The Vitruvian

Harnessing Morning Rituals for Enhanced Well-Being and Productivity

Sleep rebuilds dopamine overnight. A junior A&E doctor working 50-hour weeks explains the deliberate protocol she uses to protect that reserve — and why the first five minutes determine the rest.

Video·Zeliha Akpinar·10 min read·June 2026

A junior A&E doctor working 50-hour weeks explains how she structures her pre-dawn hours around one principle: protect the dopamine sleep rebuilt overnight.

The Dopamine Premise

The alarm sounds at 3:55am, well before any light has touched the miles of farmland outside the window. Before her feet reach the floor, the first decision of the day has already been made — and it is a decision about what not to do. The organizing principle of everything that follows is preservation: protecting the neurochemical state that sleep spent the entire night building. The resource in question is dopamine, and its condition in those first waking moments shapes the quality of every hour that follows.

if I wake up and the first thing I did was to scroll TikTok, it's like crushing out all that dopamine in one go

Dopamine is the chemical that enables motivation, focus, and the will to take deliberate action. It is the signal that makes effort feel purposeful — that bridges intention and output, that sustains concentration when the work grows difficult. Like any biological reserve, it responds to how it is used: spent recklessly in the first minutes of the day, or conserved and built incrementally toward work that matters.

Sleep is not only rest. Through the regenerative process of deep sleep, the brain rebuilds dopamine reserves depleted by the previous day's demands. By the time the alarm sounds, those reserves sit at their peak — the highest concentration in the cycle, a brief window of clarity and drive that exists only in the hour after waking. What happens in that window determines the neurochemical character of the entire morning.

Reaching for a phone at that moment spends the reserve almost instantly. Social media delivers stimulus in rapid, fragmented bursts — each scroll triggering a small dopamine release, none of them earned through effort or intention. The reward system responds to volume rather than value, burning through the overnight rebuild before the day has properly begun. What should sustain hours of focused work is consumed in the first five minutes, leaving a familiar flatness where momentum might have been.

Small physical actions work in the opposite direction. Brushing teeth, making the bed, preparing the kettle — each requires a modest and real effort, and each prompts the brain to release dopamine in proportion to the task completed. Motivation accumulates. What might otherwise feel like a reluctant 4am start becomes, through this sequence of deliberate small actions, a morning that arrives at the desk with genuine direction.

Protecting morning neurochemistry is not accidental. It is a discipline: a set of decisions made the night before so that willpower is not required at 4am, when willpower is at its most scarce. Every element of the early protocol — from the phone left face-down on the desk to the bed made before a single screen is opened — serves one purpose: to arrive at the work with dopamine reserves intact, clarity available, and focus already in motion.

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3am Dopamine based Morning Routine as a Doctor in Rural UK

00:00to preserve my dopamine levels in my to preserve my dopamine levels in my brain. 50 hours of work a [Music] [Music] week. Good morning. It's 3:55. So the week. Good morning. It's 3:55. So the week. Good morning. It's 3:55. So the first thing I try not to do in the first thing I try not to do in the first thing I try not to do in the morning is to go on social media to morning is to go on social media to morning is to go on social media to preserve my precious dopamine levels in preserve my precious dopamine levels in preserve my precious dopamine levels in my brain. By the way, dopamine is a my brain. By the way, dopamine is a my brain. By the way, dopamine is a chemical in our brain that enables us to chemical in our brain that enables us to chemical in our brain that enables us to take action and have motivation. And at take action and have motivation. And at take action and have motivation. And at night, our brain has been building up night, our brain has been building up night, our brain has been building up some dopamine through the regenerative some dopamine through the regenerative some dopamine through the regenerative process of sleep. So if I wake up and process of sleep. So if I wake up and process of sleep. So if I wake up and the first thing I did was to scroll Tik the first thing I did was to scroll Tik the first thing I did was to scroll Tik Tok, it's like crushing out all that Tok, it's like crushing out all that Tok, it's like crushing out all that dopamine in one go. But if I get up and dopamine in one go. But if I get up and dopamine in one go. But if I get up and take action like brushing my teeth or

