It’s a way for me to unwind after a long day.

When I go alone, I try to walk in silence.

No music. No phone.

Just listening to the sounds around me, feeling each step, paying attention to my breath.

I notice what comes into my mind, but I don’t hold onto it.

Thoughts come and go—like the houses and trees I pass.

I see them, acknowledge them, and keep moving.

I could talk about the physical benefits of walking.

But that misses the point.

This isn’t about steps or exercise.

It’s time that’s just mine.

And the benefits aren’t something you can really measure.

During the walk, I reflect.

On my day.

On myself.

On things I didn’t have time to process.

It’s one of the few moments where there aren’t constant distractions pulling at me.

It reminds me of being a kid.

Walking to school.

To the bakery.

To the library.

To a friend’s house.

Kicking rocks.

Looking at dogs, birds, lizards.

No destination that really mattered.

Just moving.

Carefree.

There’s something about that feeling I come back to on these walks.

A way to reconnect with what’s real.

To let go of some of the weight that builds up—from work, from life.

And I think the reason it works is simple:

I don’t expect anything from it.

I’m not trying to optimize it.

I’m not trying to get something out of it.

I just walk.

The world is loud.

It’s easy to feel overwhelmed.

Find a way to step away from it.

Even for a little while.

I used to think about that mostly at work.

In the ER, we’re constantly being measured—wait times, length of stay, all these different metrics. And when something isn’t where it’s supposed to be, the first instinct is to look at the person.

This doctor is too slow.

That nurse isn’t doing this right.

But the longer I’ve been doing this—especially in more of a leadership role—the more I’ve realized that’s almost never the full story.

Because none of it exists in isolation.

Wait times depend on staffing.

Staffing depends on volume.

Volume depends on things you can’t control.

Boarding affects everything.

It’s all connected.

So instead of asking who’s the problem, you start asking:

What system is creating this result?

And once you see it, it’s hard not to see it everywhere.

Including in your own life.

Because the life I have right now is the result of a system I’ve built—consciously and unconsciously.

Not luck.

Not randomness.

My habits.

My routines.

The way I think.

The decisions I make every day.

It all adds up.

And that realization is uncomfortable at first.

Because it means I can’t just blame the outcome.

Or blame other people.

Or blame circumstances.

If something isn’t going the way I want, it’s usually because of something I’m doing.

But that realization is also freeing.

Because it means I can change it.

Now, when something feels off, I try to pause and ask:

Is this actually the situation?

Or is it the system I’ve built around it?

If I’m not improving at something—

Is it really that hard?

Or is it how I’m practicing?

If something in my life feels off—

Is it just bad luck?

Or is it a pattern I haven’t looked at closely enough?

The same is true for how we think.

I see this a lot working with patients struggling with anxiety, depression, and PTSD.

Two people can go through the same experience and end up in completely different places.

And a lot of that comes down to how they process it.

The story they tell themselves.

The patterns they reinforce.

That’s part of the system too.

So instead of getting frustrated with outcomes, I’ve been trying to look at them differently.

Not as failures.

But as feedback.

Because if the outcome isn’t what I want, there’s always something upstream that can be adjusted.

Something small.

A habit.

A routine.

A way of thinking.

A lever I haven’t pulled yet.

And that’s really the shift:

Stop staring at the result.

Start looking at the system.

Because the result isn’t random.

It’s built.

And anything built—

can be rebuilt.

I took care of a young man who died today.

He was at work when he was electrocuted after coming into contact with a live wire.

Paramedics did everything they could. CPR. Shocks. Medications. Intubation.

When he arrived in the ED, we kept going. We had to try—he was so young.

But nothing we did could restart his heart.

He had a family. A wife. A child.

They don’t get another chance.

And what stays with me isn’t just the moment. It’s what it represents.

He was living a normal day.

Doing what he was supposed to be doing.

And then it was over.

Just like that.

We like to think we have time.

That we’ll say the things later.

Do the things later.

Become the person later.

But the truth is, there’s no guarantee of later.

Not for any of us.

So the question becomes:

If today was your last day—

Or the last day for someone you love—

What would you regret?

What would you wish you had said?

Who would you wish you had called?

What would you wish you had done differently?

Because one day, without warning, it will be.

And when that moment comes, the only thing that will matter is the life you actually lived—

And the things you said and did while you still had the chance.

One of the ideas I’ve been trying to live by recently is simple: just do it.

In my mind, that means not stopping myself from doing things I know I need to do or want to do.

