Alternative Investment: Time Alone

“I only go out to get me a fresh appetite for being alone.” -Lord Byron


TASK AT HAND: This week I’m thinking about time alone. Whereas loneliness is traditionally considered a painful state, solitude can recharge and rekindle our energy and creativity. Time alone needs to be time well spent and is an essential component of renewing the acquaintance with ourselves. There is no potential for authenticity without being comfortable in your skin.

“There is no potential for authenticity without being comfortable in your skin.”

Whether you are introvert or an extrovert, time alone pays dividends. For introverts, the act of “recharging” usually involves time alone. As a group, introverts tend to do better at consistently carving out time or reflection. For extroverts, who typically renew their energy with others, there needs to be regular commitment to the act of solitude.


A few quick tips to maximize time alone.

1.    Time alone outdoors trumps most activities indoors. Nature walks are king.

2.    Your smartphone will ruin every precious sound moment of silence. Airplane mode is essential to protect ourselves from the endless distraction of our smartphones. Refuse to let your smartphone notify you of anything else going on.

3.    A few minutes are ok. Time alone is akin to meditation and a few minutes will sometimes do. You don’t need to clear a weekend or isolate an afternoon; rather, find small pockets of time in daily routines that offer you the investment of time alone.

4.    Initially, your time alone may cause you to feel bored or restless. This is a superficial transient state and will quickly fade into calmness.


I consider time alone an investment in development. Like sleep restores physiological processes, solitude guides your assessment and planning. Social partnership is necessary, but at times, you need to break away alone. This is a wonderful time of year where we celebrate holidays with family, friends and loved ones; however, time alone can be hard to find. Use the quick tips above to maximize the fleeting moments that you may encounter.

Finally, I’ll leave you with this thought: how can others appreciate or tolerate you if you can’t tolerate or appreciate yourself?


MEDICINE & MACULA: Here are stills from a surgical video of a patient I recently operated on. She had cataract surgery complicated by a massive intraoperative choroidal hemorrhage. After waiting approximately 10 days and following closely with serial echography, I took the patient to surgery for choroidal hemorrhage drainage.

In this technique, an anterior infusion is secured and the intraocular pressure is increased to 60mmHg. Next, using a 25-gauge platform, a non-valved cannula-trocar is introduced 7mm posterior to the limbus in the most detached quadrant. The latter can be determined with preoperative or intraoperative echography and the choroidal height should be at least 5mm.

Introduce the trocar with a flat approach forming an incident angle of about 20 degrees to the sclera. Here you see placement of the 25-gauge cannula 7 mm posterior to the limbus.

Finally, open the cannula and, if placement is correct, the hemorrhage will drain effortlessly. Maintain the intraocular pressure at 60mm Hg during active drainage. Here you see copious amount of dark hemorrhage draining from the trocar with the infusion running.


A few quick surgical tips:

–       Avoid the 3 and 9 meridians to spare ciliary nerves from possible trauma.

–       If possible, drain the inferotemporal quadrant first as this site is easiest to access.

–       If doing a vitrectomy at time of drainage, avoid an air-fluid exchange because choroidals often recur during this step and may push fluid posteriorly, endangering the macula. Instead, use non-compressible mediums like balanced salt solution or silicone oil.


GRATIS: “Life could be wonderful if people would leave you alone.” -Charlie Chaplin


My best to you,

David Almeida

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