01:00take action like brushing my teeth or take action like brushing my teeth or making my bed, that little bit of effort making my bed, that little bit of effort making my bed, that little bit of effort helps my brain boost dopamine. And that helps my brain boost dopamine. And that helps my brain boost dopamine. And that dopamine helps me dopamine helps me dopamine helps me stay with stay with stay with my By the way, I promise I was not doing my By the way, I promise I was not doing my By the way, I promise I was not doing my toilet whilst I was sitting here. I my toilet whilst I was sitting here. I my toilet whilst I was sitting here. I just wanted to sit somewhere. Oh yeah. See, research shows that If you See, research shows that If you naturally have an early body clock or naturally have an early body clock or naturally have an early body clock or circadian rhythm, meaning you wake up circadian rhythm, meaning you wake up circadian rhythm, meaning you wake up early, you're more likely to have a big early, you're more likely to have a big early, you're more likely to have a big appetite in the morning, which I do, and appetite in the morning, which I do, and appetite in the morning, which I do, and my appetite is even bigger now because I

02:00my appetite is even bigger now because I my appetite is even bigger now because I don't really have dinners anymore. I'm don't really have dinners anymore. I'm don't really have dinners anymore. I'm not promoting skipping your dinner, by not promoting skipping your dinner, by not promoting skipping your dinner, by the way. Please don't do that. But I the way. Please don't do that. But I the way. Please don't do that. But I recently started working as a doctor in recently started working as a doctor in recently started working as a doctor in A&E accidents and emergency department. A&E accidents and emergency department. A&E accidents and emergency department. It's so chaotic there. It's nothing like It's so chaotic there. It's nothing like It's so chaotic there. It's nothing like I've experienced before, which doesn't I've experienced before, which doesn't I've experienced before, which doesn't say a lot to be honest because I only say a lot to be honest because I only say a lot to be honest because I only started working as a doctor 8 months started working as a doctor 8 months started working as a doctor 8 months ago. Our shifts finish at 8:00 p.m., ago. Our shifts finish at 8:00 p.m., ago. Our shifts finish at 8:00 p.m., which is my usual bedtime. So, when I'm which is my usual bedtime. So, when I'm which is my usual bedtime. So, when I'm home, I'm knackered. I just go straight home, I'm knackered. I just go straight home, I'm knackered. I just go straight to sleep. I have no evening routine to sleep. I have no evening routine to sleep. I have no evening routine whatsoever at the moment. And that's why whatsoever at the moment. And that's why whatsoever at the moment. And that's why it's even more important for me to make it's even more important for me to make it's even more important for me to make the most of my mornings. the most of my mornings. the most of my mornings. [Music] Now, by the way, this duvet cover, my Now, by the way, this duvet cover, my bed sheet, and all these like flimsy bed sheet, and all these like flimsy bed sheet, and all these like flimsy pillows are all hospital property. I pillows are all hospital property. I pillows are all hospital property. I mean, is it hospital property or mean, is it hospital property or mean, is it hospital property or hospital accommodation property? I don't hospital accommodation property? I don't hospital accommodation property? I don't really need to like bring anything. They really need to like bring anything. They really need to like bring anything. They even do my cleaning for me once a week, even do my cleaning for me once a week, even do my cleaning for me once a week, but obviously I got to pay extra for

03:00but obviously I got to pay extra for but obviously I got to pay extra for that. Also, they increased the rent, that. Also, they increased the rent, that. Also, they increased the rent, guys. Now, I pay is it like £800 or guys. Now, I pay is it like £800 or guys. Now, I pay is it like £800 or something? I'll put the exact price something? I'll put the exact price something? I'll put the exact price there, but I pay a lot there, but I pay a lot there, but I pay a lot more. These towels, they also come with more. These towels, they also come with more. These towels, they also come with the room and they wash it for us and the room and they wash it for us and the room and they wash it for us and they put a new one every week as well, they put a new one every week as well, they put a new one every week as well, which is not too bad. It's exactly 5:00 a.m. right now. bad. It's exactly 5:00 a.m. right now. To be fair, usually I sit for work To be fair, usually I sit for work To be fair, usually I sit for work earlier, but today also I'm filming, so earlier, but today also I'm filming, so earlier, but today also I'm filming, so it delays the process a little bit. As it delays the process a little bit. As it delays the process a little bit. As soon as I sit on my desk, I have a quick soon as I sit on my desk, I have a quick soon as I sit on my desk, I have a quick look at my planner on Xiles, my digital look at my planner on Xiles, my digital look at my planner on Xiles, my digital planner, and track my progress on my planner, and track my progress on my planner, and track my progress on my goals. And according to that, I create a goals. And according to that, I create a goals. And according to that, I create a daily to-do list to catch up on whatever daily to-do list to catch up on whatever daily to-do list to catch up on whatever needs to get done. Currently, I'm needs to get done. Currently, I'm needs to get done. Currently, I'm working on creating an e guide.

