Back in undergrad, a friend told me a story about nuclear power plants.

We were studying in the campus center, next to the cafeteria, when one of the nearby refrigerators switched off its cooling cycle and a powerful silence overwhelmed our little table. She looked up with a wild look in her eyes and smiled at me: “Did you know that’s how alarm systems work in nuclear reactors? It’s not like the movies. Think about it this way: if you were sitting at your Homer Simpson desk, eating a donut, and then sirens start blaring and lights begin flashing all over the place, you wouldn’t react calmly to the situation– you’d PANIC!” She smashed the table with her fist, and laughed, to emphasize her point.

“Instead, there’s a low drone constantly sounding off in the background. When things get hairy, the hum shuts off. This does two things: the first is that you always know when the alarm system is malfunctioning, because it will turn off. In a conventional alarm system, you never know when it doesn’t work until it doesn’t go off when it should– no bueno when you are talking about nuclear fission! The second is that people will calmly react to the situation. Silence, rather than noise, is the prompt to action.”

I’ve never verified her story, but the concept has buried itself in my brain ever since. Most alarms cause panic or distress– I can name some cheery songs I’ve used as morning wake-up tunes, but after a week or two the first few chords will jump-start my heart rate like a shot of adrenaline. It’ll wake you up… like a splash of cold water on the face.

Broadly speaking, a positive alarm is what you are familiar with when you think of an alarm: set it, forget it, then it buzzes to remind you that time is up. A negative alarm is less common, or at least less considered: start the timer, the alarm continues until it stops, then time is up. There are advantages and disadvantages to both methods, but I generally prefer negative alarms because they are far more gentle to the nerves. Consider my favorite negative alarm– the hourglass.

I have been hourglassing for my studies since medical school started. The Esington Glass is a 24min timer that is incredibly sexy and a terribly effective study aide. I gather all of my study materials together, remove all distractions (phone on silent, bathroom break, no extra tabs open), flip the hourglass, then go HAM for the next 24min of fully-focused effort.

While I study, I’ll peek over at the glass to estimate how much time is left or to check if it’s still going. When I look and it’s all done, then I stop where I am (so I can pick up immediately where I left off) and take a delicious 5-10min break. Rinse and repeat, as necessary. Anyone can study for 24min at a time; I find going for the full 50min reduces efficiency through minutes 35-50. It reflects a lesson from working with my father, maintaining the house and landscaping the property– work hard and break often. Pausing before I lose the motivation to continue is essential for maintaining a pace over a long period of time; medical school is most definitely a marathon, not a sprint.

A philosophical negative alarm, rather than a productivity-based one, is the tattoo. I have two pieces on my body, and soon a third: the first one completed after graduating college, and the second before moving down to Tampa for medical school. When discussing tattoos with friends, I often hear, “I’ll never get one because I don’t want to regret it later!” To me, that is the point of putting needle to skin– allowing yourself the room to outgrow your decision.

Each of my tattoos denotes a time in my life when I needed to put words into flesh. Going forward into the unknown future, if I one day look upon these pieces of art and feel like they no longer represent my philosophies or outlook, then I’ll know that I have moved on from that stage of life. These words are my lodestones, my compass, to let me know if and when I have strayed away from that person I once was. That may be a good thing or a bad thing– the desires and fears of a young man in his twenties will be different from an aged and broken body on his deathbed.

Time is a slippery and squishy thing: without a method or a plan to manage the passage of time, I can find myself at the end of a month wondering where the past four weeks went. A life led by positive alarms has all the anxieties of a high-stakes game of red-light green-light, but none of the fun. Negative alarms are a way to roll with time, to be aware of its drip and drop, like a soldier on deployment counting off the days until their return flight home or a student writing a weekly reflection to mark the many changes in life.