The Art of Routine

Discover How Routineology Can Transform Your Life

Angel Iscovich

• Publisher: Skyhorse
• Year: 2021
• eBook ISBN: 9781510764569
• Topic: Personal Development
• Subtopic: Personal Success

This is not a "How to." Th ere is no "one size fits all" when it comes to routine. Dr. Iscovich shares his original study of routine—learn through his observations how routine can improve longevity, performance, and adaptability. You will be better equipped to construct a routine that works best for you! Conventional wisdom suggests that the best way to navigate our noisy new world is to accept change. Open up to novelty. Go with the flow. Live in the moment. Embrace the relentless pelting of content minute by minute. But routine experts Angel Iscovich, MD, Joe Garner, and Michael Ashley are here to say that's a bad idea. Humans don't just benefit from structure; they require it. Years of observation and practice led to their breakthrough concept of routineology, the key to optimize your life and the cure for crisis. Routineology's fundamental prescriptive is to look inside and live your life in a "time bubble" to find purpose, meaning, and joy. Offering insights from top performers and stories of triumph over adversity, this book demonstrates that routine isn't just a good idea—it's imperative for surviving and thriving today. Live a life of deeper meaning and navigate toward a better world with The Art of Routine.

CHAPTER 1

March Madness in 2020

I USED TO PRACTICE EMERGENCY MEDICINE, working long shifts in hospital facilities for up to forty-eight hours at a time. I had just snuck off to the sleep room near the end of a marathon session when a nurse woke me in a panic.

“We’ve got a woman in labor who’s not progressing,” she said, urgency seizing her voice. “The baby’s heart rate is variable. We need you now.”

After arriving at the labor and delivery area, I found no anesthesiologist, no ob-gyn—just a distressed mother in desperate need for help.

“We’ve been calling everyone, but no one’s answered,” said the nurse.

The baby’s heart-rate monitor slowed, further alarming the mother and gathering nurses. Worse, the woman still hadn’t dilated, and her baby was clearly in distress.

We must do an emergency C-section, I thought. But I’ve never done one on my own, let alone without an anesthesiologist.

The obstetrician arrived, quickly and quietly preparing for surgery. I sighed with relief until I remembered that the anesthesiologist still wasn’t here.

“We’ll do a conscious sedation,” I said, trying to calm the mother.

I opted for a local injection of lidocaine below the umbilicus, the way they did in the old days to make an incision. We opened the abdominal cavity, then the uterus, and finally the amniotic sack to deliver the baby seconds before the anesthesiologist arrived with the pediatrician in tow.

As we resuscitated the baby who was blue, listless, and without a discernable pulse, I was suddenly struck by the moment. Instead of thinking about the success of the resuscitation and the danger lessening by the second with all hands on deck now, I contemplated the anatomy we all share. As the baby was safely placed in the mother’s warm embrace, I couldn’t help thinking about this protective womb as a model for how we live. For a brief period, we’re protected in a controlled environment. We’re fed. We’re sustained. We grow.

It’s a stable, routine-sustaining life, but eventually we must be born. When this happens, our bubble bursts. Out we come, kicking and screaming into a new existence. This pattern repeats throughout our days. It’s what we originate from, what we become in our never-ending dance from stability to instability and back again.

This routine constitutes the very essence of life.

* * *

My residency training in psychiatry inspired my interest in human behavior, especially behavior put to the test in stressful environments like the ER story I just told. For more than a decade, I got an up-close peek at the full spectrum of humanity—all its inspiring and frightening displays—when I served as associate clinical professor at the Keck School of Medicine of the University of Southern California in the notorious Los Angeles County+USC Medical Center.

However, my frontline experience pales in comparison to the situation the world faced when the COVID-19 pandemic hit in spring 2020. On March 31, CNN reported the Brookdale University Hospital Medical Center in New York reached ICU capacity with patient beds lining hallways of the emergency department and an overflowing morgue. Emergency room physician Dr. Arabia Mollette described the place as a medical war zone. “Every day I come, what I see on a daily basis is pain, despair, suffering, and health-care disparities.”

Though hellish, the overwhelmed American health-care system was just a part of the global chaos. Country after country experienced unthinkable tragedies. On March 28 and 29, the United Kingdom “recorded two straight record-high death tolls from the virus, with 944 total deaths in 48 hours,” according to Business Insider. Within a month, Italy’s death toll dwarfed China’s. On March 21, the New York Times reported, “The government has sent in the army to enforce the lockdown in Lombardy, the northern region at the center of the outbreak, where bodies have piled up in churches. On Friday night, the authorities tightened the nationwide lockdown, closing parks, banning outdoor activities including walking or jogging far from home.”