04:00Let me give you a tour of my visual Let me give you a tour of my visual planner on Xyles. My whole life is on planner on Xyles. My whole life is on planner on Xyles. My whole life is on here. I have my doctor related goals and here. I have my doctor related goals and here. I have my doctor related goals and creator goals and all those tasks from creator goals and all those tasks from creator goals and all those tasks from different pages are automatically synced different pages are automatically synced different pages are automatically synced to one place which is amazing for my to one place which is amazing for my to one place which is amazing for my dopamine deficient ADHD brain with dopamine deficient ADHD brain with dopamine deficient ADHD brain with multiple commitments because it keeps multiple commitments because it keeps multiple commitments because it keeps them neat and together. It has all these them neat and together. It has all these them neat and together. It has all these pre-made templates for different pages pre-made templates for different pages pre-made templates for different pages so you can steal and customize it or so you can steal and customize it or so you can steal and customize it or create your own and add any links or create your own and add any links or create your own and add any links or photos. And if you're wondering why the photos. And if you're wondering why the photos. And if you're wondering why the heck did you add a photo of yourself on heck did you add a photo of yourself on heck did you add a photo of yourself on your planner? Are you that selfobsessed? your planner? Are you that selfobsessed? your planner? Are you that selfobsessed? is just that I'd like to design my is just that I'd like to design my is just that I'd like to design my planner in a way to keep me motivated. planner in a way to keep me motivated. planner in a way to keep me motivated. When I see a picture of myself from my When I see a picture of myself from my When I see a picture of myself from my childhood, I think to myself, I want to childhood, I think to myself, I want to childhood, I think to myself, I want to make her proud. I want to make her make her proud. I want to make her make her proud. I want to make her dreams come true. As cheesy as that

05:00dreams come true. As cheesy as that dreams come true. As cheesy as that sounds, you know, there is a quote sounds, you know, there is a quote sounds, you know, there is a quote saying, act like your younger self is saying, act like your younger self is saying, act like your younger self is watching. For some reason, that really watching. For some reason, that really watching. For some reason, that really resonates with me. And Xiles allows you resonates with me. And Xiles allows you resonates with me. And Xiles allows you to see your dreams and tasks in a to see your dreams and tasks in a to see your dreams and tasks in a structured way in monthly, weekly, daily structured way in monthly, weekly, daily structured way in monthly, weekly, daily pages. If you ever used notion and pages. If you ever used notion and pages. If you ever used notion and thought it was too hard to use, Xstyles thought it was too hard to use, Xstyles thought it was too hard to use, Xstyles is more ADHD friendly version, you can is more ADHD friendly version, you can is more ADHD friendly version, you can try Xiley today by using the link in my try Xiley today by using the link in my try Xiley today by using the link in my [Music] [Music] description. Let me show you guys description. Let me show you guys description. Let me show you guys another perk of living in a shared another perk of living in a shared another perk of living in a shared apartment. apartment. apartment. [Music] [Music] Wait, I won't be cleaning that one this Wait, I won't be cleaning that one this Wait, I won't be cleaning that one this time time time because yeah, I just won't be. This is because yeah, I just won't be. This is because yeah, I just won't be. This is masaman curry and basmati rice. You masaman curry and basmati rice. You masaman curry and basmati rice. You might think, isn't that dinner food might think, isn't that dinner food might think, isn't that dinner food rather than breakfast? Maybe it is, but rather than breakfast? Maybe it is, but rather than breakfast? Maybe it is, but it was already, so I just need to it was already, so I just need to it was already, so I just need to microwave it. And it saves time.

