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What Wakes Me Up Early?

By Efrain Farias-Cisneros, MD, PhD

“Early to bed and early to rise, makes a man healthy, wealthy and wise.”
– Benjamin Franklin.

When I was kindly asked to write down something with the topic, “What keeps me up at night?” for this forum, I wasn’t sure I had something useful to share with the community. However, after thinking about it a little more, I decided instead to change the subject to, “What wakes me up early?”

During medical school and orthopedic residency, I was often staying until long hours after midnight studying and reading. Even during my night shifts, I always studied when no work was left.

Now, I’m just about finishing my formal studies: In one month, I present my oral PhD dissertation and, as a member of a family with children, the formula does not work anymore. I arrive home after morning surgeries and long hours of afternoon clinic, I am exhausted, hungry, but eager to share time with my wife and kid. Firstly, I try to play with my boy, I take the dog out for its night walk and finally, spend time with my wife. We can have a Mexican dinner together — which is lighter and later compared to American or Canadian dinners. We can watch a TV series, a movie, or read in the company of each other, and finally, fall asleep. That is a pretty conventional end of day, I assume.

What inspired me to write down this essay was something I learned from one of the most important mentors I have had on hand surgery. Dr. Carlos Zaidenberg showed me that if you wake up early, it’s a great moment for studying. Initially I wasn’t sure about it, and it is sometimes impossible for me to wake up early after a previous long day. I started doing it by necessity, when nighttime wasn’t enough to finish my homework, where home chores and tiredness prevented me from studying for my surgeries and difficult cases. After following Dr. Zaidenberg’s advice, it was pretty simple. I think the reason for it is also physiological, I am using the circadian peak of daytime cortisol to an early start of my day. I feel rested, fresh, and ready to advance on my work. During the morning, before going out to the hospital’s operating room, I already studied, chopped fruit for my family, walked the dog, and read the most important news from the previous day.  

I find my hand surgery learning very eclectic, I love to read and re-read some classics like Brand’s Clinical Mechanics of the Hand, Taleisnik’s The Wrist, and Toubiana’s The Hand. Also, I’ve found very practical and reader friendly the latest ASSH publications like those on tendon transfers and flaps. My current study is Rockwood’s The Shoulder. Finally, I’m still using the Green’s Hand Surgery for teaching my residents. For sure, I know I wouldn’t be able to keep pace on the field’s advance, but reading current publications from JHS, Shoulder and Elbow, Bone and Joint, just to mention some.

I know that the formula won’t work for everyone, some people like to start the day exercising, while others like getting out from bed as late as possible. For me, it has worked nicely. I hope some of the readers can try it, and if the outcome is as good as in my case, embrace it.

Comments (5)
Utkan Aydin
August 8, 2019 8:01 pm

Excellent article, very inspiring!

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Ranulfo Romo
August 8, 2019 9:41 pm

Great Efrain! Medical school and residency taught me to wake up really early. In my case y sometimes study but basically I try to fit in all kinds of activities that I could not do otherwise.

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Dominik Rog
August 9, 2019 12:14 am

Efrain, I wish I had your discipline to wake up early and educate myself on hand surgery. My mornings usually involve a scramble when I realize that I’m running late to clinic yet again. Thank you for sharing your wisdom!

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Elisa
August 9, 2019 2:48 am

Nice habit to start with! Thank you for sharing

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María Arellano
August 9, 2019 6:39 pm

I’m so proud of you! Te amo

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