Caffeine is practically a hospital food group.
Most adults consume caffeine daily, and physicians are probably overrepresented in that group. Early rounds, long cases, overnight calls — coffee fits naturally into the workflow of medicine.
And to be clear, caffeine works. It blocks adenosine, the chemical that makes you sleepy, and reliably improves alertness and reaction time.
So this isn’t a post arguing that coffee is bad.
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I pretty much chose the one subspecialty within plastic surgery that encompasses true emergencies…microsurgery. Which means waking up early, long cases, and late night surprises. I also make the choice to do it without caffeine.
So why not talk about that today!
Why I choose to wake up without caffeine
I don't drink any caffeine at all. No coffee. No caffeinated pop (not soda!). I guess I eat chocolate so that's it.
But why?!
Coffee smells so good. And comes in so many fancy forms.
Maybe I avoid it so I can save money on lattes to accelerate my path to FIRE?!
No! No, no, no. I don't believe in the latte factor.
Actually, I avoid caffeine because I recognized in college that it had an adverse effect on me. It didn't just “wake me up” but made me more anxious and overly jittery.
For some people, caffeine sharpens focus. For others, especially at higher doses, it can increase anxiety, jitteriness, and even interfere with sleep later that night.
I realized pretty quickly which camp I was in.
Even so, I continued to drink it a bit in medical school. Every once in awhile. But then one day I had a bunch right before being in the OR for a long time. And I was miserable.
So, from that moment, I just stopped drinking it and found other ways to get myself alert. And it's now been about ten years…
Now, compared to when I did drink coffee, I feel my transition from sleepy to awake actually happens smoother.
How do I wake up without caffeine?
To be honest, on a usual run of the mill day when my kids run in the room and wake us up around 6 AM after 6-8 hours to sleep, I just kinda wake up.
I think I've been off of caffeine for long enough that I just don't really know any alternative and just wake up.
So I don't have much to report there. I think once you live without caffeine long enough, you just acclimate.
But what about those middle of the night emergencies?!
In my practice, I perform complex reconstructions by transferring “flaps” of tissue throughout the body and reattaching the blood vessels to give them life and reconstruct cancer, congenital, or traumatic defects. You can learn more about microsurgery here.
Due to the nature of the surgery, if an issue arises with the blood vessel connections, it is a surgical emergency and needs to be dealt with in the OR within 30-60 minutes. These issues can often arise in the middle of the night.
My unexpected wake up routine
My usual process for getting alert starts with just the ring on my phone. For calls from the hospital, I have a unique ring set on my phone. Because this is different, my brain gets hardwired to wake up more quickly to this ring. This takes some conditioning but has helped.
I then always drink a bunch of water. When waking up, you are always dehydrated so I find this helps my system to get back in gear quicker.
Before leaving I always also brush my teeth and wash my face, even if I've just been asleep a few hours. By going through the motions of these parts of my “normal morning routine,” I'm conditioned to feel more awake like it is the actual morning.
Driving in, I force my brain to think through the steps that I am going to take immediately getting into the hospital and in the OR. It's easy to fall into a brain fog listening to music or something on the drive so being active with my thoughts helps jolt me awake and into the right mindset.
And that is why I wake up without caffeine and how I manage!
One thing I’ve learned over the past decade is that alertness is highly conditioned.
If you drink coffee every morning, your brain learns that coffee equals “start the day.” If you drink coffee before call, your brain associates it with performance mode.
But conditioning works both ways.
You can train your brain to wake up to a specific ringtone.
You can train it to respond to certain routines.
You can train it to activate when you mentally rehearse what you’re about to do.
Caffeine is one trigger. It’s not the only one.
And most importantly…I also will be financially free because I don't spend money on lattes…just kidding!
What do you think? Do you live without caffeine? If so, why? If not, what's your favorite drink? How do you wake up? Let me know in the comments below!
One Response
I like the post. For decades, I never drank coffee. Never really liked it, and it made me jittery so didn’t want to have it before any surgery. A few months ago my wife brought to my attention, that recent science suggests that coffee intake can reduce risk of dementia as we age. (I am, for lack of better description), am a “senior” plastic surgeon, so when the concept of dementia comes I pay attention (while I can, haha). Now I drink coffee on my non-surgical days (when I can remember…lol)