Take a breath. Let’s start again (again)


When I first started practising medicine, I worked for about six months before I had annual leave. My break lasted two weeks. At the end of it, I was certain that I had forgotten everything I knew about being a doctor.

This feeling turned out not to be true, but it did turn out to be common – I've had friends call me the night before returning to work after a long absence, and declare that they had forgotten how the heart works, or something equally ridiculous*. It’s a bit like impostor syndrome (the feeling that you’re faking being a smart person, but no-one has caught on yet) which is also really common.

* I believe this was said to me by a cardiologist.


This post is about resetting when you feel out of your depth, or you can no longer do a thing that you used to be able to do.

One of “those” days

Every now and again, when you perform a complex task, one where the outcome will depend to some extent on your mood and your ability to think on your feet, you’ll have an off day. It may be because your favourite café was closed, or someone you admire brushed you off, or you simply woke up filled with the unshakeable sensation that all humankind’s achievements are meaningless. For whatever reason, you’re not performing with your usual agility. This definitely happens when improvising, and the temptation is to try and be brilliant – to show the audience that despite the mediocre work you've dished up so far, you are capable of genius. It seldom works.

Here is an effective strategy:

Recognize when you aren’t on fire. This takes insight.

Let your team-mates make the main decisions and be in the forefront.This relies on having trust in your team.

Stop trying to wring brilliance out of your tired brain, and go back to basics. This means that you have to have a strong grasp of the fundamentals.

I want to talk mostly about item 3, the fundamentals. You should be able to articulate the core elements of your role. Maybe in one word, or a brief and unforgettable list of instructions, or a trigger phrase that gets you into the zone.

Trigger phrases

Once when I was performing in an improv show in Texas, the director asked me to name something I found difficult. “Speaking in a believable South African accent,” says I. The director then challenged me to attempt this during the show, resulting in a performance which was probably interesting to watch, but only in the way that it'd be interesting to watch a caveman try to reroute your modem, setting fire to the drapes in the process.

The experience spurred me to work on my South African accent. One of the tricks with accents is to have a “stock phrase” which you say out loud to reset your brain. The phrase will contain a spread of sounds which are unique to that accent. For me, my South African accent reset phrase is “All she wanted was to look at the photographs.”  If you ever hear me mutter that to myself, be prepared to be transported to Cape Town.

When your issue is more about self-belief, you have to get back in touch with why you’re doing this complex thing in the first place – your values. You also have to separate your self-belief from other people's beliefs about you. I recommend a ritual created by game designer Jesse Schell.

Let’s say it’s about writing. You say to yourself:
    I am a writer.
    I am a writer.
    I am a writer.


Improv has quite a few fundamentals, for example “make your partner look good” or “be changed”.

Medicine has a core sequence as well: gather information, work out the problem, take action, check on the outcome. In medical language: history, examination, investigations, diagnosis, management, follow-up.

In both cases, we practice, practice, practice those core things until we can do them in our sleep, with confidence.

If anyone ever asks you why you’re making the whole class of advanced masters practice basic moves, it’s because one day your confidence will be shaken, or you’ll be running from killer bees, but you will still be able to do the thing you are good at.

The hidden wondrousness

There’s a further reason why all this is great. If you know that you know how to start again from the beginning, and you know that when you do, it will all come back to you quickly and easily – you won’t be afraid to fail.

And when you’re not afraid to fail, your world gets much bigger.