Ode to the 3X5 Card

A couple of coworkers recently asked me where I got the leather holder for the 3X5 cards that I always have in my shirt pocket. Turns out they wanted to buy one for their boss as a joke. I don’t want to think about what that says about their opinion of my routine, but it did get me thinking about how attached I am to my cards, and why.

Like many physicians I know, I started carrying cards as a medical student to keep track of patients I was following on my hospital rotations. I think I started with 4×6 cards and kept them in the pocket of my short white coat. I “stamped” each with the addressograph card (remember those?) of the patient, and wrote out key facts of the patient’s history, physical findings, and labs. At some point I “downsized” to 3×5, perhaps inspired by a line in the infamous book about medical training, The House of God, that went something like: “there is no patient whose medical history is so complicated that it cannot be reduced to a 3×5 card.” As a house officer at Boston’s Beth Israel Hospital in the mid-1980’s, I felt like I was living the book, and I learned to write small! The practice of using cards to manage our patient load was so ubiquitous that reviewing the service with other house officers or the attending physician was called “card-flip” rounds. Of course, I also had my “scut list” of things to do each day, which I usually kept on a separate piece of paper.

Over the years, the scut list made its way onto a 3X5 card, and the individual patient cards went away, leaving me with the life-long habit of writing down things I need to do each day. I have experimented with other ways of doing this, and along the way amassed a collection of electronic gadgets that promised to work better (and make me work better) than my simple cards can. I went from Psion to Palm (a few of those) to smartphone, but decided that nothing beats the cards – they’re cheap, never need recharging, are thin and light, can be read at a glance without entering in an “unlocking” code, won’t break if I drop them, have a great “interface” (an equally cheap pen), and – best of all – provide the simple and satisfying joy of crossing things off as I get to them.

How do you organize your day?

3 thoughts on “Ode to the 3X5 Card

  1. Ira: Finally, a man after my own heart! I use my iPhone to store all kinds of data – phone numbers, appointments, etc. However, nothing comes close to the 3×5 card for patient data and to-do lists. During rounds if a resident or medical student is writing stuff down, there is a sense of comfort in knowing that it is likely to be followed through on. Long live the 3×5 card! And incidentally, where did you get a card holder anyway? I’ve always relied on another relic from the past to keep my cards together – a big black paper clip. Raj Narayan

    1. I, too, use index cards which, too, started back in medical school. This card is lined with each “to do” item to be done for the day. Of course, each “to do” item listed is started with my hand drawn box that once I complete the item allows me the great satisfaction to CHECK it off. This work organization habit has transpired into my home life over the years. As a working mother with 3 children, the index card method has been vital to keeping me organized!

      1. I am delighted that this seems to have resonated with at least a couple of you! I think it will be a long time before the “pen and paper interface” is supplanted by an electronic device. Then again, my “millennial” children seem to be surgically attached to their smart phones and can’t imagine a world in which the functionality that they provide did not exist, so who knows!

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