06:00microwave it. And it saves time. microwave it. And it saves time. [Music] I'm excited. Okay, so the hospital I I'm excited. Okay, so the hospital I work in is so rural that all I can see work in is so rural that all I can see work in is so rural that all I can see from my window is miles and miles of from my window is miles and miles of from my window is miles and miles of farmland. I get to have a pretty nice farmland. I get to have a pretty nice farmland. I get to have a pretty nice breakfast view. And fun fact, because breakfast view. And fun fact, because breakfast view. And fun fact, because this village is home to loads of farmers, we see a wide range of farming farmers, we see a wide range of farming related injuries at the hospital. related injuries at the hospital. related injuries at the hospital. [Music] [Music] I try to have at least one of my meals I try to have at least one of my meals I try to have at least one of my meals without looking at any screen and you without looking at any screen and you without looking at any screen and you know just trying to practice mindfulness know just trying to practice mindfulness know just trying to practice mindfulness and be in the moment because honestly and be in the moment because honestly and be in the moment because honestly since I started my first job life has since I started my first job life has since I started my first job life has been moving on so fast that I feel like

07:00been moving on so fast that I feel like been moving on so fast that I feel like I'm on autopilot. I don't even know I'm on autopilot. I don't even know I'm on autopilot. I don't even know where I am. I don't know why I'm going where I am. I don't know why I'm going where I am. I don't know why I'm going to work. And with all the digital to work. And with all the digital to work. And with all the digital stimulation and phone use in between, stimulation and phone use in between, stimulation and phone use in between, having these silent screen-free meal having these silent screen-free meal having these silent screen-free meal times helps me feel grounded and reset times helps me feel grounded and reset times helps me feel grounded and reset and understand my why. and understand my why. and understand my why. [Music] vitamin C vitamin C [Music] [Music] serum and of course serum and of course serum and of course [Music] [Music] sunscreen. Look at my view. Honestly, I sunscreen. Look at my view. Honestly, I sunscreen. Look at my view. Honestly, I can't get over this view. It's so can't get over this view. It's so can't get over this view. It's so pretty. pretty. pretty. [Music]

08:00Sometimes during my break, my default is Sometimes during my break, my default is to grab my phone and scroll social to grab my phone and scroll social to grab my phone and scroll social media. But good news is my phone media. But good news is my phone media. But good news is my phone literally physically doesn't allow me to literally physically doesn't allow me to literally physically doesn't allow me to go on social media before 10:00 a.m. go on social media before 10:00 a.m. go on social media before 10:00 a.m. because of this app I downloaded called because of this app I downloaded called because of this app I downloaded called Opal. By the way, I'm not sponsored by Opal. By the way, I'm not sponsored by Opal. By the way, I'm not sponsored by them or anything, but it really helped them or anything, but it really helped them or anything, but it really helped me decrease my phone use. So now instead me decrease my phone use. So now instead me decrease my phone use. So now instead I take some kind of action during my I take some kind of action during my I take some kind of action during my break like doing my skin care or tidying break like doing my skin care or tidying break like doing my skin care or tidying up my room for a few minutes because up my room for a few minutes because up my room for a few minutes because even taking these small actions help our even taking these small actions help our even taking these small actions help our brain boost dopamine. And you know brain boost dopamine. And you know brain boost dopamine. And you know forget about all the dopamine signs for forget about all the dopamine signs for forget about all the dopamine signs for a second. I know from experience that if a second. I know from experience that if a second. I know from experience that if I scroll social media my brain feels I scroll social media my brain feels I scroll social media my brain feels fuzzy. that if I organize or tidy up, I fuzzy. that if I organize or tidy up, I fuzzy. that if I organize or tidy up, I feel more motivated and get into a feel more motivated and get into a feel more motivated and get into a better flow when I return