As might be expected, already vulnerable countries endured terrible losses as the COVID-19 whirlwind touched down on suffering populations. According to a March 29 article from Science Magazine, “As of today, Iran has 38,309 confirmed cases and 2,640 deaths—the highest totals in the Middle East. The latest model from scientists at the University of New South Wales predicts that by late June, Iran could see 48 million cases—more than half of its population—without major efforts to curb infections.”

In the last few years, war-torn Yemen had already suffered through the world’s largest cholera outbreak with more than a million confirmed cases. To avert more deaths from COVID-19, the Secretary-General of the United Nations called for a global ceasefire between pro-government forces and Houthi rebels in March. Unfortunately, this warning went unheeded as violence actually increased with killing in the streets.

Financial fallouts followed on the heels of rising mortality figures in nation after nation. On March 30, Al Jazeera predicted massive devastation would disproportionately impact poorer states. “The socioeconomic hit on poor and developing countries will take years to recover from, UNDP said in a report released on Monday, stressing that income losses in those countries are forecast to exceed $220bn. Nearly half of all jobs in Africa could be lost, it also warned.”

Meanwhile, business as usual in America stopped being anything close to the definition in March, beginning with athletics, a $500 billion industry. The NCAA canceled the basketball championships known as March Madness. Following suit, the NBA suspended its season until further notice. The PGA tour canceled the Players Championship and all other tournaments until the Masters. Likewise, the NHL paused its 2019–2020 season and Major League Baseball postponed games until May 1, 2020, at the earliest. To retain viewership, ESPN announced it would offer programming of obscure sports most people had not heard of and would most likely never watch except for these unusual circumstances. “Sports such as cherry pit spitting, marble racing, death diving, and sign spinning,” according to the Miami Herald.

Though streaming services saw viewership numbers spike by a shuttered population hungry for content, overall, the entertainment industry suffered from COVID-19. In March, movie theaters closed, studios laid off staff, film festivals were cancelled, and production schedules stalled. Theme parks, including Disneyland, shut down. According to Newsweek, “The industry that thrived during the Great Depression by providing affordable entertainment to a weary nation is experiencing a crisis unlike any other in its history. The effects vary, but all of show business is feeling it.”

Backing up to see the big picture, it might be more apt to remove the qualifier in that last sentence to describe what is being called the biggest crisis in mankind’s history. At this moment, all of business is feeling it. All of us are feeling it. Whether it be elementary, middle school, high school, or college, nearly all classes have gone remote. Commencements have been postponed. Weddings have been canceled. Vast contingents of the economy now work from home (alongside their children). Restaurants have switched to takeout and delivery. And grocery stores have moved to rationing supplies and limiting guests to protect an already stretched supply chain.

These are but a few of the ways the world changed in March 2020 but come nowhere close to describing the full impact. Chronicling the aftermath would require a book—or books—in its own right. This is, of course, beyond our scope. Nonetheless, the above revelations share something in common: disrupted lives. Stressed lives.

Even before COVID-19, the 2019 annual Gallup poll found Americans to be “among the most stressed people in the world.” When the dust settles from the pandemic, it is all but assured that this number will rise. Prior to coronavirus, escalating internecine and external tensions had whipsawed us all in an era of unmatched volatility. Though the Y2K hysteria at the turn of the millennium proved unwarranted, it’s as if the intensity switch never shut off. Coinciding with the rise of the web as “the centerpiece of modern life,” and supercharged with the emergence of social media and smartphones, daily experience had already become ever more complex and complicated these last few decades.

Prior to disease updates blowing up our phones, we were being pelted with more content than we could handle. From the second we awoke, a barrage of stimuli and endless demands bombarded us, screaming for attention. Haven’t received the latest push alert? You must be living under a rock. Didn’t respond to your client’s email on Sunday? You must be a bad businessperson. Didn’t like and share the latest Facebook update? You must not care about your grandchildren.

We’ve changed as a result of the ever-present technology mandating more of our attention. Multitasking, for one, has become the new normal. Want to be successful? You’d better know how to juggle: work, relationships, a family life. Slip up and the consequences are dire: loss of job, loss of income, loss of security, loss of everything you hold dear. But as COVID-19 has shown, times are changing. Fast. And it’s time we changed how we respond, too, beginning with how we think.

So Much for Conventional Thinking

For years, we were told that the best way to navigate our noisy new world is to accept change. Open up to novelty. Go with the flow. Live in the moment. Embrace the relentless delivery of content minute by minute. But what if that’s wrong? What if living in a bubble is a good thing? After all, that’s what people the world over were told to do in March 2020.

Social distancing—the act of staying six feet away from others and avoiding crowds—was deemed essential behavior to contain the contagion. But the self-imposed bubble should not only be confined to the physical. Many leading mental health professionals, including Owen Hoffman of Mountain Family Health Centers, have suggested limiting time families spend viewing the news. “As soon as you notice it’s making you feel bad, stop watching or tuning in,” Hoffman said in an interview for Post Independent. “As soon as you start feeling nervous, anxious, depressed, or upset, turn it off and engage in some other useful activity.”

