Interventions In The Golden Hour

One of the early lessons in trauma care during my emergency medicine residency was the concept of the Golden Hour: early, appropriate intervention during the critical first hour following traumatic injury can avoid death.

I ended up practicing in a community hospital where our critical care cases are more medical than traumatic (stroke, sepsis, heart attack). Yet the concept of the Golden Hour stuck with me, and it has influenced my thinking beyond patient care.

Last week I took a walk with a dear friend, and in response to his probing questions I had what might be considered either an A-ha or a Duh moment.

In the course of our walk he helped me understand that I value discipline; that I pride myself on the ability to do hard things; and that I seek out this feature in those I consider my closest tier of friends. Yet discipline is not a trait that comes naturally to me.

Mornings are the make or break moments in my day in terms of whether I will be productive or sloth. I try to make what I do in that first hour after awakening pave the way for the rest of my day. It's a minor nod to stoic philosophy that pays a large dividend.

This morning I was up before 6 AM, the live webcam at my local surf break looked good, and I was in the water by 7 AM. In the brisk chill of the parking lot, I was changing into my wetsuit when another car pulled in alongside me.

The older guy behind the wheel stepped out of his parked car, vintage 1970s long hair and beard awash in ancient flannel. He was in a chatty mood.

Shaggy: How's it look?

Me: Not as good as the report predicted, but there's no place I'd rather be at this hour.

Shaggy: Exactly. My son and grandson are meeting me here soon to surf together.

We exchanged a few more pleasantries as the sun crested the hill and spilled warmth over us, and then I was walking down the trail to the beach.

In the water, the dropping tide helped. I huffed to get beyond a large outside sneaker set that threatened to pummel most of the lineup. Catching my breath after making it to safety a little further from shore, I was surprised by a loud exhalation six feet ahead of me. A slick gray form broke the surface, the telltale dorsal fin of a dolphin.

It was magical in the way things are when you are eleven and the world is a series of glorious adventures.

After an hour in the water, an elder statesman who is an accomplished surfer paddled up to me in his Cobra Strike. We'd greeted one another warmly for years now, as we collectively constituted half of the tiny tribe of kayak surfers in our area until I forfeited my membership and sold my kayak last summer.

I was home in time for breakfast with the family.

That momentum from overcoming inertia early, of resisting the urge to return to bed, would set the tone for the rest of my day.

I can do hard things.