Business Musings: Productivity (Writing With Chronic Illness)

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Note: I have just written a short book titled Writing With Chronic Illness. The book will appear in mid-April, just in time for my annual spring Writing Storybundle. I’ll be excerpting three chapters from the book on this blog. There’s a lot of material in the book that’s not available on the blog, but I feel this post, the previous post, and the next post are general enough to appeal to everyone.


For my entire writing life, people have called me prolific. By the standards set by the modern publishing industry in the past twenty years, I am. But most prolific writers were stymied by the traditional publishing system, which couldn’t handle more than one or two books per year from an author—any author. The traditional publishing system put in a series of checks and balances like revision requests, and publication dates more than one year out. To make matters worse, traditional publishers buy at most three books under one contract, and wait until the numbers are in on all three of them before buying any more. That slows a writer down—at least from the point of view of readers.

Many writers, me included, dealt with this big roadblock by writing under a variety of names. Even though I’ve retired many of my pen names or consolidated them under my real name (Rusch), I still have a few very active pen names. Of the ones I admit to, Kris Nelscott and Kristine Grayson have established careers and fan bases of their own. I couldn’t retire those pen names if I wanted to.

From the outside, it seems like I write a lot. From inside my day-to-day existence, it seems like I don’t write nearly enough. I constantly feel behind or overwhelmed or trapped by whatever project I’m working on. Every new idea becomes an oh-shiny!, and I want to work on that, until I get started, and then a different project becomes an oh-shiny!, much to my dismay.

I suspect that, ten years from now, my word counts and my habits won’t seem prolific at all. I can already see young (in writing experience, not years) indie writers catapulting ahead of me on daily word count. Some of these writers will burnout, because they aren’t managing their work-life balance—which is, in reality, those priorities I mentioned in the previous post.

But some of them are finding ways to be more prolific. Many of those ways have existed forever, or so it seems. My friend Kevin J. Anderson, whom I’ve known since college, has dictated his novels for decades. He has someone transcribe them—or he did before Dragon software—and then he edits the project.

A lot of writers use dictation software, training it to respond to their voice, and then producing 3,000 words or more in an hour. Which sounds great when you’re focused on new words, but with the voice-recognition software comes an inevitable editing draft, just to make sure the paragraphs and punctuation are in the right place, and that the software understood you correctly. I can’t get Siri to understand me for the length of a text, and that’s after years of using voice commands for texting, so I worry about the editing part.

Not that I would ever dictate. I try it every now and then, and have since Kevin tried to get me to do it back in the 1980s. But I worked in radio long enough that my critical voice accompanies the sound of my voice, as close as the fingers are to the palm of my hand. If I want to write critically rather than creatively, then dictation is the way to do so.

I think, too, I’m reluctant to sacrifice my vocal talents to my writing career, especially since I’m planning to do a lot more work in audio and video in the next several years.

But that’s personal for me, and tells you little about my methods.

How do (and did) I get work done, even with a chronic illness that, at its worst, incapacitated me 21 out of 28 days every month?

Some of my methods were, and are, draconian. I once told the World’s Greatest Doctor about them and she looked at me as if I was crazy. Hard on yourself much? she asked. I laughed and replied, If I don’t push, I would get nothing done at all.

She was a doctor, who went through medical school and interning and residency and all of that horrendous stuff they put doctors through. She understood pushing. She just didn’t recommend it for someone with health issues.

I don’t blame her. As my husband would often point out, if I pushed too hard, I would be sick more rather than less. So the balance, for me, was finding a push that was hard, but not so hard that it would incapacitate me for days on end.

So let’s see if I can break this down in ways that might help someone else.

First, let’s go back to the priorities. Family first, health second, and writing third.

When I was younger, I put writing second. That led to many more days incapacitated than I needed to suffer through. I finally acquiesced to my body and made my health a priority.

What that meant, in practical terms, was that there were days when I had to choose between getting new words done or completing my exercise. As a young woman, I chose words; as a middle-aged woman, I chose exercise—and was often rewarded with time to do words as well.

As I got sicker and sicker, time became the focus of my life. Time equaled energy for me. I only had so much energy per day, it seemed, and so I had to ration my time to accommodate that energy. In the ten years before our move, I could not do something different in a day without losing that day.