I’ve always had a tendency to delay. To negotiate with myself. To come up with reasons why something can wait until later.

And in the end, I still have to do the thing.

All the delay does is make the transition harder.

The cold shower has become a way for me to train that moment—to practice moving through resistance without overthinking it.

It might not make perfect logical sense. But it makes sense to me.

Because how can I expect myself to follow through on bigger things if I can’t do this one small thing I’ve chosen for myself?

Stand under cold water for two minutes.

That’s it.

If I can do that—if I can intentionally choose discomfort and follow through—then maybe I can start to trust myself in other areas too.

Because in the end, I’m the one choosing.

The Moment Before

When I first had the idea, I didn’t plan it.

I didn’t research it. I didn’t optimize it.

I just decided I’d start the next morning.

There wasn’t much to think about anyway. I either do it, or I don’t.

So the next morning I got in the shower, set a two-minute timer, turned the knob to cold, and stepped in.

And I’ve done that every day since.

Even on the days I would normally quit.

After overnight shifts.

When I was running late.

When I didn’t feel like doing anything.

Because the truth is, I need to shower anyway.

And I have two minutes.

It Never Gets Easier

Let me tell you—it doesn’t get easier.

Every morning, when the cold water hits my face, I gasp.

My body tenses. My mind immediately looks for a way out.

You don’t have to do this today.

Just make it warm.

Skip it this once.

The same story shows up every time.

And every time, I step in anyway.

That moment—that space between the thought and the action—is the whole point.

Because that’s where the choice is.

What Actually Changed

What’s interesting is how I feel afterward.

More awake.

More focused.

More present.

And almost immediately, I forget how uncomfortable it was.

But the real change isn’t the cold water.

The real change is everything else.

Starting my day this way has made other decisions easier.

I hesitate less.

I negotiate less.

I move forward more.

I still procrastinate. I still feel resistance.

But now I recognize it.

It feels the same as those first few seconds in the shower.

The same tension. The same urge to step away.

And now I know I can move through it.

A Small Way to Not Be Sick

The cold shower isn’t about toughness.

It’s about alignment.

Doing what I say I’m going to do.

Not avoiding discomfort.

Not getting stuck in the story my mind is telling me.

It’s a small daily way of not being “sick.”

Of not being stuck in hesitation, avoidance, and delay.

If I can start my day by doing something my mind and body resist, then the rest of the day feels more manageable.

Not because life is easier.

But because I’ve already proven to myself that I can act anyway.

Right Now

There’s a phrase I keep coming back to:

The fool is always getting ready to live.

There will always be a reason to wait.

To start tomorrow.

To do it later.

To prepare a little more.

But that’s not real.

I’m not living tomorrow.

I’m living right now.

And for me, stepping into cold water each morning is a small reminder of that.

The first is:

“You must be an adrenaline junkie.”

The second is:

“What’s the worst thing you’ve ever seen?”

Both of those miss what the job really is.

The adrenaline one has some truth to it. There are moments of intensity, and I think a lot of ER doctors are comfortable in those moments—being the ones making decisions when things matter.

But most of the time, that’s not what the job looks like.

Most of the time you’re sitting at a computer. Reviewing labs. Putting in orders. Reassessing patients.

It’s steady, methodical work and the adrenaline only comes in short bursts.

The other question—the one I find more difficult—is:

“What’s the worst thing you’ve ever seen?”

The problem is, people don’t actually want the answer to that question.

And it’s not something we want to talk about.

It’s a little like asking a combat veteran if they’ve seen someone die in war. If they have, it’s probably something deeply personal. Maybe it was someone they knew. Maybe it’s something they’ve worked hard to process or move past.

The same is true in the ER.

The worst things we see are the worst parts of humanity. Terrible things happening to people. Sometimes things people have done to each other. Sometimes things no one could have prevented.

They’re not stories you tell casually.

So I usually avoid the question or give a safer answer—a story that’s strange or uncomfortable, but not devastating.

Typically, if you ask me, I’ll just say: “We see everything.”

And leave it at that.

Because when you start to talk about the real things, it changes the room.

And honestly, I don’t want to relive those moments either.

A more interesting question—the one I get less often—is:

“How do you do it?”

How do you function in those situations?

For me, the answer is that you have to change how you think in the moment.

When you’re dealing with something truly terrible, you can’t approach it fully as a human experience.

You can’t sit there thinking, this is someone’s child or this is someone’s life.

Not in that moment.

Because if you do, you freeze.

You lose the ability to act.

So instead, you shift into something more structured. More procedural.

