Building a Second Brain for Acupuncturists

"Second brains" or personal knowledge management (PKM for short!) has become a popular productivity topic online and can be a big asset in the acupuncture clinic! This entry introduces the idea and offers a few suggestions for applications you can try.

Introduction

"Personal knowledge management"(or PKM) is a method of collecting information (such as notes about meetings, classes, from books, etc.) in a program or database, which allows you to quickly sort, retrieve, connect, and use the information, as well as find connections between concepts. Historically, people wrote in "Commonplace books," or notebooks where people took notes on ideas, conversations, quotes, and other information from daily life to reference later. Another, slightly more modern (relatively speaking - we're talking 1700s+) version is a Zettelkasten, which uses index cards for notes and includes tags, categories, and other ways of organizing the notes. In that sense, electronic PKMs are closer to Zettelkasten than Commonplace notebooks. By creating an electronic version, we can sort through information more quickly; there's no need to remember which book or page number your note was on or sort through paper cards - you can just search for the information.

The idea of compiling information outside your brain, whether it is on paper or electronically, is also called creating a "second brain" - a way of externalizing information in your brain to help you recall it later. If you are someone who struggles to remember things later, then having a tool to help you may be a good idea! I deal with brain fog on and off from chronic health conditions, so having a resource where I can refresh my memory or confirm what I think I remember is very reassuring to me.

This becomes a useful resource when you're running a business and working with patients, because you can quickly find information you're looking for, whether it is a point combination you learned in a CEU or a note about an herbal formula you want to double-check. When you're busy, it can often be hard to have the time to look up information you need for a patient. But, being able to quickly search your notes can be a big help!

One of the key features (for me) about PKM or Second Brains is that you can organize the information in whatever way makes the most sense to you, rather than being forced to use another organization system. There are a lot of people online who offer their systems and strategies for creating and maintaining a PKM system, and it can turn into a bit of a rabbit hole if you spend too much time looking into it. I have a bit of a contrarian view on it (as always), but having a PKM has been so essential to me while running my clinic that I wanted to share the idea here so you could try it out, too.

Picking a PKM tool

Here are my rules when it comes to picking out a PKM system:

1. It needs to be easy to use. I don't want to spend more time trying to figure out how to use it than I do actually using it.
2. It needs to be flexible. I want to be able to customize it how I want it to be, not be forced to operate using a pre-designed system.
3. I want to store it locally. I don't want it to be only stored in the cloud, because I want to be able to access it without internet. Also, if it is stored on a company's server, then if the company goes out of business, I am out of luck.
4. I don't want it to be written in a proprietary language. This is related to #3. I don't want to be locked into using a particular company's product to access my notes.
5. I want a free option. There is some nuance to this (as the internet maxim goes, if a product is free, you are the product). But, I want there to be a free option so I can try it out.

Before we go much further, a disclaimer with a few things that you should not store in your PKM (even if it is stored locally):

• Passwords (use a password manager like 1Password)
• Medical information (especially your patient's medical info)
• Financial information (particularly if it's not stored locally)

Your PKM software is not HIPAA compliant. Don't use it like it is.

PKM Software Suggestion

There are a variety of software options out there that you can use. Popular apps include Obsidian, Notion, Roam Research, and many others. I use Obsidian because it meets all five of my criteria above. I'll write a bit here about why I prefer it over other PKMs. I've also used Notion a bit, so I'll compare/contrast it a bit with Obsidian as I go.

Obsidian is free, unless you want their sync. Your "vault," or collection of notes, is stored locally on your computer (or in the cloud, if you use a service like Dropbox).

• It scales to the complexity you want. It is perfectly usable just writing notes, adding links to other notes, and organizing them into folder (if you want!). It can get considerably more complicated if you want to use SQL for queries, but you absolutely don't need to.
• The notes are written in markdown, so they can be exported and used in other apps. This format isn't unique to Obsidian, so it doesn't lock me into using it forever. (Technically, you can export Notion docs in markdown, but because of how their pages are organized, it still becomes very difficult to navigate outside their app.)
• There are great built in plug-ins that you can turn on or off to customize the functionality of the program. This is a quick and easy way to customize your experience, or keep it simple if you don't need a tool.
• There is a wide range of community plug-ins that add more features (and complexity) if desired. These plug-ins aren't reviewed by Obsidian, so they are a bit use-at-your-own-risk, but you can see the number of downloads of a plugin on each page and whether it is still maintained. This can easily spiral into having a ton of features, so I try to keep my set up pretty minimalist.
• If you are someone whose brain thrives on creating meaning by finding the context between ideas, then you'll love Obsidian. Its purpose is essentially to help you create that context, and be an easy way to remember it later, so you don't always have to rely on remembering it.