09:00[Music] work. Let me show you my coming home work. Let me show you my coming home work. Let me show you my coming home from work and dumping everything on from work and dumping everything on from work and dumping everything on there corner. So, I have my work ID, there corner. So, I have my work ID, there corner. So, I have my work ID, then my cream, random cream. This is my then my cream, random cream. This is my then my cream, random cream. This is my doctor stamp and then my stethoscope. doctor stamp and then my stethoscope. doctor stamp and then my stethoscope. Four different pens, hair clip, dental Four different pens, hair clip, dental Four different pens, hair clip, dental floss. It's almost 10:00 a.m. and we floss. It's almost 10:00 a.m. and we floss. It's almost 10:00 a.m. and we have teaching to attend have teaching to attend have teaching to attend before we have teaching to attend before before we have teaching to attend before before we have teaching to attend before work. So, we got to go soon. Our shifts work. So, we got to go soon. Our shifts work. So, we got to go soon. Our shifts in A&E either 10:00 a.m. till 8:00 p.m. in A&E either 10:00 a.m. till 8:00 p.m. in A&E either 10:00 a.m. till 8:00 p.m. or 8:00 a.m. till 6:00 p.m. So, it's or 8:00 a.m. till 6:00 p.m. So, it's or 8:00 a.m. till 6:00 p.m. So, it's always 10-hour shifts. and Monday to always 10-hour shifts. and Monday to always 10-hour shifts. and Monday to Friday that would be 50 hours of work a Friday that would be 50 hours of work a Friday that would be 50 hours of work a week which is insane. I think it should week which is insane. I think it should week which is insane. I think it should be made illegal to work that many hours. be made illegal to work that many hours. be made illegal to work that many hours. Honestly, I hear resident doctors in USA Honestly, I hear resident doctors in USA Honestly, I hear resident doctors in USA working like 60 to 70 hours a week and working like 60 to 70 hours a week and working like 60 to 70 hours a week and that's just crazy to me. So, I feel that's just crazy to me. So, I feel that's just crazy to me. So, I feel blessed that I work less than that, but blessed that I work less than that, but blessed that I work less than that, but it's

10:00still I'm already still I'm already [Applause] [Applause] [Applause] [Music]

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When Every Morning Counts

The context in which this protocol operates is extreme. Shifts in A&E run ten hours, five days a week — a pace that totals fifty hours of one of the most demanding forms of clinical practice. Shifts end at 8pm, which is also the usual bedtime. When home arrives, sleep follows immediately. There is no decompression, no transition, no evening routine of any kind.

That reality makes the morning non-negotiable. It is the only window in the day that belongs entirely to the person who chose it — unscheduled, uninterrupted, self-directed. The setting is hospital accommodation: standard-issue bedding, shared amenities, a view over miles of rural farmland. But before the shift takes over, those hours are genuinely free, and that freedom is treated as the most valuable resource of the week.

The protocol begins at 5am. The first act at the desk is a review — not email, not notifications, but a deliberate look at the day ahead through a digital planner. Goals are tracked here. Progress is recorded. A to-do list is built from what still needs to happen, holding both clinical work and a parallel life as a content creator in the same organized view.

For a mind managing ADHD alongside fifty-hour work weeks, that consolidation is not a preference — it is structural. Multiple commitments across different domains fragment attention and drain the dopamine reserves that the morning carefully rebuilt. A unified planner keeps every thread visible and organized, reducing the overhead of context-switching and restoring the clarity that makes focused work possible. One view, one place, and the momentum of the early hours stays intact.

Inside that planner is a photograph from childhood — not decoration, but motivational anchor. When drive falters or the scale of the day feels immovable, the image redirects attention toward a longer arc. The question it poses is quiet and entirely serious: is this the life that person would have hoped for. Act as though your younger self is watching. For a mind prone to distraction, that anchor steadies the whole structure.

When I see a picture of myself from my childhood, I think to myself, I want to make her proud.

There is something precise about this arrangement. The planner does not simplify life — it makes visible the full scope of what is being built across two demanding disciplines. Medical goals sit alongside creative goals; daily tasks sit alongside longer ambitions. The ADHD brain, which struggles to hold multiple threads without losing them, finds its equilibrium here: everything gathered, nothing forgotten, the day structured before the shift claims it.

