Working with your ZK remotely?

achamess

Hey all,
So I am using the Sublime ZK package for my ZK. I really like it. And in the end, it's just text notes, and could be compatible with anything else that comes along, including The Archive.

The issue is, I'm not always at my own personal computer. I will begin my job as a resident physician very soon, and for most of my day, I will be at various work terminals (e.g. Windows computers). I will be doing a lot of learning in that time, and I want to capture what I'm learning.

A cloud interface for my ZK would be ideal. Dropbox has the files, but does anyone have a good way to create and edit ZK files (text notes) remotely?

Surely, I'm not the only one dealing with this. Anyone here who has to use a work computer during the day will feel this struggle.

What do you do?

monk

Congratulations and condolences on starting your residency. You are in for a ride.

I am a graduating resident browsing for tips and ideas for my own note-taking. To call me a novice on ZK would be generous, so I'm sure others can help you more there, but I can offer some tips on storage from a healthcare perspective.

You will likely find that your hospital system blocks cloud storage platforms from communicating due to over-worship at the altar of HIPAA. There are workarounds, but the most reliable way to be able to take notes is to (have a way to) do it offline and then sync your devices outside of the hospital. There are many ways to do this such as github/gitlab, syncthing, manual backups, evernote/notion/ulysses/etc. My personal choice at the moment is gitlab for sync and version control between linux desktop, mac laptop, and iphone and use the editor of your choice on each respective device. I use Working Copy on my iphone which allows using any editing app (e.g. iA writer). Important to have good full text search. I don't closely follow ZK guidelines so ymmv.

Depending on your specialty, you will likely find that you do not have time to sit and take many notes during a shift. If you do, then I am jealous. Though a smartphone is not a great device for long notes, most days I would just make quick notes or add a Todo item so I don't forget, and flesh it out later. Consider using dictation for longer notes and edit formatting later. Make dictation your friend in residency or you will pay for it in time, sanity, and/or carpal tunnel.

Looking forward to other comments as I haven't found a great system in 3 years of residency.

Good luck!

achamess

@monk
Great to see another physician on the forum. Congrats on finishing residency!

Your points about the hospital computers being limited is well taken. I can use Google Drive from a web browser. So there is always that. But that's not exactly what I want, since it'd be separate from the text ZK I currently use.

Maybe I'll just keep my iPad mini on me so I can write in text. I use 1writer, which syncs with Dropbox and my desktop ZK.

I was just hoping to not have to use my own devices. It's much easier when you're on a work computer. Not to mention, the 'optics' of clinical work matters too (sadly). If you're on a work computer, no one is paying attention to you. But if you're using your own device, it might draw some unwanted attention.

Good point on dictation. I'm definitely going to embrace it. My hospital has a dictation system that looks pretty good. And we can use our mobile phones if a workstation doesn't have a microphone.

What kinds of things do you want to try to capture in your ZK?

For base medical knowledge, we have a lot of good resources. I don't need to reinvent the wheel. I want my personal notes to be things that aren't in books or UpToDate, like practice tips from colleagues, personal lessons/insights from patient interactions. Stuff that is more 'on the fly' and less codified in books.

Good luck!

achamess

@monk I've been trying to use Github and Github pages for taking notes in the last few days. Benefits:

• I can access from the web
• It's easy to create Markdown files and directories
• I can drag in other file types like PDFs and images
• I can make a nice interface with Github pages

Here is my page:
https://achamess.github.io/Residency_Wiki/

Downsides:

• It's not easy to make the ZK-style IDs
• Linking between pages is hard since I have to go back to the main repo page to see all my pages. After adding several, it's going to get cumbersome.
• It would be nice to be able to do a wiki style [[page name]] like I do in Sublime_ZK to do an auto-search.

Because I lack these features, my note repo probably won't be as granular as a normal ZK. But it'll be good enough.

Thoughts? Github pages as a ZK?

ctietze

That sounds even clunkier than, say, installing a dokuwiki or zimwiki for your own use. Too many steps to create and link stuff, which means you'll do less of that in the long run.

Yet I think you could write a Jekyll helper that looks for [[...]] and makes a link from it.

achamess

@ctietze It is too many steps, yes. But it took little effort to make, and I can pull it up on any computer in the hospital. That's key. It has the benefit of git versioning, and can be pushed to the web easily. Maybe I'll look into a Dokuwiki or Tiddlywiki. Zim is a no go. No zim on hospital computers.

Apart from the hard-linking of zettels by ID, what actually distinguishes a ZK from a wiki anyway? I know this has been discussed a while back. But I don't really see the difference. Perhaps the principle of atomicity, but there is nothing inherently against that with Wikis. You could just change the granularity of your notes and build them up. The granularity is the main distinction I see. But that's more a mindset and usage thing.

monk

I have struggled with the same issue and it is part of the reason I have not fully bought into ZK. Fuzzy full-text search on any device is powerful enough that I have not personally missed links. I can see how this would be desirable if your knowledge base was more extensive or more granular, however, so don't let me lead you astray if you have a strong interest in ZK-style linking.

To answer your earlier question on what I store in my notes: I try to keep a record of clinical pearls related to a problem, chief complaint or diagnosis that would be difficult to come across in a web search such as UpToDate. As an example, here is a short note that has a descriptive file name that could be easily fuzzy searched based on keywords if I can't remember the exact process:

#tricks #em
# obtain larger bore IV access

obtain small gauge IV in hand
infuse NS with pressure bag with tourniquet in place on proximal arm
larger AC veins will engorge and will allow you to place a larger gauge IV more proximally

See: [edited out link to social media]

This type of system does not preclude ZK linking, however. I just have not put in the effort such as a main note for tricks with links, or a main note for IV access with branching links. The way I access these notes is by searching on my phone while on a shift, and I have not found a good way to both have ZK linking as well as the search that I find more useful without investing time in creating something like a wiki that I would likely bypass. A large part of why I even take the notes is to help solidify the memory so I don't have to search it again.

ctietze

Now that you bring up the topic of granularity, I remember another thread of discussions on the blog: You could, theoretically, put your whole Zettelkasten into 1 big file, and instead of linking to different files, you link to different headings within the same file. That way you don't have to trouble yourself with handling multiple files on GitHub: edit the single archive file once, and you have access to everything. May not be the nicest interface when you have to scroll around all the time, though

mediapathic

@ctietze said:
Now that you bring up the topic of granularity, I remember another thread of discussions on the blog: You could, theoretically, put your whole Zettelkasten into 1 big file, and instead of linking to different files, you link to different headings within the same file. That way you don't have to trouble yourself with handling multiple files on GitHub: edit the single archive file once, and you have access to everything. May not be the nicest interface when you have to scroll around all the time, though

As someone who tried this in emacs org-mode files, I can also say from experience that some pieces of software are going to choke on Extremely Large Files.

What about having a one big file that you use as an inbox, then, when you are not behind the HIPAA firewall, break that out into your actual Zettelkasten? I do something similar for different reasons, and I find that it adds a layer of taking the time to think about an entry which helps me with internalizing understanding.