What do I mean? I mean that if I went to lunch with a friend, that was all I could do for a day. If I agreed to speak on someone’s podcast, I could do nothing else that day.

It wasn’t that I was lazy or that a podcast was a particularly hard thing to do.

It was that I only had about three hours of energy every day, and I had to acknowledge that. A podcast, one hour only, would put me flat on my butt afterwards, because I had to think on my feet, be gregarious, and remain present. Lunch held other dangers, like fragrance or food triggers that might make me sick for days. So in addition to the basic enjoyment of a conversation with my friend, I also had to be ultra vigilant, sniffing the air whenever someone new came into the restaurant so that I wouldn’t get poisoned by the slow low-grade stink of someone’s cologne.

I literally had to choose between lunch or a movie or an interview, and writing. Often I had to choose between those things and exercise as well.

Needless to say, I became more and more of a recluse. And I turned down a lot of online interviews. In-person interviews had been out of the question for years.

So…time and energy.

They correlate for anyone with a chronic illness. The other thing I learned about time and energy and my illness as that there were, generally speaking, times of the day when I was more alert or energetic than other times. By evening, I would get brain fog and couldn’t guarantee that I would be able to work—any kind of work, from nonfiction writing (which I find easier than fiction) to reading (for editing) to again, interviews or consuming story. I had to mentally block evenings off of my scheduled work time. Any evening I got was a bonus.

Mornings weren’t great either, when I lived in Oregon. Some of that was health. Much of it, I learned when I moved to the sunny desert, was the light. I now wake up early and with energy. In the darkness of the north, I would wake up and struggle through the first two hours of my morning, trying to ease myself into wakefulness. I know this was based on light because when we have the rare cloudy or rainy morning in Las Vegas, I can feel the difference. It takes me longer to become alert in the darkness of a cloudy day than it does in full sunshine.

Sunlamps help, but not as much as I had hoped they would.

So, mornings were something I had to ease into, and evenings were out of the question. Afternoons was my best work and exercise time.

I always prefer to write first, but living in the north in the winter meant that I only had a few hours of daylight. The small town I lived in had a rather mediocre health club with a running track so small that calling it a “track” is unfair to the goat path that it was. I loathe treadmills, although I used them early on in my exercise routine, before the Fitbit and the 10,000 steps. (The Fitbit quickly taught me that whatever I was doing on the treadmill, it wasn’t exercise.)

I either walked to a destination or, in the later few years, I ran. Outside. In all kinds of weather. The only limit I had was daylight. Up north in the rain and darkness, the chances of me getting hit by a car were huge—even on the sidewalk. (I nearly got hit on the sidewalk dozens of times, in the bright light of day. Tourist town with distracted drivers. It was awful.)

The daylight thing meant that I would change my writing to post-exercise on the shortest days of the year which meant that winter became my least productive time, rather than most productive, as it had been for years. But, exercise before writing, remember. Those priorities. And damn if I didn’t feel better after a run or a walk, even in the bracing cold.

I started running because of time. It takes me nearly two hours to get 10,000 steps. It takes me 40 minutes if I’m going slowly to run 3 miles, which for me is 7500 to 9000 steps (depending on the path I use). I trained myself to run, even though I thought I would hate it, to get more writing time.

Turned out that after the pain of learning how to do it, I liked running better than any other exercise. Still do.

But running was a time saver. I had a lot of time-savers built into my life, so that I could gain more hours of alertness for my writing.

I automated as many things as possible, setting times for all kinds of things. Laundry on down days (extra steps) because laundry takes no brain power. Meal planning and prep, with lots of big meals that would allow me to freeze food for those days when I didn’t trust myself to cook. (That has changed here in Las Vegas, because I can get take-out or delivery if I’m having a really bad day.) And so on. Everything had its place in the schedule, based on how much brain power it took.

Top of the brain power list, of course, was fiction writing.

So many writing gurus advise that you set an hour count (work 5-8 hours per day) or a word count. Which is well and good for the healthy folk, but for someone with a chronic illness, a daily quota is as impossible as a day job. I never know if I’m going to get gassed out by someone wearing too much cologne or if I’m going to accidentally walk into a store that reeks of incense because some idiot owner believes that’s enticing to customers.

