Sole Purpose 61
Embracing the Pain: What Stoicism, Residency, and Running Teach Us About Resilience

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Today’s article is all about pain—both the physical and mental variety. As a long-distance runner, I’ve also learned to embrace pain as a regular part of my day-to-day existence. Back in high school and college, my track and field event was the 800m—a race widely regarded as one of the “most painful”, because you are essentially SPRINTING but for two whole laps around the track. But if we’re being honest, I’d argue that the 400m hurdles takes the crown. Running all-out and jumping? No, thank you.

Some might say I have an unusual tolerance for suffering, considering that I spend my free time writing podiatry-based articles while juggling a demanding residency schedule—and still choosing to run for fun. But here’s the thing: I genuinely love podiatry and writing these articles, so there’s no suffering involved—just passion. (The long runs, however,… those are still up for debate.)

Lately, I’ve been hearing a lot about stoicism, especially in my professional life. My residency director, Dr Patrick DeHeer, is an avid reader of The Daily Stoic⁵ and often shares insightful quotes and reflections with us residents. Stoicism, the ancient philosophy championed by Marcus Aurelius, emphasizes controlling what we can, cultivating virtues like wisdom, courage, and moderation, living in harmony with nature, and treating others with fairness¹. One of my podiatric medical school mentors, Dr Jarrod Shapiro, has also written about stoicism—because, let’s face it, few things test your stoic resolve quite like a career in medicine. Here is Dr Shapiro’s article in case you’d like to take a look - Practice Perfect 894: Stoic Quotes Applied to Podiatry.

I also happen to be dating an incredibly stoic (yet wonderfully warm) man whose pain tolerance is beyond my comprehension. During his training, he developed a rare condition called Keinbock’s disease, which led to avascular necrosis of the lunate bone in his wrist. With the death of this bone, he lost all use of his right hand. He spent over 9 months in a cast failing all conservative treatment and required multiple surgeries, including one particularly intense, experimental procedure where they took part of his patella and used it as a replacement for the lunate bone. As you can imagine, this left him unable to walk on his right leg or use his right arm for months—a level of inconvenience that would send most people into full meltdown mode.

The night before his final surgery, I asked if he was nervous or if there was anything I could do to help him prepare. With complete composure, he simply shrugged and said he wasn’t worried. He wasn’t exactly looking forward to the pain, but in his words, “It’s just pain.” And that was that. He needed the surgery to get better and he wanted to get back to training.

True to form, the doctors said it would take him a year to recover and within six months, he was back to outrunning me, fully recovered, and had gotten back to training and eventually accomplished everything he set out to do. Calling him the strongest person I know feels like an understatement. I’m incredibly proud to stand by his side and witness firsthand what true resilience looks like. His approach to pain and adversity has taught me invaluable lessons about strength, perseverance, and the power of a calm mind in the face of challenges.

When talking about enduring pain and stoicism, a name that frequently comes up in conversation is David Goggins. A retired U.S. Navy SEAL and motivational speaker, Goggins has a résumé so impressive it almost sounds made up. He’s the only person in the armed forces to complete SEAL training, Army Ranger School, and Air Force Tactical Air Controller training.² As if that weren’t enough, he’s also an ultramarathoner and triathlete—which is how I first heard about him. He was introduced to me as the guy who wins ultramarathons but says he “hates running.”

There’s no denying that Goggins is remarkable, and I have nothing but respect for the sacrifices he’s made for our country. But I’ll be honest—he’s intense. His take on stoicism isn’t the refined, philosophical musings of Marcus Aurelius; it’s more of a zero-excuses, shove-your-emotions-aside-and-get-it-done approach. His philosophy is blunt, no-nonsense, and often sprinkled with language that would make even the toughest drill sergeant raise an eyebrow. Goggins sees pain as a motivator, actively seeks out suffering, and places extreme emphasis on mental toughness, self-discipline, and complete internal control. It’s hardcore, no doubt—but for many, his message is a game-changer.

If you’re curious, Goggins has written two books, which I’ll link below.^6,7 Whether you’re drawn to his brand of relentless self-mastery or just need a little extra motivation, his work definitely delivers a punch—in more ways than one.

Now, onto my personal favorite perspective on embracing pain, and one of the people I look up to the most: Courtney Dauwalter. If David Goggins is the intense, no-excuses side of ultramarathon running, then Courtney is the softer, sweeter, and more positive counterpart. She’s a gritty ray of sunshine that I genuinely aspire to be. Dauwalter is considered one of the best ultramarathoners of all time, truly a once-in-a-generation athlete. I could go on and on about the races she’s won (seriously, it’s mind-blowing), but suffice it to say, she can run really fast for really long distances - think 100 miles and races that stretch for over 24 hours. Oh, and did I mention she has no coach and works full-time as a science teacher? Her incredible achievements? Just a side gig^3,4.

