Really struggling four months after my half ironman, I was on the precipice of learning a valuable lesson. I was sick, whether a with cold, GI bug, or some other virus every other week. In fact, I was sick during the process of writing and editing my last blog post – 70.3 Miles Into the Pain Cave to Find my Why. By April, I had been sick 12 times since the race. I’d had enough. Why the hell was I, at 35 years old and otherwise fit and healthy, getting so sick all the time? I was using Advil, Tylenol, and Zofran almost daily to make it through work, and all the stupid possibilities I learned in medical school started running through my mind. Then I became like patient “Dr. Google,” who looked up a few symptoms and started convincing myself I was dying. Had I developed something worse beneath it all? Did I have leukemia or something? Or was I suffering as a result of my own decisions?
In April, I gave in and became the patient. I allowed someone else to see me and make the decisions. After some blood work and imaging, I learned I wasn’t dying of leukemia after all. I had pneumonia. I started antibiotics and finally took a full week off from workouts. Low and behold, I started feeling better. I was subscribing to the Jocko Willink and David Goggins mentality (or at least how I pictured it). Haven’t heard of them? Here’s a quote from each as a brief introduction:

“Don’t think in the morning. That’s a big mistake that people make. They wake up in the morning and they start thinking. Don’t think. Just execute the plan. The plan is the alarm clock goes off, you get up, you go work out. Get some.” – Jocko Willink

“It’s a lot more than mind over matter. It takes relentless self-discipline to schedule suffering into your day, every day.” – David Goggins

After the race, I took one week off all workouts. I knew I needed to recover but underestimated how much recovery I needed. I jumped back to my normal routine, and I was sick (again) two weeks later. I refused to give in, and I kept to workouts even while sick. My alarm sounded at 4:45 each morning, and I peeled myself out of bed. Sometimes, I put off the workout until after work, but I still got up at 4:45 to work on other things. I knew better, even when I was crawling from the alarm to my medicine cabinet, popping Advil Liquigels for the chills, cold sweats, and body aches. By 5:30, I felt well enough to either workout or work on my side hustle. By noon, I was taking more medication to beat back advancing body aches and shivers to finish clinic and rounding in the hospital, and by dinner I took more to remain engaged at home for Rebekah and the kids. 04:45 the next morning, I did it all over agin. This pattern repeated itself 2 to 4 days in a row every other week. Why? Because I was refusing to “give in.” I’m not a quitter, and if it didn’t kill me it was making me stronger, right? Wrong. I was being stupid, and I was completely ignoring one of the most important aspects of health, fitness, and performance – rest and recovery. Consequently, my performance in everything suffered – relationships, training, coaching, medicine, and business. I grew less engaged with loved ones, less empathetic towards patients, less effective as a wrestling coach, and burnt out at work. I was becoming a resentful person, and something had to give. Something had to change. In sports medicine, we call this overtraining syndrome. In any of my patients, I would have recognized it much sooner. Perhaps that’s why we doctors shouldn’t be our own doctors…
Steve Magness, in his books Do Hard Things and Peak Performance, challenges commonly held beliefs about mental toughness and stresses the importance of rest. In what he calls “the old model of toughness,” you keep doing what I was doing – just keep pushing and grinding all the while hoping you’ll eventually break through. In contrast, the “new model” requires the calm application of our minds to observe, assess, reassess, change directions, and learn new skills in mental resiliance to keep ourselves going. In comparison, the old model is like the “adolescent” of mental toughness. To mature into real mental toughness, we need to swallow our pride and take courage in analyzing and considering different courses of action. This does not mean “giving up” or “quitting.” This means honestly assessing the situation and making a call that could change your current course of action to keep you going. There’s a quote famously attributed to Winston Churchill, “If you’re going through hell, keep going.” But, there’s more to it than that. This doesn’t mean, “keep running into the wall until you break through it.” Instead, we can climb over the wall, or better yet, just open the damn door and walk through…Sometimes, plans need to change – we need a course adjustment to keep moving forward. Steve Magness says it eloquently:

“real toughness is experiencing discomfort or distress, leaning in, paying attention, and creating space to take thoughtful action. It’s maintaining a clear head to be able to make the appropriate decision. Toughness is navigating discomfort to make the best decision you can. And research shows that this model of toughness is more effective at getting results than the old one.”
― Steve Magness, Do Hard Things: Why We Get Resilience Wrong and the Surprising Science of Real Toughness

I decided to take another full week off workouts and sleep every minute I could, going to bed early and sleeping until 07:00 every day that week. The following week, I still slept in an hour longer than normal, not getting up until 05:45. I also scaled every workout. Over the subsequent couple weeks, I continued scaling, sleeping, and taking days off when I felt tired. As I started making real progress, my ego almost derailed me as it grew loud when I didn’t “show up” for the workout and threatened to put me back into the downward spiral that brought me here. However, I applied my mind and logically worked past my ego. I know I can handle and push pain, and I reached to memories as “cookies from the cookie jar” (Goggins analogy) to keep my ego in check. I pulled from these memories to ease my ego of “taking a break,” reminding myself that I’m “not weak.” (Or maybe it’s weakness that I needed to remind myself?) I believe even Jocko might have pointed to my ego when he said, “If you get your ego in your way, you will only look to other people and circumstances to blame.” At one point, I blamed all my illnesses on society being shut down for 2 years then suddenly re-opening, allowing every virus in history to have hay-day on our immune systems. That was my ego talking, preventing me from taking full ownership of my actions, and trying to convince me to stop resting. Changing this way of thinking has been a journey.
However, I eventually analyzed my situation with honesty and understood that changing course did not mean I was quitting. On the contrary, I was “creating space to take thoughtful action.” Setting my “why” (see my previous blog) as true North, acceptance and adaptation provided the only path to move forward. Since making these changes, I have only had one minor cold in the last 8 weeks. I show up more energized at home and I’m more intentional as a husband and father. I’m starting to find joy in being a doctor again. I’m excited to keep growing my business. And I’m on a new path to discover, learn, and teach the skills of mental resilience through doing hard things. As I’ve revisited the Willink and Goggins mantra I subscribed to, I’ve found that even they understand this. My view was distorted. It is necessary to learn how to “push through pain” and “keep going.” However, this is only the first step – the adolescence in resilience development. There are skills to develop, and conquering our ego is one of them. Mature resilience requires humble, purposeful application of our minds to navigate discomfort and make decisions that keep us moving forward. Sometimes, it’s not straight forward. Sometimes, it’s a convulated path, but it’s still forward nonetheless. Sometimes, when “you’re going through hell,” you need to change course to keep going.