You break everything down into steps.

What needs to happen next?

What’s the priority?

What can I do right now?

It becomes almost mechanical.

One step at a time.

You focus on the process so you can do your job as well as possible.

Because in those moments, that’s what matters. You can’t afford to get overwhelmed by the full weight of what’s happening.

But that doesn’t mean you don’t feel it.

It just means you delay it.

Because afterward—when things slow down—it comes back.

The reality of what just happened.

The people involved.

The weight of it.

That’s the part that stays with you. That’s the part that makes the job hard.

Learning how to carry it without letting it break you is what makes the job hard. It’s why not just anyone can do it.

For me, writing is part of that process. It’s how I try to remain not sick.

It’s a beautiful phone. The screen is incredible, the camera is amazing, and it can do far more than I even use it for.

I didn’t want to hide how nice it looked. I carried it carefully, made sure it stayed in my pocket, and tried to avoid anything that might scratch or damage it.

Then one day I sat down at my desk and the phone slid out of my pocket.

It hit the floor and dented a corner.

I felt awful. My new phone was no longer perfect.

So I did what most people do. I bought a case. A nice one—something that still looked good but would protect it. Then I added a screen protector to keep it even safer.

Now it was protected.

And I relaxed a little. I enjoyed using the phone without worrying about damaging it, even though I couldn’t show off its original beauty anymore.

Then one evening I was out for a walk.

I had my phone in my hand and tripped on something. In that split second I let go of it.

It fell and landed in the exact wrong way. Despite the case. Despite the screen protector.

The screen shattered across the entire top of the phone.

And right there, in that moment, I realized something.

The moment I bought the phone, it was already broken.

The mistake wasn’t dropping it. The mistake was becoming attached to it—treating it like it was something permanent, or like it somehow reflected something about me.

It reminded me of an old Buddhist teaching of the “broken cup.”

When you buy a cup, you should think of it as already broken. Because someday it will be.

If you accept that from the beginning, you can enjoy the cup while you have it. And when it eventually breaks, you won’t be surprised, saddened, or disappointed.

The same is true for almost everything in life.

Accomplishments.

Possessions.

Even the people we love.

None of them are permanent.

That doesn’t mean we shouldn’t enjoy them. It just means we should hold them a little more lightly.

My phone breaking was a small reminder of that.

So now I’m getting another phone because the cracks are affecting the front camera and text inputs. And yes, I’m ordering a case and a screen protector.

But not because I’m trying to keep it perfect.

Just because I’d rather avoid the inconvenience of replacing it again.

And now I can enjoy it for what it actually is:

A tool.

A camera.

A way to connect with the rest of the world.

Nothing more.

And someday this one will break too.

I’ve been trying to improve my daily rituals as a way to improve myself and create the kind of life and environment I want.

One of the things I’ve been working on is being more intentional with my reading.

There was a time when I would have considered myself an avid reader. Before medical school I read constantly—mostly sci-fi, thrillers, horror, and adventure. Pretty typical stuff for a young guy who just enjoyed getting lost in a good story.

Then medical school happened.

For those years, it became about survival. Most of my time was spent studying and trying to stay afloat with the volume of information we were expected to learn, and reading for enjoyment fell by the wayside.

I still read a little during that time, but not nearly as much, and most of it shifted toward nonfiction, finance, health, and self-improvement.

In the years since, reading has stayed part of my life, but it’s been inconsistent. I’ve definitely read more since becoming an attending, but not as much as before and not with the same enjoyment

Recently I decided I wanted to change that.

One thing I’ve become more aware of is that I don’t want to spend time reading without really getting something out of it. Enjoyment matters, of course, but I’ve found that I actually enjoy things more when I’m actively engaged with them.

When I exercise, I want to improve.

When I work, I want to grow.

And when I read, I want to extract ideas I can think about and apply.

So I decided to create a simple challenge to improve my daily reading.

The goal is straightforward: 20 pages a day.

That number gets thrown around a lot—20 pages a day equals dozens of books a year—but the number itself isn’t really the point. The point is consistency. The number was just an easy starting point.

If I can read 20 pages every day and actively engage with the material, then little by little I’m exposing myself to new ideas and hopefully improving myself in small increments.

To help with the structure, I actually used AI—not to do the reading for me, but to help me organize the plan.

I try to use AI like an assistant. Not to do the meaningful work, but to help remove friction from things I tend to get stuck on.

Planning is one of those things.

I have a tendency to overplan. I’ll refine a system endlessly before ever starting. Sometimes I get stuck perfecting the plan instead of actually doing the thing.

