Rethinking Busyness
Try as we might, many of us can’t shake the overwhelming sense that we're just too damn busy. That feeling that there’s something we’re forgetting about, somewhere we should be, some person we should be checking on, lingers. And this feeling persists, perhaps gets even stronger, when our to-do list is shorter than usual and our calendar has fewer appointments staring back at us.
Ironically, we have more tools at our fingertips for dealing with the challenges of busyness than ever before. From productivity systems to project management software to automation, if technology were the answer, we’d have solved this problem by now.
Busyness is sticky.
Busyness is sticky because it encompasses more than the amount of tasks on our to-do lists or the appointments on our calendars. Busyness is social, structural, and even political—though our go-to “solutions” for it tend to be individual. So I want to talk about how we can understand busyness on a deeper level—and in doing so, navigate it with more care and grace.
And I can think of no better way to start than by talking about The Pitt. First, we’ll explore a nuanced theory of what busyness is and why we experience it. And then, we’ll distinguish between two forms of busyness and why differentiating between the two matters for how we navigate our responsibilities. Finally, I have a few recommendations for how we can approach limiting the harms of busyness without isolating ourselves.
Busyness: An “Emergency” Theory
My first exposure to The Pitt was the thumbnail on the HBO Max app. I assumed it was an ER reboot. After all, given our current cultural penchant for recycling intellectual property, the wizened visage of Noah Wyle in scrubs seemed to point in that general direction. But no, The Pitt isn’t ER. And that’s not Dr. Carter; it’s Dr. Michael “Robby” Robinavitch (Noah Wyle).
ER centered on a hospital emergency department, but its personal and professional drama also extended into settings and times outside the work shift. In contrast, The Pitt leverages an extremely limited setting—both in place and time—and offers no escape from the relentless pace of work. The viewer never leaves the ER. From the ambulance bay to the waiting room to the treatment rooms and hallways, there is no scene in which the presence of work is absent. What’s more, the entire season takes place over one shift, hour by hour, in “real time.”
The emergency department of The Pitt serves as the backdrop for an exploration of contemporary work and the way our work-lives intersect with neoliberal privatization, gender, race, violence, and the untenable balance of family and career. Given that focus, dealing with busyness as a central theme is unavoidable. The Pitt offers a life-or-death lens through which to view our own busyness—not to diminish it, but instead to ask, “Why is this the way it is?”
But what are we really talking about when we talk about “busyness?”
In her book, The Social Life of Busyness, scholar Clare Holdsworth argues that busyness is more than the condition of having too much to do and not enough time to do it. Busyness is a condition of uncertainty—of unresolvable contradictions—in the face of our responsibilities to others and ourselves. It’s an awareness of our “multiple, open-ended and (a)synchronous responsibilities” and, often, our inability to square their sequencing and timing.
A hospital emergency department, like the one depicted in The Pitt, is a perfect encapsulation of this uncertainty. Busyness is foundational to the very nature of emergency medicine. Every shift, doctors and nurses must prioritize some care and deprioritize other care in the name of saving lives, even at the expense of others’ needs or relative comfort. Their job is to keep the possibilities open for as many people as they can. Saving a life doesn’t mean fixing the problem that’s jeopardizing it. Saving a life means doing just enough to get the patient to the next phase of the process.
Or, as Holdsworth puts it, “busyness keeps people to the mantra of keeping going and getting as much done as possible so not to restrict their choices.”
Similarly, the nurses and doctors triage incoming patients to limit irreparable harm. Which patient gets seen when is always an open question, one that can be answered quickly when a teenager arrives in the middle of an overdose or a man begins seizing in the waiting room even as less critical patients wait for hours to be seen. The show’s morality is quite clear: it sucks to wait, but dying sucks more.
The waiting room at the Pitt
Busyness is a study in contradictions.
