To do or not to do?

As an ophthalmologist, do you use to-do lists? They're a handy way to keep on top of your business, from such mundane things as buying toilet roll or milk to more important matters like noting which eye you'll be operating on. It's not a new phenomenon. Benjamin Franklin famously kept to a 13-point self-improvement plan that he carried out on a weekly basis four times a year. Themes included temperance, frugality and resolve. Thomas Edison kept lists of ideas and plans throughout his life, in particular a five-page list of "Things doing and to be done". These included what may seem like standard inventions now but were not exactly household items in 1888. "Artificial Silk"; "Silver wire wood cutting system"'; "Red Lead pencils equal to graphite". None of this compares to the wildly ambitious to-do list of Leonardo Da Vinci from the 1490s. The Renaissance polymath sought to learn as much as possible about a host of tasks. Da Vinci kept a book hanging from his belt at all times, in which he would jot ideas or thoughts as they came to him. A list of the artist's, translated by NPR's Robert Krulwich from a book by Toby Lester (Da Vinci's Ghost: Genius, Obsession, and How Leonardo Created the World in His Own Image), contains references to a number of experts in other fields, which shows a humility alongside that hunger; acknowledging one's own shortcomings is important when it comes to making headway into new territories. As well as intending to calculate the measurements of Milan and several noteworthy buildings in the city, he expressed an interest in learning about how to square a triangle, how people travelled on ice in Flanders (ice skating? general travel?), how to repair locks and mills on canals and more. He also wrote on his list, simply: "Draw Milan." It brings to mind a short story by Jorge Luis Borges entitled On Exactitude in Science. A simple paragraph, it imagines a fictitious empire where cartographers draw up a map that matches the realm in size. Perhaps I'm jumping to conclusions. Maybe Da Vinci merely intended to paint a view of the city. Regardless of the size of his drawing, one can imagine the intensity of purpose that would have gone into such a task. A 2009 study found that care teams often used a vague to-do list or "signout" sheet, which could feature specific directions for patient care as well as more vague notes or suggestions. The study created a hierarchical model of tasks based on these forms that provided insight into the nature of clinical tasks and the management thereof. Working with this knowledge, it suggested how such to-do lists could be integrated with a patient's electronic health record in order to enhance work flow as a kind of Plan B to such a muddied approach. Further studies are under way at present that expand on such models while taking into account patient concerns over privacy. Perhaps if Da Vinci were alive today he would be able to suggest a manner in which the quest for efficiency and fears over personal privacy could be reconciled. For now, that task is left for us mere mortals to complete.