I hate those days when something just gets under your skin so deeply that you can’t think of anything else. Everytime you stop moving—on the elevator, stopped at a red light, waiting for your onions to saute—you take this one issue and you roll it around in your mouth, tasting all the bitterness of frustration, desperation, and defeat. Sleep doesn’t provide relief cause you just have anxiety dreams with analogies of whatever is eating at you. Staying busy helps, but I’m usually performing at less than 100% as I’m preoccupied with my thoughts. Ahhhh, torture.

Once in a while, when I’m in the throes of an agonizing conundrum I actually stop and think “Hmmm maybe a run would help. Maybe distracting my mind, which is now spinning out of control with a sweaty, panting, screaming-leg workout would somehow hit the reset button.” And once in a while—for some reason—I listen. A cool, rainy October day in 2013 was just one of those days.

I had come home from work after another 36 hour shift exhausted and angry. I was angry with myself for making, what seemed at the time, a harmful clinical decision. I had made the decision that is one of the hardest for a surgeon to make—not to operate. I struggled with the decision as the patient seemed initially to be doing well. Maybe my judgement was clouded by fatigue, but as soon as I left for the day, my partner saw the writing on the wall and took her to the operating room. She did well (thank God), but I could not stop thinking that I had made a potentially devastating mistake. Plus, in retrospect, it seemed so obviously the wrong thing to do. I stewed, feeling every tired muscle in my body contract into little knots. I could feel my heart beating in my very tight chest. Knowing there was no way I could sleep nor relax and enjoy the day with my family, I put on my running shoes and headed out into the rain.

It was perfect, really. The cold rain spraying in my face was like a baptism. My exhausted muscles were initially in agony, but then warmed up, fueled by my anger and self-doubt. My goal: to experience as much pain as I could stand. It was my penance, like a self-flagellation. I did 8 miles that day—one of the longest runs I had done—in cold, soaked clothes. But in addition to coming to terms with my error in judgement, I figured out some other things. I had recently been given a leadership position, and it caused me more anxiety than I had realized. Determined to be a great leader, I had begun questioning every decision I made 2 and 3 times. I knew I would certainly make mistakes, but that they had to be the exception. I would trust my first instinct and listen to my gut instead of overthinking clinical situations. Arriving at my driveway, I had begun to let go of the self-loathing, and was determined to attack this new position with renewed confidence and resolve.

Since that day, it has become fairly common for me to say to my husband after a particularly stressful day “I really need a workout”. I NEED. Like Xanax, like therapy. Maybe it’s the adrenaline that clears my mind and helps me to see through a forest of worries and doubts. Maybe the endorphin release cures my mental as well as my physical pain. I just know that the world seems like a better place after a hard workout. My chest loosens up and my heart slows down. I’m somehow able to ignore the noise of the “little things” and focus on what’s really important. I tuck my kids into bed, I kiss my husband goodnight, and I sleep really…really…well.