I have those issues less here, but when I lived up north, something as simple as stepping into a crowd might make me sick for days. Not to mention all those years when I didn’t have the migraines firmly under control.

I had plans for work that I could do when I couldn’t write fiction. In fact, my alertness to-do list looks something like this:

Fully alert: Fiction

Slight headache/brain fog: non-fiction

Headache/brain fog: reading/editing

Bad headache/brain fog: TV or movie watching


Of course, if the headache/brain fog was so bad that I couldn’t look at a screen, I would sleep. Sometimes that made things better. Often it made things worse.

I’m going to add how the exercise would fit into those categories now:

Fully alert: Fiction or exercise

Slight headache/brain fog: non-fiction or exercise

Headache/brain fog: exercise or reading/editing

Bad headache/brain fog: TV or movie watching

Note that I could exercise with a headache, but not with a bad headache. It was too dangerous. I wasn’t alert enough to see a curb, let alone cross a street.

But I learned after I started walking and running outside that a walk in the bracing fresh air sometimes cleared up a headache or at least made it recede enough for me to work on non-fiction.

So exercise had its list as well.

The days in which I couldn’t work at writing or editing at all became my days off. They were rest days, and if I actually used them to rest, I would be better quicker than if I worried about them or tried to force myself to work.

I gave myself permission to be sick, usually after trying to get some words or exercise under my belt. And that was how I lived for a long time.

So…I needed to maximize those alert hours.

I did so by having lists of projects, and what I would work on next. Again, the less time I spent dithering over what to do gave me more time to do whatever I needed to.

I broke my work day into segments:

1-2 hours writing.



1-2 hours writing


Bonus time (maybe)


Or…in the winter



1-2 hours writing

Short break

1-2 hours writing


Bonus time (maybe)


There were many days when I only got the 1-2 hours of writing done along with the exercise. And in the winter, those 1-2 hours were always a struggle.

I did my very best to get at least 1,000 words done no matter how my headache was or how bad I felt. Even with a brain fog, I could manage a bit of nonfiction. I usually got more than 1,000 words done, because once I got started, I would keep going to the end of a scene. But 1,000 words was a small goal, and a doable one in less than an hour. I felt like I accomplished something.

1,000 words of new material five days per week is 5,000 words per week, or 260,000 words of new material per year. That’s about three 90,000 word novels. Three novels is prolific by traditional publishing standards—hell, by any standards.

I usually wrote a lot more than that. In fact, I don’t think I’ve ever had a year that low on word count because I would have 5,000 word days mixed with 3000 word days mixed with the 1000 word days.

The key was the two-part minimum: I had to try at least an hour of writing, and in that hour, try to get 1,000 words.

If I couldn’t do either, fine. I would default to the other parts of my list.

But if I did, then that was a victory.

Victories are important. Because in a world where everyone else seems to have more energy and an ability to get more than one task done per day, it’s so easy for a chronically ill person to see life as a series of failures.

I can’t becomes more prevalent than I can.

Rather than set myself up for failure every day by trying to hit some artificial goal of a word count or hours at my desk, I had a vague goal to do 1,000 in an hour. If I didn’t make it, I didn’t beat myself up. I celebrated whenever I did make it, and marked those victories in my calendar.

When I was writing novels for traditional publishers, I set my deadlines (they ask you to) at a pace that was roughly equivalent to the one I listed above. I planned 5,000 words per week on a novel. I usually got much more than that. Either I turned the book in early or I worked on other projects at the same time.

And somehow, through all of that, I became known as prolific, even though I was struggling each and every day.

I think the biggest part of being productive for me, especially when I was really ill, was that I believed I could do the minimum every single day. A glance back in my calendar shows me that missing the minimum happened every week for me. But so did exceeding the minimum. And it all balanced out.

Priorities helped me choose what to do every day—family, health, writing. If something didn’t fit in those categories, it came in lower on the priority list. Which made saying no to things easier, and allowed me to make choices that benefitted me.

My life is different now because I’m healthier. I can do more than one thing in a day. In fact, today, I went to a meeting, went out to lunch, wrote 3,000 words and once I’m done with this, I’ll head to the gym to do my daily run. (It’s too cold and windy to run outside today.) Then I’ll come back and read.

