The Heart of Endurance

Tag: mental-health

  • When Research Became a Garden

    For many years, research after surgery felt like a second job.

    After a long operation, many surgeons could go home.

    But I often went back to writing, experiments, meetings, grants, and mentoring.

    At times, I wondered why I was doing this.

    Why continue working after already giving so much in the operating room?

    Why carry another responsibility when no one seemed to recognize the effort?

    Why keep running when the work was exhausting and often invisible?

    In those years, research still felt connected to expansion.

    More grants.

    More publications.

    More productivity.

    More proof.

    I kept going because that was what I had trained myself to do.

    ⸻

    Over time, however, something changed.

    The same activity began to feel different.

    Research was no longer only another burden after clinical work.

    It became one of the few places where I could breathe.

    ⸻

    Research gives me a different kind of space.

    A quieter space.

    There is writing.

    There is creativity.

    There is the slow building of an idea.

    There is the possibility of asking a question that did not exist before.

    Most importantly, there are young people.

    Students.

    Trainees.

    Mentees.

    A small lab group where communication is respectful, honest, and positive.

    In that space, I feel something very different from the clinical side.

    I feel growth.

    ⸻

    This helped me understand why I still write grants.

    It is not mainly for recognition anymore.

    Not for title.

    Not for institutional approval.

    Not to prove that I still matter.

    I write because funding protects the garden.

    It allows ideas to continue.

    It allows young people to grow.

    It allows mentorship to happen.

    It allows my creative mind to stay alive.

    ⸻

    Research once felt like a second job after surgery.

    Now I see it as one of the few places where my mind can breathe.

    ⸻

    This shift changed the meaning of the work.

    Earlier, research was another mountain to climb.

    Now, it feels more like a garden to cultivate.

    A garden does not grow through force alone.

    It needs attention.

    Patience.

    Protection.

    Consistency.

    It also needs the right environment.

    ⸻

    That is what I am trying to preserve now.

    Not endless expansion.

    Not pressure for more.

    But a small, meaningful space where creativity, mentorship, and discovery can continue.

    ⸻

    Clinical work uses my hands.

    Research and mentorship allow my inner life to keep growing.

    And perhaps that is why, even after surgery, I still return to the work.

    Not because I must prove something.

    But because something in that quiet space still feels alive.

  • When the Season Changes

    For many years, my life felt like summer.

    Active.

    Bright.

    Productive.

    Expanding.

    There was growth everywhere. Work, training, research, responsibility, ambition. I was building outward. I was using energy to create, achieve, and move forward.

    Summer was necessary.

    It gave me strength.

    It built discipline.

    It created structure.

    It helped me survive and grow.

    But no season lasts forever.

    ⸻

    Now I feel fall arriving.

    Fall is beautiful, but it carries sadness.

    Leaves change color before they fall. Something is being released. The tree does not fail when leaves drop. It simply knows what can no longer be carried into the next season.

    I feel something similar inside myself.

    I am cutting off unnecessary leaves.

    Old expectations.

    Unneeded meetings.

    Social pressure.

    The need to prove.

    The desire for recognition.

    The habit of fighting every criticism.

    Some of these leaves were useful in earlier seasons. They gathered energy. They helped me grow.

    But now they feel heavy.

    Letting them go makes me lighter.

    ⸻

    At first, this lightness can feel like loss.

    Less involvement.

    Less social participation.

    Less ambition for certain things.

    Less desire to chase what once seemed important.

    From the outside, it may look like decline.

    But internally, it feels different.

    It feels like preparation.

    ⸻

    A tree in fall is not giving up.

    It is becoming ready for winter.

    Winter looks quiet from the outside. There is less visible growth. Less movement. Less activity.

    But life has not disappeared.

    It has moved inward.

    The roots remain alive.

    Energy is conserved.

    Structure is protected.

    Strength becomes hidden.

    ⸻

    Perhaps this is also true in life.

    In one season, growth must be visible.

    In another season, growth becomes internal.

    Earlier, I grew through expansion.

    Now, I grow through release.

    Earlier, discipline helped me climb.

    Now, discipline helps me let go of what no longer belongs.

    ⸻

    This change is not always easy.

    There is grief in releasing what once mattered.

    But there is also peace.

    Because with fewer leaves to carry, I can feel the trunk more clearly.

    The core remains.

    These are not falling away.

    They are becoming more visible.

    ⸻

    I am learning that life stage change is not simply losing something.