The show contrasts the implied righteousness of triage with the metric of patient satisfaction. Every so often, a hospital executive checks in with Dr. Robby (Wyle) to update him on where the ER stands on important numbers—chief among them, patient satisfaction. On one level, we see the exec as an enemy, even the villain, because she is making life harder for the crew we’re coming to care for. But on another level, we’ve all been patients, and we’ve wanted to feel like we received the care and attention we needed. We can at once identify that a metric like patient satisfaction is deeply flawed and want to be a patient who leaves the ER satisfied.
The reality of triage—that a patient with a very real problem who is relatively stable may wait for hours for care—is at odds with the reality of the patient satisfaction score, which subjectively measures speed, attention, and hospital conditions in one reductive tally. Again, being “at odds” is core to how Holdsworth theorizes busyness as “the sense of being pulled in different directions by responsibilities and obligations that compete rather than synchronise.”
None of the doctors, from the attending physician to the students getting their first taste of the job, is certain that they’re with the right patient at the right time. The doctors with more experience seem to accept this. That acceptance doesn’t lessen their busyness, but it does seem to allow them a more committed presence with the patient who is in front of them. At some point, they learn to put aside their second-guessing and focus on the human they’re caring for.
Busyness—its uncertainty, multiplicity, and social character—feels even more palpable in the setting of the emergency room. In the ER, busyness is visceral.
For a definition of busyness with less viscera, we might say that busyness is characterized by a lack of knowledge about what is important from moment to moment. Should I spend time on this project or that project? Should I work on making this client even happier or work on courting a new client? Should I trade an hour of work for an additional hour of sleep? Should I do the work that pays the bills, or should I pay my bills?
We can measure our options against our goals, but we can never be quite sure of the “right” thing to do—only that we’ve got to keep going.
Busyness in Practice
The condition of busyness can include acceleration (i.e., work faster), intensification (i.e., work harder), and extension (i.e., work longer). But busyness is more than the sum of those components. It’s a condition defined by the uncertainty inherent in dealing with contradicting demands on our time, activity, and attention. With our theory of busyness established, let’s move on to busyness in practice.
Not all busyness is created equal. Some busyness is transient, coming and going with the seasons, a coincidence of scheduling, or an intentional push toward a goal. We can call this situational busyness. There’s also a kind of busyness that lingers—even festers—because it’s built into the structure of daily life or work. We can call this structural busyness.
We experience both situational and structural busyness within a political economy of busyness, by which I mean a policy regime that generates busyness by design.
Light spoilers to follow.
Structural Busyness
The first ten episodes of The Pitt follow the staff—attending physician, residents, medical students, nurses, orderlies, and security officers—dealing with a never-ending queue of patients. We see the overcrowded waiting room, the equally overcrowded patient area, and the frenzied pace of healthcare workers. Small details, like the acknowledgement that the student doctors shouldn’t expect a lunch break, emphasize the crushing nature of the workload.
We see the push-and-pull between the market-based, for-profit healthcare industry and the care-driven practice of medicine. I mentioned patient satisfaction scores earlier, but Dr. Robby is also confronted with a potential corporate takeover of the hospital and has been instructed to complete patient records so that the hospital can account for (i.e., bill) every step of care.
The daily busyness of the hospital emergency department is structural. The limited capacity of the building and the staff simply can’t meet the demands placed on them. The available resources just don’t balance out the relentless need, intensifying the sense that the doctors and nurses are pulled in different directions. This structural busyness can’t be resolved until the appropriate resources are made available or the need greatly diminishes. Since neither is addressed in any meaningful way, the structural busyness persists.
The reason that more resources aren’t provided or that the need never diminishes is our political economy of busyness. A market-based, for-profit healthcare industry requires healthcare providers to work in a state of consistent scarcity for the benefit of wealthy shareholders. The United States’s market-based, for-profit healthcare system is a policy choice—as well as a moral choice that rests on who deserves care and health.
Situational Busyness
In the twelfth episode of The Pitt, the staff learn that there’s been a mass shooting at a music festival. They begin to make plans for accepting an unknown number of victims. What was once everyday busyness morphs into an extraordinary crisis. Everyone in the emergency department, plus many more from throughout the hospital, rises to the occasion. This onslaught of uncertainty and conflicting responsibilities is situational busyness.