That’s a normal person’s life and unless someone at the gym is wearing too much cologne, I’ll manage it.

But I recognize that this life is unusual for someone who suffers from a chronic illness. It was nearly impossible for me to have a day like this as recently as a year ago.

I feel fortunate that I can do it.

But I know how to remain productive if my health gets worse.

It’s all about planning, priorities, and energy evaluation. And self-care. Always self-care.

Which is why I’m heading to the gym. Right now.


As I mentioned above, this is part of the book Writing With Chronic Illness that will appear later this spring. If you support my Patreon at the $10 or above level, you’ll get this book (and others that I write while doing this blog) for free. If you support at the $5, you’ll be able to see some Patreon-only content, including one other short essay that’s part of the book, but too short (in my opinion) to be part of this weekly blog.

The next two posts will be from the book as well, unless something major happens, the way it did last week, with the whole plagiarism scandal. Then I’ll bump the chapters back to accommodate the news items.

And…since I’m mentioning Patreon…here’s the weekly reminder that this blog is reader-supported.

If you feel like supporting the blog on an on-going basis, then please head to my Patreon page.

If you liked this post, and want to show your one-time appreciation, the place to do that is PayPal. If you go that route, please include your email address in the notes section, so I can say thank you.

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“Business Musings: Productivity,” copyright © 2019 by Kristine Kathryn Rusch. Image at the top of the blog copyright © Can Stock Photo / andrewgenn.


17 thoughts on “Business Musings: Productivity (Writing With Chronic Illness)

  1. I have a chronic illness that also leaves me fatigued. Recently, I made up a work schedule for my writing and art with set clock in and clock out times. The change in my productivity was amazing. In one month I wrote 30K words a few different stories. The problem was before I wasn’t allowing myself to rest and constantly worrying about being productive. That drained what little energy I had.

  2. I have two chronic illnesses, neither of which has a cure (except for radical surgery for one that I don’t actually qualify for at the moment). The last two months, they’ve been feeding on each other. Throw in the time change and I’m NOT a happy chronic pain warrior. I despise the spring time change. I’ll spend the next two months getting adjusted to it. Both illnesses make exercise incredibly difficult and it doesn’t make me feel better. It often makes things worse, in fact.

    I’ve never been considered prolific. It’s just not me. And I’ve always been okay with that. I made a radical change to ,y writing routine last fall and the benefits to my body have been amazing. My daily output has gone down a bit, though. In the long run, it’s a trade I’m willing to make.

    I’m now drafting by hand, with my fountain pens, in an A5 notebook. Writing this way allows me to get truly comfortable when the pain is making itself known in various parts of my body. I’ve spent nearly every writing session of the last two weeks stretched out on the couch with my lap desk. I could do that with my laptop, but that requires extra energy of plugging and unplugging because the battery is shot. And right now, I can’t stand the weight of it on my lap. It hurts too much.

    I do have a daily goal for pages written, but I’ve only met it twice this month. It’s been too much with everything else I’m dealing with. So I’m happy with just words on the page, even if it’s only two paragraphs. It’s still forward progress, and more words than I had the day before.

    I’ve also developed a ton of scent/perfume/chemical allergies over the last few months, so I’ve been learning how to live with those. It makes me grateful I started working for myself a couple years ago so I don’t have to deal with triggers in an office environment.

  3. It’s like you’re writing about my life with post-TBI! Thank you for writing this, count me as buying a copy of this book on launch day! Hell, I’ll buy it in all formats, just saying!

  4. Thank God I have been blessed with good health and, most of the time, stamina as well. I never set any word or time goals,but during the decades I was wor– I almost said “working’ but it was not work!–writing any of the 12 novels currently on Amazon, and 3 or 4 that languish unfinished for other reasons, I was “in the zone” for as many hours and as many days as were available to me. And during days when other tasks required my time, looking forward to the next writing session was a joy anticipated.

  5. I thought I was being lazy and sloughing off my responsibilities because YOU could do it – write with chronic illness – until I got to the part where you run. And reality set in.

    We are in entirely different categories of chronic illness; that’s why I can’t even aspire to what you can do. You are orders of magnitude more functional, even with your limitations. Maybe not compared to ‘normal,’ whatever that is, but definitely compared to me.