    It is revealing what must remain.

    ⸻

    Fall made me sad because summer had been real.

    But winter does not mean life is gone.

    It means life has moved inward.

    ⸻

    I spent many years growing in the sun.

    Now I am learning how to stay warm in the quiet.

  • When Priorities Became Quiet

    For many years, I tried to organize my life from the outside.

    I made lists.

    Long lists.

    Tasks.

    Meetings.

    Projects.

    Deadlines.

    People to contact.

    Things to finish.

    Then I tried to prioritize them.

    What is most important?

    What should come first?

    Where should I place this in the calendar?

    I thought better organization would create a better life.

    And sometimes it helped.

    But often, even with careful planning, life did not follow the plan.

    Unexpected things happened.

    Other people changed direction.

    Meetings moved.

    Energy changed.

    The day unfolded differently.

    The list remained.

    But the mind became tired.

    ⸻

    Looking back, I think the problem was not only lack of organization.

    The deeper problem was that too many things felt important.

    Work felt important.

    Opportunity felt important.

    Recognition felt important.

    Responsibility felt important.

    Other people’s opinions felt important.

    Because my internal hierarchy was not clear, I had to create hierarchy externally.

    Lists.

    Calendars.

    Schedules.

    Systems.

    But external systems cannot fully solve internal confusion.

    ⸻

    In my current stage of life, something has changed.

    I still use a calendar.

    I still respect responsibilities.

    I still prepare carefully for work.

    But the decision-making feels different.

    I no longer need to think so much about every choice.

    Somehow, my internal voice gives me a clear impression.

    This matters.

    This does not.

    This deserves energy.

    This can pass.

    It is not loud.

    It is not emotional.

    It is quiet.

    But it is clear.

    ⸻

    I think this became possible because my values became clearer.

    These are not separate priorities anymore.

    They are connected.

    Because the important things are internally related, there is less conflict.

    ⸻

    This has changed how I select.

    Which meeting should I attend?

    Which task deserves time?

    Which relationship should I invest in?

    Which opinion should I listen to?

    Which disagreement should I enter?

    Before, these decisions required much more thought.

    Now, many of them are obvious.

    Not because I know everything.

    But because I know what matters.

    ⸻

    This also changed how I respond to disagreement.

    Earlier, I felt the need to engage.

    To explain.

    To correct.

    To fight for my opinion.

    Now, if the issue is not truly important, I can let it go.

    Let others talk.

    Let others decide.

    Let others win.

    Not from weakness.

    From selection.

    If it does not affect truth, integrity, patient care, family, peace, or craft, it may not deserve my energy.

    ⸻

    This has made life simpler.

    Less hesitation.

    Less regret.

    Less internal argument.

    I still work hard.

    I still care deeply.

    But I no longer spend energy trying to organize everything from the outside.

    ⸻

    When my values became clear, prioritization stopped being a calculation.

    It became a quiet sensation.

    ⸻

    I used to organize life with lists.

    Now life organizes itself around what matters.

    ⸻

    The clearer my inner life became,

    the less I needed to fight for space in the outer world.

    And for this stage of life,

    I feel deeply grateful.

  • The Timing of Yes and No

    These days, people often talk about the importance of saying no.

    Protect your time.

    Reduce commitments.

    Do less.

    Live simply.

    There is wisdom in this.

    But I think it is incomplete.

    Because saying no is not always the right answer.

    It depends on the stage of life.

    ⸻

    When I was younger, I said yes to almost everything.

    Work.

    Meetings.

    Opportunities.

    Difficult tasks.

    Social gatherings.

    Responsibilities.

    At that stage, saying yes was not a mistake.

    It was necessary.

    I needed exposure.

    I needed experience.

    I needed to build skill and credibility.

    Saying yes opened doors.

    It placed me in difficult situations.

    It forced me to adapt.

    It built discipline.

    It showed me what I could endure.

    Without those years of saying yes, I would not have developed the foundation I stand on now.

    ⸻

    In the expansion phase of life, yes can be important.

    Yes creates movement.

    Yes creates challenge.

    Yes creates opportunity.

    Yes reveals capacity.

    A person does not always know what matters early in life. They do not yet know their strengths, limits, temperament, or direction. That knowledge often comes only after experience.

    So if someone says no too early, before building enough life structure, no may become avoidance.

    It may look like wisdom.

    But underneath, it may be fear, comfort-seeking, or underdeveloped discipline.

    ⸻

    Over time, however, the meaning of no changes.