I like to describe Obsidian as a way of making a web of connections out of your information, or an interconnected map of ideas. As you make new pages, you create links to previous pages you've created, thus connecting ideas. There is actually a tool that will show this to you in Obsidian. Here is a picture of the "web" of my pages in my Obsidian vault:

All the dots are pages (the colors are particular topics) and the lines are connections between the pages. The dots without lines are pages without any links to other pages (aka "orphans"). Some people make it a priority to avoid having these, but I don't really care. You can click on each dot to go to the page, and drag dots around to better see connections if needed. This isn't necessarily a super functional view, but does act as a nice overview of the contents of your vault and give you a high level view.

But how does this apply to acupuncture?

Here are a few examples of how I use Obsidian in the clinic.

Create indexes of information.

Keep in mind you're linking pages to other pages, which allows you to create different indexes or ways of accessing the information later. It's a web, not linear! So, for example, if you create a page for a particular point, you can link it in pages that list that point for a treatment, on charts that collate points, in book notes you take, etc. For example, here is a familiar chart to many acupuncturists:

A little tour of this image:

• Each of the salmon colored texts are links to other pages. If you click the link, it will take you to that page. Darker text is an existing page, lighter text does not exist yet, but will become a link when the page is created (which happens as soon as I click on the link).
• Each small number in a box is where the text is mentioned elsewhere. This is from a plug-in called Strange New Worlds (more on plug-ins in a future entry). If you hover over the number, it will have a small pop up window that lets you preview the other mentions.

I like to create small indexes on the top of pages that are part of a group to make navigating the information easier. This image is an example of general notes for the Yangming channel, with contextual links.

As an example of how your vault can grow and evolve over time, I originally had the Applied Channel Theory (book notes) for the yangming channel in this note, then it became too long. Once that happens, you can easily create a new page (called "extracting") and link to it.

Take notes from books, classes, etc. so the information is quick and easy to find later.

You can take notes by topic; for example, I have one central note about sleep and insomnia where I have collected treatment notes from various texts, formulas that can help with different patterns, notes on how Chinese medicine views sleep and insomnia, etc. When this information can be linked to other pages, such as points, books, CEUs, etc., I include a link:

Again, each salmon colored text above links to another page. There are concepts on this page that could also be linked (such as shaoyin, taiyin, etc.), but I didn't have pages for those when I created this page. There is also a section on the bottom of each page that searches for linked and unlinked (but related) pages:

Each of these expand to show the links. In the case of the unlinked mentions, it references any time "sleep" is mentioned on another page - so you can narrow the search down using the magnifying glass as needed.

Or, you can group notes by class. This is how I like to organize longer CEU notes:

For longer classes, I like to group lectures by lesson. So, for this CEU, I have a different page for each lesson view I watched. Then, in each lesson, I have a header with the same Up/Previous/Next/Related that I showed above.

While a lot of this looks time consuming to create, there are easy ways to streamline it:

• I have premade templates for classes, book notes, etc. that I can use each time I start a new one (there is a plug-in for this).
• I will sometimes use voice to text if I am trying to add a lot of information from a paper book, and I will read passages I want to save. I typically will have to go back and format things (especially checking Chinese terms!), but it's still faster than typing it all.
• There are tools to import from e-books or other electronic media, or you can simply copy and paste. I am absolutely thrilled that Obsidian recently added a web clipper feature, which saves a ton of time. If you use tools like Readwise, Raindrop.io, etc., there are plug-ins to import your highlights.

Wrap up

Hopefully you're starting to get an idea of different ways you can use Obsidian in the clinic! I didn't even touch on the ways I use it for the business side of things, but that can be a future entry. I am also planning on writing a list of some of the plug-ins I use, and I can always elaborate on different ways I navigate things if anyone has questions.