that isn’t relevant or of use to you just yet. But in the future, it likely will be.

So what you’re doing is investing now. You’re putting in the time now, and you have to trust that in the future you’ll be able to put this to some good use. You might be looking at this and go, “That took a lifetime, that took forever. I can’t possibly catch up.”

But there’s that great expression, the best time to plant a tree is 20 years ago. But when it’s the second-best time? The second-best time is now. If you’re not reading, if you’re not keeping the commonplace book, it’s not too late. Start not tomorrow, not next week. Start now. Don’t wait for the purpose of just start reading, reading actively, read a part of a great practice, and then start putting in the work in whatever form makes sense for you. Again, I can’t rave about this process enough. I can’t overstate the impact it’s had on my life.

If you want some more information, we talk a lot about this in our Read to Lead course based on that famous quote from Truman about readers and leaders. You can check that out at dailystoic.com/reading. It’s one of the best things I think we’ve done, and almost every story in it ironically came from the archives of my commonplace book. I’ve heard from thousands of people over the years who’ve started their own process because of it, and I hope you become one of them. Hey, it’s Ryan Holiday. Thank you so much-

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Next Lesson

I think this is a good breaking point. We’ll come back at 2:30 by Apple time and jump back into ONTRAPORT. I’ll show you two automations to put into your system and how to integrate the ONTRAPORT system with this note-taking system that Ryan Holiday taught you that he learned from Robert Greene.

All right, I hope this is helpful to you. I’ll be back at 2:30 on the dot, Apple Time.

Preview of What’s Coming

The following diagram is explained more in the more help section here. We have not covered all of this yet, but it may help to see where we are going, where we have been, and how today’s lesson fits (a video explaining the diagram can be seen here).