    After years of work, struggle, responsibility, and reflection, a person may begin to see more clearly.

    What matters.

    What drains energy.

    What aligns.

    What no longer belongs.

    At that stage, saying no becomes different.

    It is no longer avoidance.

    It is selection.

    ⸻

    In the integration phase of life, no protects clarity.

    No protects rhythm.

    No protects peace.

    No protects the ability to do meaningful work well.

    ⸻

    This is why the same action can have different meanings at different times.

    A young person saying no may be avoiding growth.

    An integrated person saying no may be protecting wisdom.

    A young person saying yes may be building capacity.

    An older person saying yes to everything may be losing alignment.

    The action alone does not tell the whole story.

    The inner phase matters.

    ⸻

    For me, saying yes built my life.

    Saying no now protects the life I built.

    ⸻

    I do not regret the years of saying yes.

    They gave me discipline, endurance, and opportunity.

    But I also understand that continuing to say yes forever would eventually damage the peace and clarity I now value.

    There is a time to expand.

    There is a time to select.

    There is a time to build.

    There is a time to protect.

    ⸻

    Perhaps the real question is not:

    Should I say yes or no?

    The deeper question is:

    From where is my answer coming?

    Fear?

    Ambition?

    Obligation?

    Alignment?

    ⸻

    No becomes wisdom only after enough yes has taught us what truly matters.

  • Vertical and Horizontal Expansion

    For most of my life, I understood growth as vertical.

    Vertical expansion means climbing.

    Higher title.

    Greater responsibility.

    More recognition.

    More output.

    More measurable impact.

    In medicine and academia, the ladder is clear. Training leads to faculty. Faculty leads to promotion. Grants lead to larger grants. Case volume leads to reputation. Leadership leads to visibility.

    Vertical growth is structured. It is competitive. It is measurable.

    And for many years, it is necessary.

    Vertical expansion was survival for me. I needed to prove competence. I needed credibility. I needed discipline. Vertical expansion built my engine.

    But vertical expansion has an inherent direction: up.

    And when growth is defined only as “up,” something subtle happens. Identity attaches to ascent. Motion becomes mandatory. Rest feels dangerous. The mind begins to ask, “What is next?” before asking, “What is enough?”

    You cannot see the ceiling from the bottom of the ladder.

    At some point, however, the ladder narrows. Titles become limited. Institutional centrality shifts to younger generations. Recognition stabilizes or plateaus. The illusion of infinite ascent fades.

    If growth is only vertical, this moment feels like decline.

    But there is another dimension.

    Horizontal expansion.

    Horizontal expansion does not seek height. It seeks breadth.

    It asks:

    What else can I learn?

    What else can I experience?

    What new dimension can I explore?

    Horizontal expansion includes:

    • Deepening relationships.

    • Refining craft without seeking promotion.

    • Writing without chasing audience size.

    • Training for endurance without competing for podium.

    • Learning music as a beginner.

    • Cultivating presence.

    Horizontal growth is not measurable in titles. It is measurable in texture.

    Vertical expansion builds structure.

    Horizontal expansion builds richness.

    When I began shifting toward detachment, I initially feared stagnation. If I was not climbing, was I regressing?

    But I discovered something unexpected.

    When vertical pressure decreased, attention widened. I began noticing subtleties: the rhythm of surgery, the nuance of conversation, the tone of my children’s voices, the silence between thoughts.

    Horizontal expansion did not reduce intensity. It redistributed it.

    I still wake early to train. I still prepare thoroughly for operations. I still write with discipline. But the direction is different. I am not trying to become larger. I am trying to become deeper.

    Vertical expansion is important in the construction phase of life. It builds competence and resilience. 

    But horizontal expansion becomes essential in integration. It prevents identity from collapsing when ascent slows. It protects peace without sacrificing vitality.

    Growth does not end when climbing slows. It changes direction.

    Upward growth builds the tower.

    Outward growth cultivates the garden.

    Both are necessary. But only one, horizontal expansion, can continue indefinitely.

  • Expansion and Detachment: Two Necessary Phases of a Life

    When I was younger, I believed expansion was the only direction.

    Expansion meant training longer, operating more, publishing more, earning grants, building credibility, advancing rank. As an immigrant restarting my career, expansion was not optional. It was survival. I pushed. I focused. I measured progress constantly. Case numbers mattered. Funding cycles mattered. Titles mattered.

    At that time, ambition felt clean. Necessary. Even noble.

