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The Sunday Letter · Issue 04

Make room

September 27, 2026 3 min read

Saying yes to one thing is saying no to something else. I wrote that here a few weeks ago. This letter is about the other half of that sentence.

Making room. Not adding one more thing. Taking something off.

If stepping back feels like throwing away the work you already did, it isn't. It goes in the compost pile. It feeds whatever grows next.

Below are a few things worth your time, and one small experiment. Try it for two weeks.

Most of us try to fix an overfull life by adding. A better system, a new app, one more habit. The fix is usually subtraction. Here is one way to practice it.

Try it for two weeks

One in, one out.

For the next two weeks, before you say yes to anything new, name what it replaces. Write both down. The new thing, and the thing it pushes out.

If you cannot name what it replaces, you have not decided yet. You have only agreed.

At the end of two weeks, read the list. Circle one thing you want back. That is where to make room first.

If the hard part is the wording, the Say No Scripts are free with the rest of my worksheets at laurenfine.com.

The coach's view

When people feel stuck, they almost always look for something to add. A course. A credential. A new routine.

Researchers at the University of Virginia found this is a built-in default. In a 2021 study in Nature, people asked to improve something overlooked subtraction, even when taking something away was the better fix. Adding comes to mind first. Subtracting takes a second look.

So the most useful question is rarely what to start. It is what can come off.

Lauren Fine after her first 5K in ten years, holding her medal

After 10 years I ran my first 5K. No training but my Pilates somehow helped prepare me…although I'm paying for it already. Was such a nice event with our Nova Southeastern University students and faculty.

Make room for a walk

A new thing, every week: one small thing worth making room for.

This week, it is a walk. Just 10 minutes after you eat is all you need to lower your blood sugar.

In a small 2025 study, a 10-minute walk right after a glucose drink brought the peak down from about 182 to 164 mg/dL.

Lauren Fine out for a short walk

Worth making room for

01 · The essay

How to Stop Asking for Permission

Read the essay

02 · The research

Why We Miss the Fix That Takes Something Away

Read the article

03 · Try it

Stay in the Meeting, Not in Your Notes

See the notetaker

For the pajama charting crowd

Pajama charting, in case the term is new to you, is the charting we do at home after everyone else is asleep.

About 1 in 5 physicians spends more than 8 hours a week in the EHR outside of work hours, according to the AMA. Burnout rates are falling. Pajama charting is not.

One health system cut after-hours EHR time by about two thirds, mostly with small fixes to the inbox. Worth forwarding to whoever runs yours.

Until then, if you are charting in pajamas, they may as well be good ones.

The Eberjey Gisele long set is my favorite. Soft TENCEL modal, and warm enough for a cold room.

Prefer no buttons? The Lake kimono set wraps instead.

And for when the laptop finally closes: a washable silk pillowcase.

The pajama picks are affiliate links. I may earn a commission, at no cost to you.


Now tell me one thing you are taking off your list. Just hit reply, or email me. I read every one.

← Issue 03: Who you are when the title is gone All issues →
Lauren Fine, MD

Lauren Fine, MD

Coach · Speaker · Story Strategist

Lauren Fine is a coach, TEDx speaker, and story strategist helping people at every inflection point identify, shape, and tell the story of who they're becoming. She is a physician, medical educator, Harvard Macy Institute faculty, and the founder of ReasonDx.

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