What sets her apart, aside from her ridiculous endurance, is her positivity. Dauwalter is known for smiling during races, offering encouragement to other runners, and her relaxed approach to nutrition, which sometimes means indulging in candy mid-race (I think we can all relate to the joy of candy). But it’s her perspective on pain that really stands out. She talks about entering what she calls her “pain cave” during races.⁵ Instead of dreading the pain, she reframes it as a place to celebrate reaching, not something to avoid. In a recent interview with Runner’s World, she described how she embraces her pain cave, telling herself that she’ll be fine and that there’s no such thing as a perfect race.⁴ As someone who tends to strive for perfection, that’s honestly a game-changer of an idea for me.

While there’s some research suggesting a link between success in endurance racing and a history of trauma or addiction, Dauwalter insists that there’s no "demon" driving her. She’s simply out there having fun in the mountains. Every interview I’ve seen of hers, she radiates warmth, cheerfulness, and serenity. It’s no wonder she’s become such an icon. One of my favorite quotes from her is, “You can be working really, really hard at something and care about its results, but you can also be having fun. Those things aren’t separate.”⁴ She’s got that Minnesota Nice vibe, wrapped up in pure, positive energy.

Okay, but what does any of this have to do with residency or podiatry?

A prospective student recently told me they weren’t sure about going into podiatry because it’s “going to be hard and take a lot of school.” I smiled and said, “You’re absolutely right. It IS hard.” Residency is no leisurely stroll through the park, and while I’d choose podiatry again in a heartbeat, let me be clear—I have zero desire to relive my first two years of podiatry school or relive my first week on call ever. Those preclinical years were a fever dream of textbooks, flashcards, and an endless cycle of studying, sleeping, and—you guessed it—more studying. Hobbies? Nonexistent. Social life? What’s that? A proper meal? If it didn’t come in a microwaveable steamable bag, I wasn’t eating it.

And residency? Still hard, just in new and exciting ways. It’s hard when you lose a patient. It’s hard when your pager screams at you at 1 AM. It’s hard working with a new attending and suddenly feeling like you know absolutely nothing all over again. But if anyone has mastered the art of “embracing the hard,” it’s ultrarunner Courtney Dauwalter. Her philosophy of pushing through pain and challenge really resonates. Residency—and medical training in general—is brutal. But hard doesn’t mean impossible, and it definitely doesn’t mean it isn’t worth it.

The best example of this mindset shift has been my mindshift change for my on-call weeks. I’ve been working on reframing how I approach them. As the clock ticks down to my pager takeover, that familiar wave of nerves and anxiety still hits. But instead of dreading it, I’ve started to see call as a week packed with learning opportunities—because, let’s be honest, there’s no shortage of those when you're sleep-deprived and running on caffeine.

Yes, it’ll be exhausting. Yes, I’ll probably be sleep-deprived and mildly grumpy. But odds are, I’ll have at least one meaningful patient interaction. I’ll make a difference for someone. And beyond that, it’s a chance to step into that uncomfortable space where I have to make decisions and take responsibility. Sure, I’m not truly alone—I have my attendings, chiefs, and co-residents as backup—but there’s something about being the first line of decision-making that forces growth. Will I end the week exhausted? Absolutely. But here’s the thing: it’s just a week. I can survive a week. And when it’s over, I’ll walk away a little stronger, a little more confident, and better prepared for whatever comes next.

Now, do I occasionally feel a surge of rage when I’m finally leaving the hospital at 8 PM, only to get an immediate consult that sends me right back? Of course. But yelling about it doesn’t change the fact that I have to go back. Getting overly worked up just gives me further to fall. Staying calm, recognizing the situation, and taking it one step at a time—that’s the best way to move forward.

In the end, it all comes down to perspective. Hard work, pain, and challenges are inevitable—whether you’re in podiatry, running ultramarathons, or just navigating life. But the way we respond to those obstacles is what really matters.

We can see them as burdens, or we can view them as opportunities to grow. Some days will be tougher than others, no doubt. But when we lean into the discomfort and push through, we come out the other side stronger, more resilient, and better equipped for whatever comes next.

After all, it’s not the easy path that shapes us—it’s the hard one. And if we approach each challenge with the right mindset, we’ll realize that even the toughest moments are worth it for the growth they bring.