    I did not see any ceiling.

    You cannot see the ceiling from the bottom of the ladder.

    ⸻

    The Expansion Phase

    Looking back, I now understand that expansion is a developmental phase.

    It is not a personality trait.

    It is not greed.

    It is not necessarily ego.

    It is construction.

    In expansion, you build:

    • Skill

    • Discipline

    • Competence

    • Resilience

    • Identity

    You prove to yourself that you can endure difficulty. You learn to tolerate rejection. You train your nervous system to stay steady under pressure. You build credibility through repetition.

    Without this phase, detachment later becomes fragile.

    You cannot integrate what you have not built.

    Expansion is where you develop the engine.

    ⸻

    The Hidden Cost of Endless Climbing

    But expansion has a shadow.

    Goal-oriented thinking can become addictive.

    After one achievement, the mind quickly moves to the next. Promotion leads to the next promotion. A grant leads to a larger grant. A milestone leads to another metric.

    The system rewards motion.

    For many years, I lived in this rhythm:

    95% pushing.

    5% brief relief.

    I admired my own discipline. I could endure almost anything. But I rarely stopped. If I stopped, I felt uneasy — as if my value might decline.

    At the time, this seemed normal. Productive. Even admirable.

    But something subtle was happening.

    When identity is built primarily on expansion, rest feels dangerous.

    ⸻

    The Transition

    Detachment did not come from reading philosophy.

    It came from friction.

    Disappointment.

    Recognition fatigue.

    A sense that success did not equal peace.

    I went through several years of internal questioning. During that period, I rediscovered triathlon. I re-centered faith. I began protecting family time more intentionally. I reduced unnecessary commitments.

    Gradually, something shifted.

    Problems that once felt personal began to feel structural.

    Instead of asking, “Why is this happening to me?”

    I began asking, “What system is this part of?”

    Instead of reacting, I observed.

    Instead of pushing immediately, I waited.

    Detachment did not reduce my discipline. It reorganized it.

    ⸻

    The Detachment Phase

    Detachment is often misunderstood.

    It is not laziness.

    It is not loss of ambition.

    It is not withdrawal from responsibility.

    Mature detachment means:

    • Identity is no longer dependent on constant advancement.

    • Ego becomes a tool, not the core.

    • Conflict becomes exploration, not threat.

    • Problems become events, not personal attacks.

    In surgery, I noticed something surprising. I began operating more deliberately. Slower in some ways. More precise. More organized. My nervous system was calmer. Performance did not decline. In some complex cases, it improved.

    When identity detaches from outcome, performance often stabilizes.

    In conversations, I found I could ask deeper questions without fear. I was no longer trying to control the room. I was trying to understand it.

    Calm and depth began to coexist.

    ⸻

    Why You Cannot Skip Expansion

    Sometimes I meet young people who appear detached early. They speak about balance, minimalism, or avoiding ambition.

    But without expansion, detachment can be premature.

    If you have not:

    • Pushed yourself,

    • Built real skill,

    • Faced rejection,

    • Developed discipline,

    Then detachment may simply be avoidance.

    True detachment usually follows expansion. It comes after competence is earned, not before.

    You need structure before you can release attachment to it.

    Expansion builds capacity.

    Detachment builds freedom.

    Both are necessary.

    ⸻

    Integration

    I now see a third stage beyond expansion and detachment: integration.

    Integration keeps the discipline but removes the desperation.

    I still wake early to train.

    I still prepare carefully for cases.

    I still write on weekends.

    But the energy is different.

    There is no pressure to prove.

    No urgency to accumulate.

    No fear of stopping.

    My children, now adults, are constructing their own identities. I see the expansion phase in them. I do not interrupt it. I do not accelerate it. I simply remain steady. Discipline is modeled, not imposed.

    Time with family is not longer in hours than before. But it is deeper. Presence has density now.

    ⸻

    The Ceiling

    One day, everyone who climbs long enough reaches a point where the ladder narrows.

    The illusion of endless ascent fades.

    If that moment arrives without internal preparation, it can feel destabilizing.

    But if detachment has already begun, the narrowing feels like refinement.

    Expansion is vertical.

    Detachment is horizontal.

    Integration is centered.

    You cannot see the ceiling from the bottom of the ladder. But one day you will. And when you do, you will need a philosophy that goes beyond expansion.

    Ambition builds the structure.

    Detachment builds the peace.

    Integration allows both to coexist.

    ⸻