In this crisis, the feeling of being pulled in multiple directions takes on a distinct aesthetic. “The goal is to triage each patient in ten seconds,” Dr. Robby tells the doctor in charge of the entrance. After assessing an incoming patient, he’ll give them a slap bracelet in a color that corresponds to their level of need. Red bracelets are likely to die in five minutes without treatment. Pink bracelets within one hour. Yellow bracelets designate patients with primarily extremity wounds, “but a Yellow can change to a Red if they go south. You got to stay on top of them, even if they seem stable.”
The staff runs out of blood within thirty minutes; they respond by taking a break from care to donate their own. They run out of chest tubes; one of the student doctors gets creative. The adrenaline of the crisis leads to heightened focus and strategic risk-taking. But by the end of the episode, with an unknown number of victims still incoming, the doctors and nurses start to waver.
Luckily, situational busyness is temporary. Eventually, the crisis will subside. With time, things will go back to normal.
And that normal will still be unacceptably busy.
Dealing with Busyness
As I mentioned earlier, The Pitt presents a magnified, high-stakes busyness that most of us will likely never encounter. However, instead of minimizing our own busyness, the sheer magnitude of it encourages us to question why we are pulled in so many directions with too few resources in the first place. We may not be dealing with the same kind of responsibilities and choices as emergency room doctors, but our busyness is still very real and a product of the same political and economic systems.
If we use Holdsworth’s theory of busyness, which suggests that it’s a condition of conflicting priorities and a sense of being pulled in too many directions, then busyness isn’t likely to be something we ever escape. There’s a certain degree to which reducing the demands on our time and attention is healthy, a wisdom in eliminating the concerns that add nothing to our lives or relationships. But as philosopher Kieran Setiya argues, limiting our desires and responsibilities to the point that we could reasonably fulfill them all, without that pesky pulled-in-too-many-directions feeling, deprives us of the richness of life. “To wish for a life without loss,” he writes, “is to wish for a profound impoverishment in the world or in your capacity to engage with it, a drastic limiting of horizons.”
Busyness can be a provocation, an incitement to curiosity. Instead of an uninterrogated scramble, we can examine our busyness with a critic’s eye. The first step to doing that is to determine whether the busyness we are currently experiencing is situational or structural. Is it temporary? Or is it ongoing? Is it the product of specific circumstances? Or the persistent result of systems?
Situational busyness often calls for situational solutions. In other words, if you take on an extra project or you’re covering for a colleague on vacation, you can mitigate the stress of busyness by borrowing resources from other areas for a time. Maybe you lean on your partner a bit more, or order more takeout, or put in some work time on a Saturday morning. Are these ideal solutions? Probably not. But they’re situational. Just like the busyness, they have an expiration date. You’re not committing to a new normal; you’re navigating a limited period of increased intensity.
Of course, too often, we try to address structural busyness with situational solutions. There is no way to outwork or outpace structural busyness. It requires a change at the system level.
Yes, our economic and political systems help produce our busyness. And yes, there’s only so much we can do individually to change or opt out of those systems. However, there are smaller systems, such as work and family culture, that are far more within our control. I bring up culture specifically because it underscores how busyness is socially constructed. Productivity hacks and time management philosophies, as Holdsworth points out, often exacerbate our sense of busyness even if (and that’s a big “if”) we end up getting more done in less time.
By addressing culture, we address the expectations, narratives, and social relations that contribute to our sense of busyness—the condition of conflicting responsibilities. To work toward a micro-cultural solution to busyness, we must more clearly communicate the things that most frequently contribute to busy anxiety and develop shared understanding about ways to mitigate its toll on us.
I have three recommendations that can create short-term relief while setting the stage for long-term solutions. However, the most effective way to mitigate structural busyness is by examining how resources are distributed, identifying assumptions that need to be reworked, and understanding how existing systems contribute to the condition of busyness in the first place. It’s these needs that are so apparent in a drama like The Pitt but can be difficult to see in our own businesses, workplaces, and families. It seems obvious to us that the hospital should care less about the bottom line and more about supporting excellent patient care. However, we also need to apply the same logic to the systems that contribute to our busyness. Busyness may be socially and politically constructed, but it can be exacerbated by our choices. By adjusting those choices and reworking the systems we’ve created, we can set ourselves up for less structurally busy work-lives.