So I let AI help me create a simple framework and then focused on execution.

I gave it a general outline of what I wanted and let it do the rest.

The basic plan looks like this:

Daily

• Read 20 pages

• Highlight and Mark → while reading

• Write a quick summary after

Book Rules

• Quit bad books guilt-free

• Write a short summary when finished

• Apply one idea from the book

Habit Anchor

• Attach reading to an existing routine.

My morning looks like this now.

(My normal daily routine)

I wake up early.

Take a cold shower.

Make a cup of coffee.

(Habit Anchor)

I sit down and read while drinking my coffee.

The past few mornings I’ve done this, it’s actually been surprisingly enjoyable. What used to be a loose habit now feels more like a ritual. Drinking good coffee while reading before anyone else at home wakes up.

And rituals have a way of changing how something feels. Instead of rushing through the activity, you slow down and engage with it.

It’s also had an added benefit, it replaced a ritual I didn’t realize I had. I used to drink my coffee while scrolling on my phone or sitting at my computer. That was something I wanted to remove and now I have.

And that’s really the idea.

Small daily improvements that compound over time.

If there’s anything I’d encourage others to try, it’s this:

Take something you already do—or something you wish you did more consistently—and turn it into a small daily ritual.

Give it structure.

Engage with it intentionally.

Try to extract something meaningful from it.

You might find, like I did, that the activity becomes even more enjoyable once you start doing it with purpose.

The idea is simple: the life we experience is built from the thoughts we repeat and the beliefs we carry.

I don’t mean that in some metaphysical way where thoughts magically reshape matter. I mean that everything starts with how we think. Our thoughts become beliefs. Those beliefs drive our actions. And those actions shape the world around us.

When I look back on my life, almost everything that’s happened has followed that pattern: a thought that turned into a belief, a belief that turned into action, and actions that ultimately changed the direction of my life.

There’s one moment I remember clearly.

I had graduated from college and had been working as an elementary school teacher. I was living with my best friend in Austin and was in a long-term relationship with my girlfriend. Life was good. I felt happy with my job and where I was.

Then one day I was talking to my mom on the phone, just catching up and telling her how things were going.

During the conversation, she mentioned something almost casually: when I first left home for college, I had planned on pursuing medicine. Why was I a teacher? She reminded me I had always said I wanted to be a doctor.

She wasn’t mad. But I could hear the disappointment in her voice. And that stuck with me.

After I got off the phone, I sat there thinking: Why hadn’t I pursued medical school?

I had graduated early. I had done well in school and completed most of the prerequisites. But I hadn’t taken the MCAT or actually applied. And in a moment of honesty with myself, I realized the truth: I didn’t believe I deserved it. I was scared of the responsibility and pressure of actually becoming a doctor, of actually having to follow through. I had been stopping myself.

During undergrad, I had started creating excuses. I told myself I didn’t like my classes or the people in the pre-med track. Part of that may have been true, but a bigger part was fear. I was avoiding something that felt hard and that, deep down, I didn’t feel worthy of.

Looking back now, I think that’s one of the ways we become “sick.” Not physically sick, but mentally stuck. We start believing something is wrong with us. That we’re not capable. That we don’t deserve the life we want. That belief quietly shapes our decisions.

And before we realize it, we’ve built a life around it.

In that moment, I decided that was bullshit.

I decided I was going to be a doctor—no matter what it took. I looked at my situation and realized it didn’t reflect who I believed I could be. It didn’t reflect my worth. I told myself I am worthy, and that was all that mattered.

Immediately after that realization, I got on my computer and started researching what I needed to do to get into medical school. I didn’t overthink and didn’t hesitate. I signed up for an MCAT prep course and made an appointment with my former college counselor.

From that point forward, I wasn’t just a teacher anymore—I was someone taking the first steps toward becoming a doctor.

I realized I needed to take Biochemistry to apply to every medical school in the state, and I would have to retake Organic Chemistry since my previous grade wasn’t up to my standards. I also looked up the average MCAT scores for the top schools.

I made a decision: I was going to earn top marks in the classes I needed and get an MCAT score that would make me competitive at the best programs. I chose to see those requirements not as obstacles, but as part of the path forward.

When I studied, it didn’t feel like a chore. It felt like what was supposed to happen—what someone serious about becoming a doctor simply does.

So I did.

That summer, I earned top marks in both Organic Chemistry and Biochemistry. I did well enough that I was asked to tutor struggling students, and my professor was kind enough to write me a letter of recommendation for medical school. Later that fall, I earned the MCAT score I had told myself I would get.

