"In 1992, a British psychologist walked into two of Scotland's busiest orthopaedic hospitals and recruited five-dozen patients for an experiment she hoped would explain how to boost the willpower of people exceptionally resistant to change.'
"The patients, on average, were sixty-eight years old. Most of them earned less than $10,000 a year and didn't have more than a high school degree. All of them had recently undergone hip or knee replacement surgeries, but because they were relatively poor and uneducated, many had waited years for their operations. They were retirees, elderly mechanics, and store clerks. They were in life's final chapters, and most had no desire to pick up a new book.'
"Recovering from a hip or knee surgery is incredibly arduous. The operation involves severing joint muscles and sawing through bones. While recovering, the smallest movements – shifting in bed or flexing a joint – can be excruciating. However, it is essential that patients begin exercising almost as soon as they wake from surgery. They must begin moving their legs and hips before the muscles and skin have healed, or scar tissue will clog the joint, destroying its flexibility. In addition, if patients don't start exercising, they risk developing blood clots. But the agony is so extreme that it's not unusual for people to skip out on rehab sessions. Patients, particularly elderly ones, often refuse to comply with doctors' orders.'
"The Scottish study's participants were the types of people most likely to fail at rehabilitation. The scientist conducting the experiment wanted to see if it was possible to help them harness their willpower. She gave each patient a booklet after their surgeries that detailed their rehab schedule, and in the back were thirteen additional pages – one for each week – with blank spaces and instructions: 'My goals for this week are _______? Write down exactly what you are going to do. For example, if you are going to go for a walk this week, write down where and when you are going to walk.' She asked patients to fill in each of those pages with specific plans. Then she compared the recoveries of those who wrote out goals with those of patients who had received the same booklets, but didn't write anything.'
"It seems absurd to think that giving people a few pieces of blank paper might make a difference in how quickly they recover from surgery. But when the researcher visited the patients three months later, she found a striking difference between the two groups. The patients who had written plans in their booklets had started walking almost twice as fast as the ones who had not. They had started getting in and out of their chairs, unassisted, almost three times as fast. They were putting on their shoes, doing the laundry, and making themselves meals quicker than the patients who hadn't scribbled out goals ahead of time."
"The psychologist wanted to understand why."
(pp. 141-2, 'The Power of Habit: Why we do what we do and how to change' by Charles Duhigg – Landmark)