It has been 10 days since my last story. That must mean I’ve been working a lot of shifts in the CCU because I enjoy this newfound writing and reading during my mornings. But then again, inspiration for writing content has been harder to discover recently. The purpose of this blog wasn’t to rediscover the wheel but to really touch upon things I do in the ICU constantly that I personally didn’t deeply understand and find evidence behind the practice. Again, it was to challenge myself to take what people say with a grain of salt (not because they’re wrong because I work with brilliant clinicians) and discover my own path to medicine (using more primary data rather than secondhand). This “spiel” is just to re-enforce myself. I was going to write about midodrine use for IV vasopressor weaning today. Certain attendings have a huge preference for it and recently we’ve been dosing it like candy. And anectodely I see that patients come off these pressors and stay off of it. There are a lot of small-scale studies and retrospective studies but there aren’t many RCTs for it. Midodrine is usually indicated for orthostatic hypotension. Anyways, I’m not going to write about it today but the post will be coming.

I wanted to write about my routines that I’ve been using the past 2–3 years today. They have been working well for me but I don’t remember why I started doing what I’ve been doing. Hopefully writing about it will jog my memory and re-enforce the routine as well.

  1. Waking up by 8:30am (on my days off)

I made this arbitrary time for myself because anytime during the seven o’clock am hours seems early to me. And everything after nine o’clock am seems late. There is so much you can do in the morning to be productive and accomplish before noon. This is something I learned from my mom who wakes up around 6:30–7:00am everyday and devotes those immediate hours to a cup of keurig coffee and quiet time with God. I guess watching her do this subconsciously rubbed off on me (but I’m just not as disciplined to her earlier mornings so 8:30am is just fine for me). And it’s definitely not from watching my father since he wakes up at 10–11am. Now I have almost four hours to myself to do more wholesome things.

2. Don’t look at your phone immediately after waking

I make a point to place my phone a few meters (metric system anyone?) away from me at night when it charges. So when I wake and reach for my glasses, my phone isn’t there. Otherwise, you know what will happen: a whole hour will pass by with you scrolling through twitter/facebook/instagram/tiktok or what have you in bed. And then it’s almost ten o’clock. And something just doesn’t feel natural about starting my morning like that (and you guys know it).

3. Make a cup of coffee

There’s something therapeutic about making a cup of coffee. I have trained myself over the past few years to be super excited about this. This is motivation to get out of bed as well. And what makes it better? I have a beautiful set up curated by yours truly. A Bonavita Electric Gooseneck kettle for the perfect pour and temperature, an Acaia Pearl White scale that times and weighs to the tenth of a gram, and my Niche coffee grinder created in the UK; a stepless burr grinder that grinds with precision and consistency. And then my trade coffee subscription, which delivers me freshly roasted coffee of my choosing from a variety of roasters. Right now, I’m drinking Bookkisa, an Ethopian Roast from Passenger Coffee. Plus, I try new coffee recipes all the time! This therapeutic-ness originally stemmed from Matt D’avella’s YouTube video about minimalism. It’s about being meticulous and intentional about what you do. I’m concentrated on making my coffee (weighing the beans, how I pour, how I “Rao” swirl, etc). Rather than doing something while a Keurig brews it (yuck). I guess this is an intro to my exiting of the multi-tasking world.

4. I read the news and write in my moleskin (and now this)

This is the time I look at my Gmail inbox and open the my NYTimes Morning briefings. Reading in the morning is nice to do (even on a laptop). And what’s worse than an un-informed person? Nothing. Just kidding! I just like to know what’s going in my city, my country, and the world. It’s a way to avoid ignorance and add to my repertoire of things to be opinionated about (which I find very important nowadays).

I write things in my moleskin to develop my thoughts and for the future me to look back on. And to write my schedule down and things that happened. This helps my creativity and organization.

5. After news or lunch, anything is game

I don’t have any routine after noon/lunch hits. Anything is game. Unless I am in San Diego because then I’ll take my nap on my napping couch (West Elm) at like 1:00pm.

6. New: Walk to the park, sit on a bench, read (if it’s >60 degrees F)

I just started this two weeks ago. It’s now Spring and it’s getting nicer out. I get lazy and stay cooped up in my apartment. I have a beautiful park on the UES a block away from me. I would be crazy not to take advantage of it more. So walking there get’s me fresh air, a view of the East River and Roosevelt Island and Randall’s if I look North, a tan, and a smaller dad bod. Recently 2:00pm has been a good time to venture there since the sun is high up and it’s warm. I just finished “The Ruthless Elimination of Hurry” by John Mark Comer (after four months of reading). Great book first of all and a very close parallel to this post’s content. I’ll do a book review of it soon. Currently trying to finish Sam Parnia’s “Erasing Death” on my kindle.

7. Don’t look at your phone immediately before bed

So I place my phone on a charging pad a few meters away from me like I said earlier. It’s to prevent me from looking at my lit phone screen prior to bed and in the middle of the night when I wake up to use the bathroom. We live in a world where we stare at our phones all day and feed our brains with crap information that personally for me, isn’t very wholesome. And the screen just messes with your circadian rhythm and re-wires your brain to think it’s not nighttime (from what I read and hear but I don’t have evidence-based studies to post for this right now). So parting myself from more electronics right before bed feels liberating. As if I don’t need my phone to survive.

And there you have it. These are important parts of my day that I wanted to talk about. Hopefully this gives you more perspective in case you were looking for a change. It’s also a small window into my being and who I am maybe why I am the way I am. Cheers.


Midodrine or Comer book review on my next post.

Darren is a physician assistant specializing in Cardiac Critical Care in New York City. Passionate about resus, shock, PE, cooking & coffee.

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