In the meantime, here are three ways to navigate structural busyness in the short term.
Priorities
Situational busyness often has a clarifying effect. What is most important becomes glaringly apparent. Not always. But often.
Structural busyness hides in an abundance of seemingly equal choices. Quality time with a loved one, getting ahead at work, enjoying one’s hobby, pursuing an idea for a side hustle, even taking a nap or catching up on a TV show, etc.—they can all seem like equally good options for how to spend our time. And that’s a problem. When we lack a framework for making a choice (not only for something, but also against the other options), we experience that familiar fear of missing out.
That’s not to say that answering the question, “What is most important right now?” is easy; it’s not. But if we do it more often, find more precise ways to define “important,” and practice saying “not now” to the options we don’t choose, we can more fully commit to what we do choose—just as the more experienced doctors of The Pitt do.
Compromise
Just as structural busyness hides in seemingly equal choices, it also hides in seemingly equal expectations. We can believe that the standards we hold in one area of life should also be the standards we hold in all other areas of life.
In a 1985 essay for The New York Times, Barbara Ehrenreich mused on “the cult of conspicuous busyness.” Her conclusion was that the most successful people learned how to avoid being busy, and that the busiest people would never be successful. It’s not that successful people don’t have more than enough to do. Instead, they’ve learned when to compromise. She writes:
The secret of the truly successful, I believe, is that they learned early in life how not to be busy. They saw through that adage, repeated to me so often in childhood, that anything worth doing is worth doing well. The truth is, many things are worth doing only in the most slovenly, half-hearted fashion possible, and many other things are not worth doing at all.
In identifying what responsibilities can have the lowest expectations, we lessen their pull on our psyches. However, compromise can’t happen in a vacuum. Compromise is always a negotiation between those implicated by the responsibility in question. Just as an ER doctor can’t unilaterally lower their expectations for patient outcomes or the number of cases they’ll handle, we can’t unilaterally lower our expectations on a task that others are counting on us for.
Needs
Finally, structural busyness can lead us to believe that our needs aren’t valid. Or, at least, that our needs aren’t as important as others’ needs. In that same essay, Ehrenreich recounts a conversation with a friend who seemed to call her up only to complain about how busy she was. Ehrenreich notes that she too was busy—just with responsibilities that weren’t high-stakes as her friend’s. She didn’t mention this to the friend to avoid coming off as the wrong kind of busy.
Ehrenreich’s friend needed to vent. So she called up Barbara. In the process, her friend prioritized her own concerns over those of Ehrenreich. She doesn’t say so explicitly, but Ehrenreich implies a feeling of having her needs dismissed by her friend. The remedy is not abandoning the practice of complaining (or listening) to our friends, though. The remedy is curiosity. She ends the piece by saying, “It would be sad to have come so far—or at least to have run so hard—only to lose each other.”
If busyness is socially constructed, then our answer to busyness must be socially constructed. We can have more effective conversations about what we and others need. We can learn to see those conversations as opportunities for connection and solidarity.
The Pitt does an amazing job of modeling this kind of conversation, showing how different characters modify their behavior (or sometimes, don’t) as a result of those interactions. But that’s a topic for another day.
Last Thing
By reframing our perception of busyness from the state of being overwhelmed by the quantity or speed of our obligations to a condition of being pulled in too many different directions, we gain a valuable way to make sense of both our ordinary and extraordinary experiences of feeling busy. Furthermore, by discerning whether our busyness is situational or structural, we learn how to navigate those experiences effectively.
Given our political economy of busyness, we aren’t likely to escape its thrall. But we can adapt to deal with it in less anxious, harried, and atomized ways.
In an era of information overabundance, how we structure our ideas matters more than ever.