At 5:40 a.m., the alarm blares news-talk radio and Bill Small rolls out of bed. With a two-hour commute ahead of him, the Chicago doctor wastes little time. He showers, dresses and is out the door by 6. At this hour, his car is the only one navigating the winding streets of his upscale neighborhood in St. Charles, Ill., a quaint community nearly 50 miles west of the Chicago hospital where he works. Small’s routine is so finely tuned that he won’t stop for coffee if there are more than three cars in the drive-thru. Today there are just two, and he picks up an extra-large. But there’s no time for a bathroom break, so Small, 41, won’t allow himself a single sip for nearly an hour.