Can you count the ‘monkeys’ on your back?


HappinessPeriodically, when under pressure at work, and sometimes at home, I would think about what I could do to free up more time for myself and the family. How I could pri­oritize or drop tasks that were unimportant. There were and are many books and articles advising us how to prioritize assignments. Over time, most of us have devised an imperfect system to deal with non-urgent tasks. A high-level approach to separate the chaff from the wheat may start with things such as your own goals, organizational objectives followed by a variety of individual objectives. However, the day-to-day pesky problems added to our calendar continue to test our time-management skills.

Time-management techniques and tools have progressed from handwritten notes and checklists to paper and now electronic calendars. Many years ago, Stephen Covey postulated that we are managing ourselves, not just our time, and that our goal should be prioritizing relationships and results. His book, called The 7 Habits of Highly Effective People, is one of the best time management books I have read. Since this was written in 1990, many of my younger colleagues may not have read it. Besides discussing how to cultivate the seven habits, the book has practical advice about separating tasks by urgency and importance in a time management matrix. The two-by-two grid with four quadrants has “important” and “not important” on the y axis and “urgent” and “non urgent” on the x axis. This matrix also goes by the “Eisenhower matrix.” If you are still struggling with time management, it may be worth using this simple tool.

While the grid was helpful in prioritizing tasks one has already accepted, I soon realized that the advice was useful after I had already committed and taken on many of these management tasks. This is where the “monkeys” arrived into my life.

I came across an article in Harvard Business Review in 2011 about tasks or “monkeys” in relation to time management problems for managers.1 The source of this metaphor is uncertain. Speculation ranges from Sinbad the Sailor in Arabian Nights carrying a person or an ape across water who would then not leave, to denoting lugging a load of anger or even carrying the burden of drug or alcohol addiction. In general terms, the idiom means dealing with a difficult-to-resolve task or problem, but in practical terms it connotes a task or burden that has been transferred to you, willingly or not.2

An older “Grady” physician like me (alumnus of Grady Hospital in Atlanta, part of Emory University and Morehouse) quoted George Michael as singing, “Watch out! Baby who’s that? Don’t look now—there’s a monkey on your back!” and reminded readers of that idol of yesteryear Peter Gabriel, who, while made up as a shaman, sang, “Don’t you know you’ve got to shock the monkey?”3 Gabriel’s context was not about animal cruelty or People for the Ethical Treatment of Animals (PETA), but about jealousy, which can trigger animal-like behavior. I think he may have been onto something. The constant scratching and emotional toll of one or more monkeys on our backs for months or years may in fact lead us to overreact and act like wounded spirits—not due to jealousy but helplessness.

The ex-Grady doc discusses management time at work in three practical categories: boss-imposed, system-imposed and self-imposed time. At work, the monkeys are usually boss or system-imposed varieties.

While monkeys have many species, for discussion purposes, our monkeys come in three varieties: those that are invited in, others who we unintentionally invited in and feed for a while, and those that are forced on us who live on our backs till we get rid of them.

Then there are those monkeys who are unwittingly invited through emails or phone calls. If you are known to be a “giver,” according to psychologist Adam Grant, chances are you are highly susceptible to this dialogue. The shifting, or giving of a task (“monkey transfer”) may go like this: “I have heard you are an expert in… so, can you help me make sense of this? It will only take a few minutes… (take your pick: chapter, abstract, manuscript, statistics)?” Full disclosure: I have shamelessly used this tactic too.

Or: “I just need to pick your brains for a few minutes about… since our mutual acquaintance Dr. Y told me you helped her with…’ I am guilty of this too, but only after helping someone several times, which then forces me to switch to becoming a “matcher” so I can seek reciprocity.

The uninvited monkeys are a different problem. These are friends of friends, or relatives of relatives, who forward their images or reports. Outside of work, it’s the same pattern. In my experience as a “retired” physician, most of them are invited in. Sometimes, the transfer is so well done that I am not aware that I invited them in. I am guessing others may also have read this Harvard Business Review article and know how to seamlessly transfer the monkey(s)! Some weeks, I am dealing with the health issues of at least two to three relatives, good friends or acquaintances across the globe. Most of us gladly accept these demands, but the pace picked up after my retirement. Please do not get me wrong: I derive satisfaction from being able to assist in whatever way I can, whether it is getting someone a quicker appointment, a second opinion, or guiding them to the right physician. Any person I can direct to appropriate care, I count as a victory. It is when a five-minute informal advice changes to making a medical decision for someone who ends up asking the usual question: “What would you do if you were in my place?” One must be careful here as the “monkey” is now in transfer mode and ready to make the jump to your back.

It is a cliché, but prevention is the best medicine for this very underestimated time waster. My advice is, unless you are looking to impress your boss, or do not wish to spend any time at home, be on “monkey alert” so you can spot the incoming transfer prior to it leaving the transferor. If the creature has already started jumping through neutral space, the game is lost. Most often, it starts with an attempt to make it a mutual problem with statements like, “How should we deal with this?” The monkey is now in neutral territory or, as the authors put it, “the monkey in each case begins its career astride both their backs,” and then makes the leap.1

If you do not prevent the transfer, plot carefully about getting rid of the monkey. But where does the creature finally go? Your options are convincing someone that the monkey belongs to them, to punt it upstairs with the task resolved, boot it down to a subordinate, or ignore it hoping the other side forgets. Based on experience, the last option is your best one. Another piece of advice offered is to “pet the monkey” while it is in someone else’s lap, or on their shoulder/back, and solicitously show some empathy while changing the topic and discouraging transfer.

William Oncken, Jr. and Donald L. Wass have a few useful rules for managers struggling to deal with the “care and feeding of monkeys.”1 First, one either feeds them or gets rid of them, but does not continue to deal with them through vague language. Next, do not spend more than 15 minutes on a single monkey, and feed them only face-to-face or by telephone—and only with an appointment. They suggest avoiding being at your desk too long since that is where your computer and phone are. This is also where monkeys are waiting to switch parties. Much easier to be elsewhere since you do not have your calendar with you, or are busy in the clinic or the OR. Finally, they advise an assigned feeding time and to pre-determine the degree of effort you wish to put in it. Better still, you could offer some time next Wednesday at 5 p.m. to hear more about the potential transfer. Chances are they have forgotten, and you will not get the call. But if you do, they probably really need your help.

Alas, some of these rules are hard for we “retirees,” as people assume we sit around all day waiting to welcome the monkey. My best advice is to beware of this type of “transfer.” After you have received a monkey or two, you will know which people are anxious to make their own load lighter.


  1. Management Time: Who’s Got the Monkey?

BHAGWAN SATIANI is a Vascular Specialist associate medical editor.


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