As he moves toward the OR, McLaughlin is running through a precise series of thoughts and visualizations, which he calls the Five Ps. First is a Pause: He tries to forget what’s happened earlier in the day and focus only on the present. Next, he thinks deeply about the Patient. “This is a seventy-three-year-old man, and we need him to come out of this pain-free and able to walk more easily,” he says to himself. He reviews his Plan, mentally rehearsing the surgery step-by-step. Then he offers some Positive thoughts: “You were put on this Earth to do this operation,” he says. Finally, as he steps toward the table, he says a quick Prayer. “It’s very ritualistic, and I’m very focused,” he says.

Back when I had to do Friday night maintenance work as a GeorgiaVIEW database administrator, I had something like this. I would do the Pause to quiet my mind to become fully present. Then I would think about the systems involved. Then I would mentally step through the plan for the maintenance.