This advice makes perfect sense in an age of exploding fear and anxiety. After all, we began life in a bubble, as discussed on page 2. Our nascent experiences can offer us the best road map on how to live now. Consider this: each of us begins life surrounded by a physical membrane. This bubble both nourishes and protects. As fetuses in our semipermeable barrier, we receive amniotic fluid containing nutrients, hormones, and infection-fighting antibodies to ward off diseases. But as we grow older, our bodies continue thwarting outside threats while seeking something called homeostasis. Let us now explore why—and what our bodies can teach us.

What We Seek

Though the technical term homeostasis smacks of boring high school textbooks and Bunsen burners, offered in synonym form it morphs into something more practical sounding: stability. Seen again in another synonym, it represents the highest of human ideals: balance. Going back to antiquity, Western influential thinkers held balance to be the noblest pursuit of a well-lived life. “Aristotle in particular elaborated the concept in his Nicomachean Ethics. The ‘golden mean’ is the desirable middle between two extremes, one of excess and the other of deficiency,” according to New World Encyclopedia.

Harmony, yet one more synonym for homeostasis, also guides Eastern philosophical thought. Written by the sixth-century sage Lao Tzu, Taoism’s fundamental text, the Tao Te Ching, views balance with the natural order to be the apotheosis of a mindful existence. As Lao Tzu writes, “He who is in harmony with the Tao is like a newborn child. Its bones are soft, its muscles are weak, but its grip is powerful. The Master’s power is like this. He lets all things come and go effortlessly, without desire. He never expects results; thus, he is never disappointed. He is never disappointed; thus, his spirit never grows old.”

Enter Routine

A mother’s womb works 24–7 in service of balance. It is forever on call, preventing harmful stimuli from endangering a baby while precipitating its development far from the world’s chaos. Yet within this physical bubble lies the first stirrings of a baby’s own agency. And what is one of the first things a baby tries to do? Find its own stable way of living. “A baby in the womb will develop their own routine, sometimes very actively, sometimes very still or sleeping and so will not have ‘regular movement throughout the day’ but will actually have bouts of intense movement and times of quiet—their own daily routine,” according to Angela J. Spencer’s Babyopathy.

At the same time, natural forces cannot help but impact a child’s development. Chronobiology, the field of inquiry concerned with how living organisms adapt to solar- and lunar-related phenomena, suggests we humans are wired to respond to cyclic fluctuations. For instance, our bodies wake and sleep at certain times due to unconscious governing rhythms. Interestingly, the term chronobiology derives from the ancient Greek χρόνος (chrónos, meaning “time”), and biology, the science of life.

Time itself cannot help but exert its influence on all of us—even in utero. Then, just as soon as we are born, the need for a new bubble begins. Only now, our bubble is no longer just physical. Informed by chronobiology and the uniquely human ability to plan our days, it seems fitting to term this new bubble a time bubble. The time bubble consists of those activities and events we select (or are selected for us) to create and maintain a stable environment.

Returning to the first bubble we experience as humans, we can see the time bubble hard at work. Just as a baby born prematurely will often be aided by consistent feedings in the NICU to aid in its development, so does an attentive mother establish regular mealtimes to provide daily structure. She nurtures her offspring not just with physical sustenance, (i.e., milk or formula), but by establishing reliable processes to hasten her child’s acclimation to life outside the womb. But what happens next in the life cycle?

Drums Keep Pounding a Rhythm to the Brain

As the beat goes on and Baby develops into Toddler, his or her time bubble increases in intricacy. Parents wishing to provide stability establish routines delineating not just meal and sleep times, but a myriad of activities; hygiene: toothbrushing, bathing, haircuts; wellness: doctor’s checkups, vaccines; social: school, playdates, holidays.

As Dr. Laura Markham writes for Aha Parenting, “Routines give infants and toddlers a sense of security and stability. They help infants and toddlers feel safe and secure in their environment. Young children gain an understanding of everyday events and procedures and learn what is expected of them as routines make their environment more predictable.”

For evidence of the importance of routine on children we may again consider how COVID-19 influenced parental thinking. Across the world, overwor...

Table of contents

• Front Cover
• Half-Title Page
• Title Page
• Copyright
• Contents
• Chapter 1: March Madness in 2020
• Chapter 2: A Good Run
• Chapter 3: Wherever You Go, There You Are (Within Your Time Bubble)
• Chapter 4: When the Walls Come Crashing Down
• Chapter 5: Is It Time to Bring Rituals Back?
• Chapter 6: Tradition!
• Chapter 7: Only Keith Can Bust the Crust
• Chapter 8: When Your Bubble Goes Pop
• Chapter 9: There’s Nothing Routine about a Company Crisis . . . or Is There?
• Chapter 10: Thinking Machines and the Outsourced Time Bubble
• Acknowledgments
• Index