Screen-Free Nourishment

Research on chronotypes — the body's natural timing preferences — suggests that people who wake early tend to arrive at morning with a larger appetite. The body clock that pulls someone out of bed at 4am does not merely set the alarm; it also primes digestion, raising hunger hormones earlier than they would peak in a later riser. On shift days, there is no dinner. Breakfast becomes the primary meal: substantial, unhurried, and eaten before the hospital has any claim on the morning.

The meal on this morning is masaman curry and basmati rice — leftover from a previous day, reheated and entirely practical. What matters is not the composition but the condition in which it is eaten: without a screen in front of it. That discipline is non-negotiable. At least one meal each day passes without digital interruption, and breakfast, with its unhurried position in the morning protocol, is the natural candidate.

Since the first hospital placement, life has accelerated to a pace that can feel unrecognizable. One shift follows the next, days move faster than they can be processed, and an autopilot settles in quietly. The sense of why — why this work, why these hours, why the demands the schedule makes — begins to blur under the weight of constant stimulus and relentless forward motion. The signal gets buried.

There is a difference between mindfulness as a concept and mindfulness as a physical act. The former can feel distant, demanding an interior quiet that a fifty-hour clinical week rarely provides. The latter is available in any room: simply eating without a phone, being present with the food, noticing the view. Presence does not require stillness — it requires the removal of competing stimulation. Putting the screen down creates the condition for it.

Eating in silence interrupts the autopilot. Without a screen to absorb attention, the meal becomes the focus — the rhythm of eating, the farmland outside the window, the simple act of being present with nourishment. These small facts restore the quality of attention that a relentless digital environment erodes. Focus returns, a sense of purpose surfaces, and the why becomes clear again before the shift demands everything else.

having these silent screen-free meal times helps me feel grounded and reset and understand my why

The morning closes with a brief skincare ritual — vitamin C serum, sunscreen — executed with the same deliberateness that defines the hours preceding it. It is a transition marker, a clear boundary between the morning work block and what follows. The protocol is not a list of tasks to complete before the day starts; it is a complete sequence with a beginning, a middle, and a clear end. The hospital will claim everything after. The morning belongs entirely to the person who built it.

Protecting the Signal

The morning's architecture does not rely on willpower to hold its shape. It relies on design. Social media is physically blocked from the phone until 10am through an app called Opal, removing the option before the impulse has a chance to form. The phone cannot be scrolled regardless of how automatic the reach feels. The environment has been engineered to make the right behavior the only available one.

This matters most during breaks. The default behavior, left unchanged, is to reach for the phone — a reflex so deeply ingrained that it happens before a conscious choice has been made. A break arrives, the hand moves, and what should be rest becomes another extraction of the dopamine reserves the morning spent time building. Opal closes that path. A different default has to fill the gap.

The replacement is deliberate: skincare applied during a five-minute break, a surface tidied, a small area of the room briefly organized. These are not glamorous alternatives — they are functional ones. Each involves a small effort and a completed action, the same neurochemical formula that makes brushing teeth at 4am more effective than scrolling. Dopamine releases in proportion to intentional effort. Focus sharpens on return, and the flow state has a path back.

The experiential evidence is direct. Scrolling social media during a break leaves the brain feeling fuzzy — attention scattered, motivation dulled, the next task arriving to a depleted receiver. Organizing a corner of the room for the same five minutes does the opposite: the small act of bringing order produces a quiet clarity, and work resumes with more energy than it left with. The body registers this before the neuroscience has a chance to explain it.

That experiential knowing is worth separating from the theory. Research into dopamine dynamics explains why small completed actions restore focus and motivation while passive stimulation depletes them. But the practitioner who has lived through both states — scrolling, then organizing, then comparing the result on return to work — does not need the science to confirm what is already obvious. The body's own signal is clear. The protocol is built on that signal, and it holds.

Every element of this routine traces back to the same premise established at 3:55am. The prohibition on social media, the incremental physical actions, the planner review, the screen-free meal, the blocked phone — none of these are disconnected habits assembled by chance. They are a single coherent design, each piece protecting one resource: dopamine. Clarity is not stumbled upon. It is constructed, decision by decision, from the first moment of the day to the last minute before the shift begins.