    More power to you – and enjoy it, and Las Vegas, and all the good changes. Your priorities are right for what you’re accomplishing.

      1. Thanks, Cora.

        I’ve known about the spoon theory since it came out.

        That’s why I know I won’t get things done in writing when I have to do other things that are temporarily more important – I don’t stress over it, just note it and wish it were over.

        I waste time because all I can do during it is to breathe, so I keep doing that.

        I wouldn’t have initiated the move unless it were both necessary, and likely to eventually help. I severely underestimated how much it would take, and for how long, but I don’t stress over that, because it was still the best option.

        Now that we’re getting through it, there is hope closer than the end of the tunnel.

        I am content with that, because I am a realist. I keep reminding myself I am NOT lazy, but ill.

        How are you doing?

  6. Thank you for this. As someone with a chronic illness of my own, this is deeply encouraging. I’m looking forward to buying the book.

    I love the idea of a ‘best to worst days’ to-do list, and will implement it immediately. My decision-making skills go out the window when I’m having a bad day, so a flowchart is a useful tool. Start at the top with the highest-demand task (Write first draft fiction-novel). Can I do that now? No? Next box. If I get to the last box (Listen to audio fiction) without finding a thing I’m capable of, it’s time to curl up with an ice pack for a nap. (If I can’t read the chart? It’s a Very Bad Day. Default to nap.)

    The wrong scent can knock me down for days. It’s the hardest trigger to manage, aside from the dreaded ‘weather changes’. (I live more-or-less in the Pacific Northwest. Since we’re the only people near enough to care for aging in-laws beginning to show signs of dementia… moving isn’t in the cards right now. We were working on it before their health issues arose. Family first.) Light and heat are actually two of my triggers, so our dark winters are kind of compensation for the unstable weather patterns.

    All that rambling to say that I love to see how you managed productivity around a life with real demands and imperfect circumstances, adjusting your systems until they worked for you. It’s so helpful to hear you explain that you designed a fluid system around your needs, tweaking it as they shifted, or as you realized new thing things (like ‘running helps’), or as circumstances changed. The one thing that you kept immutable was your priority list (Family. Health. Writing.), and even that you purposefully re-evaluated and re-ordered at one point when it wasn’t working for you.

    Sometimes people are so enamoured of their system that they forget systems are a means to an end.

  7. Thank you for these articles on writing and chronic illness. I look forward to your book next month.
    Last October I was in the hospital for four days due to a new development in my illness and every nurse and medical assistant wore perfume that was so strong I usually smelled them long before I saw them and when they bent over me to adjust something I had to hold my breath. I don’t have sensitivity to smells, but my sister does and all I could think was she would probably never get out of the hospital given how often I had to deal with the perfumed caretakers. I imagine the world is quite the obstacle course for you.
    Thanks again for writing the book. It will help a lot of people.

    1. That drives me crazy! I’m now highly allergic to scents, including essential oils. People in the medical profession aren’t supposed to wear scented products for this very reason. My dad’s a doctor and nobody on his staff was allowed to wear perfume and he didn’t like highly scented lotions either. Working in his office for several years was a safe haven to my allergies.

    1. I’m aware of the spoon theory, but being a gamer I like the spell slot theory better. I can only carry so many spells. One for people, one for writing, one for chores, etc. And when I’m out of spells I have to rest to relearn the spells again. totally a gamer/geek thing, but it amuses me.

  8. How in the world did you do the mystery workshop in 2017, or all the other workshops, for that matter? I am not the most perceptive individual but I’m still amazed I didn’t notice. Except for the heavy stress on scents.

    1. There are different parts of my brain, Dave, and teaching in a comfortable environment is much easier for my brain (even with brain fog) than writing. So I just focused on the teaching. You’ll remember, though, that we had two sessions, one early and one late. I could rest between them.

      1. I attended both workshops you held in 2017 and gifted you a lap quilt I had made (scent-free ?) with a card citing 3 reasons for the gift. I could easily have cited a fourth: for your display of courage and generosity in continuing to help other writers when you were barely hanging on. You are special in so many ways and I’m very, very grateful for all you and Dean give us.

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