The Energy You Used to Get You Here Won’t Get You There(Or, Why You’re So Tired All the Time)

I was listening to a podcast about fitness and exercise when the guest, Chris Coulson, said something that would have stopped me in my tracks had I not been driving. He said something along the lines of, “I’m fine with you going all out, all Type A, all perfectionism, if it’s toward a goal that has an end. But if you use that energy for something you need to do for the rest of your life, it’s not going to go well.”

That sentence flipped a switch and brought me back to my first (and last) marathon.

Back in medical school, I was a casual runner. For reasons lost to time and hubris, I decided to run a marathon. I signed up through the Leukemia & Lymphoma Society, thinking that raising money for a good cause would keep me motivated. I trained with every ounce of Type A energy I had. I made spreadsheets. I followed the plan exactly. I did everything right. Except find shoes that didn’t destroy my IT bands. I limped for literal weeks long after the marathon was done..

The race itself, the Flying Pig Marathon in 2003, was a lesson in endurance but not in joy. I crossed the finish line, but I hated almost every minute of the long runs that got me there. My body wasn’t built for distance running. My spirit wasn’t either. But I finished, because that’s what Type A people do.

And then I never ran again.

Chris’s point was clear. That kind of energy, the sprinting, striving, white-knuckling energy, got me through a marathon. But it was never going to sustain a lifelong exercise habit that would keep me healthy into old age.

Now, before the runners come for me, let me say this. I know plenty of people who genuinely love marathons. They find peace in the rhythm, clarity in the miles, and somehow use that same energy to fuel their careers in medicine. I’m friends with some of them. I’m also friends with some of their very patient spouses. If that’s you, stay with me, because I think there’s still a lesson here. This isn’t an anti-running manifesto. It’s just a reflection on how the same energy that propels us through those finish lines can sometimes make it hard to build a career in medicine that we actually enjoy all along the way.

What Medicine Taught Us (and What It Didn’t)

Medicine trained us to run marathons. We learned to set goals, hit milestones, and check boxes. There was always something measurable to chase: the next exam, the next rotation, the next promotion. The system rewarded endurance and precision, so that’s what we gave it.

But faculty life is different. There is no finish line until we decide it’s time to retire. The seasons blur. Promotions stretch across years. Projects often span multiple fiscal years and academic calendars. There’s no syllabus, no clear stopping point, no medal at the end.

And yet, many of us still try to run it like a marathon. We push harder, do more, chase the feeling of accomplishment we used to get from achieving a clear, external goal. The result is predictable: exhaustion, resentment, and that low-grade hum of depletion that makes you question whether you’re still built for this work.

We aren’t failing. We’re just using marathon energy for a career-long race.

The Pivot: From Perfection to Sustainable Action

This isn’t about letting go of excellence. It’s about expanding our definition of success.

Perfectionism is fueled by adrenaline. Sustainable action is fueled by rhythm.

Perfectionism wants the gold star. Sustainable action wants the steady heartbeat.

Perfectionism burns bright for a season. Sustainable action glows quietly for a lifetime.

The invitation isn’t to stop caring: it’s to start celebrating consistency over intensity, alignment over achievement, presence over performance.

Five Ways to Celebrate Sustainable Action

1. Notice what’s already working.
   Sustainable action often hides in plain sight: the walk between meetings, the conversation that resets your perspective, the choice to leave work on time. Name it, celebrate it, make plans to repeat it.

2. Measure success in repeatability.
   When you find a practice you can keep doing without resentment or collapse, that’s worth more than any perfect plan. One consistent hour working on a manuscript three times a week will produce better results than procrastinating for months and then writing the whole first draft in one marathon session fueled by caffeine, rage and self-flagellation.

3. Treat recovery as an accomplishment.
   Rest isn’t what you do when you’ve failed to keep up. It’s what allows you to keep going. Nicola Jane Hobbs has said, “Instead of asking: ‘Have I worked hard enough to deserve rest?’ I’ve started asking: ‘Have I rested enough to do my most loving, meaningful work?’”

4. Let good enough be a win.
   “Good enough” is not the enemy of progress. It’s the foundation of longevity. Every small, sustainable action compounds. I love the mantra, “done is better than perfect.” My gym has a sign right up front that reads “progress over perfection.” (And I’ve been doing to that gym for years now. They don’t make me run marathons.)

5. Anchor your identity in being steady, not flawless.
   Rationally, you know that “perfect” does not exist. (Gently acknowledge your brain piping up here and offering, “Well, other people don’t have to be perfect, but I…” and stay with me for a second.) “Perfect” is an illusion our brains create to protect us from vulnerability. Every time you show up, embrace vulnerability, learn, adjust, and keep going, you’re proving that steadiness is the sustainable fuel of a long and happy career. 

There was a time when we needed perfection to prove ourselves. Now we get to choose sustainability to preserve ourselves.

That’s worth celebrating.