Abstract

We were given a gift—a sabbatical. For us (2 clinician-educator types at a big medical center) that meant 50% off our full-time responsibilities for a year. No ward attending duties and limited clinic time. Keep up your administrative and educational duties. Go. Create. Flourish. Publish that moldy essay. Go to that funky conference. But . . . do . . . something “academically useful.”For middling career types with hopes of promotion, taking a 12-month nap was not an option. But what to do? Those who had gone before us looked dreamily into the distance. “Ah, yes, I had a sabbatical once . . . I almost finished that paper . . . And there was that great conference in Copenhagen.”One of us vaguely remembered that study about smoking cessation. Weren't you more likely to quit if you told someone about it? Had a specific quit date? Could a sabbatical and nicotine addiction have something in common?We looked into this a bit more. Apparently, the idea of goal setting is gaining traction. There are goal-setting websites where people hold each other accountable to their goals. Real money is on the line—at 1 website it was $22 million.1 The idea is loss aversion: people work harder to avoid losing $50 than they do to gain $50. The website looked easy enough, but who wants 1 more password or 1 more annoying e-mail?We started the sabbatical as 2 clinician-educators with paltry publications. This was our chance to advance our scholarship. We were friendly colleagues, but not exactly friends, who had worked together on a few committees. We took a chance on each other and committed to meet the third Monday of each month at 1 pm. We also committed to making explicit, concrete goals—distinct yes/no-type goals, and we discussed them in detail. “Write more” was amended to “Write 2000 words.” “Work on that presentation” became “Submit that research abstract.”But how to enforce these expectations of our collaboration? Enter not the carrot but the stick: Sarah Palin and the National Rifle Association (NRA). Each month, if we did not reach our goals, we would donate $50 to either Sarah Palin or the NRA. Anonymous donations were not allowed. The image of real and virtual mailboxes filled with solicitations and a lifelong onslaught of e-mails quickened our resolve. One of our wives, nodding her head, quipped, “Oh, honey. . . You shouldn't have. . .” She, too, became invested in our success.Some of our monthly goals were ambitious. “Write 4000 words” (September 2015) was a tall order. Some were more humble: “Actually open the file of that old paper languishing in rejection purgatory and stare at it” (August 2014). Surprisingly, our goals evolved to incorporate more than just academic work. “Go to gym 3 times this week” (February 2015). “Fast on Wednesday and Friday for Lent” (March 2015). We also enjoyed an intellectual renaissance. One of us helped start a monthly discussion group on religion and medicine. Another deepened ties to the palliative care community.Our monthly meetings began with shared accountability, and evolved into collegiality. What began as an exercise to get things done became a renaissance of how to live. At the end of the year, Sarah Palin and the NRA had received zero dollars. We collectively had 7 publications, a handful of abstracts at various meetings, and a few off-campus grand rounds. Oh, yes, and 1 of us did go to a great conference in Copenhagen.

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