There were bumps along the way, of course. The timing wasn’t perfect. I had to apply to medical school twice. The first time, I didn’t fully understand how the application process worked. I applied late in the cycle, ended up on the wait list, and never came off it.

The following year I wasn’t going to make the same mistake and I wasn’t going to risk being wait listed again. I retook the MCAT, scored even higher, and submitted my application the day the portal opened. A few months later, I received an early acceptance to the school of my choice.

That conversation with my mom has always stayed with me. It felt like a wake-up call—not because I was doing anything wrong, but because I realized I had the power to decide where my life was going.

And I’m still trying to live by that lesson.

Now I’m no longer living with my best friend in a small apartment. I’m living in a home with my wife and kids, working as a doctor, building the life I chose for myself.

In a sense, I manifested my life as a doctor through that original shift in belief. Once something aligned in my mind, everything else gradually aligned around it.

The hard part is that I forget this all the time.

I still get stuck. I still feel trapped by circumstances. I still have moments where that voice creeps back in and tells me something is wrong with me, tries to convince me that something is wrong with me.

But the truth is the same now as it was then. I’m not sick. I’m just holding myself back, but now I know I have the power to do something about it.

That’s really all I’m trying to say.

You can do the same.

I’ve mentored students who want to go to medical school and find themselves in situations similar to the one I was in years ago. What I tell them is this: the only thing holding you back is your belief about what you’re capable of. Once you truly believe you can do something, that you are something, and start taking action—things begin to move in the direction you want.

That voice that says you’re not good enough begins to fade. The excuses lose their power. And when your belief in yourself becomes strong enough, that voice disappears altogether.

The first step is believing: you are not sick.

In the emergency department, we’re constantly making one fundamental distinction: is this patient sick, or not sick?

That question guides everything. If someone is truly sick—if they have something life-threatening—we act immediately. If they’re not sick, it means they’re stable. They can wait. They may not need urgent intervention at all.

Over time, that framework started to stick with me beyond the ER. I found myself applying the same question to other parts of life.

Am I sick, or am I not?

Not in the literal medical sense, but in the way many of us describe how we feel when life isn’t going the way we want or when a challenge seems insurmountable.

When we feel stuck, dissatisfied, or like something just isn’t right, it’s easy to start believing that something is fundamentally wrong with us—to start believing we are “sick.”

That we are broken.

That we innately lack something.

That we aren’t deserving.

But what if none of us are sick at all?

What if that feeling of being broken isn’t a diagnosis, but simply a lack of belief and momentum?

In medicine, even someone who is “sick” still has the ability to improve, recover, and move forward. And I believe the same is true in the rest of life.

We aren’t defined by our circumstances, our thoughts, or even our past failures. Those things don’t determine who we are unless we decide they do.

That idea is powerful to me. The idea that we are not our circumstances. We are not our temporary states. We are not broken.

We are not sick.

If that’s true, then the question becomes: what do we do about it?

Fundamentally, that is what I’m trying to explore with this blog.

As a doctor, I’m naturally a problem solver. I want to examine, diagnose, and treat problems. I want to identify the parts of my life that feel “sick” and work on them intentionally—shaping them in a way that moves me forward.

But this process isn’t about perfection.

It’s about small daily action.

The best medicine is often preventative, the things you do consistently to keep yourself healthy.

So instead of trying to make drastic changes I’m trying to focus on making small improvements every day. Small wins that move life forward and make life better little by little over time.

Improve my health.

Strengthen a relationship.

Learn something new.

Build a better routine.

Fix something around the house.

Each small action is a step in a direction. And over time, those steps begin to accumulate.

More importantly, they begin to change how you see yourself.

Every action becomes evidence. Evidence that you’re capable of change. Evidence that you can move forward. Evidence that you’re not sick.

Belief, it turns out, is built through action.

This blog is about proving that we are not sick by becoming the person we know we are capable of being.

It’s a place where I’ll document that process—trying things, running small experiments, building routines, and reflecting on what works and what doesn’t.

Some of those experiments will involve discipline, productivity, and mindset. Others might involve health, finances, relationships, or anything else that helps move life forward.

I’m not writing as an expert. I’m writing as someone who is trying to figure this out in real time.

The goal isn’t perfection.

The goal is progress.

Because if we’re not sick, then we’re capable of becoming something better.

And the way we prove that isn’t through plans or intentions.

It’s through action.

Every day.