This past weekend, I completed the United Airlines NYC Half Marathon, a 13.1-mile course running across the Brooklyn Bridge, through the streets of New York, through Times Square and Central Park, finally finishing upright and with both shoes still on. In the 48 hours since crossing the line, I have reflected deeply on the experience and arrived at one inescapable conclusion: It was still better than going to work. Please see my evidence below:
1. Your legs are doing the suffering, not your soul. I received two blisters, one toenail at imminent risk of falling off, and a soreness that lingered with me for two days but resolved with ice and sleep. I received no prior authorization requests, FMLA paperwork, or last-minute questions about chest pain.
2. The finish line is a real, physical thing you can touch. Unlike your quality metric targets, which are revised upward each quarter regardless of your performance, by someone who has not seen a patient in years, if at all.
3. No one expects you to juggle. You are simply expected to run. The patient portal is not open. No add-on patient, no last-minute meeting. There is just the road.
4. Strangers cheer for you and mean it. And give you high fives, and bring snacks for you just for being there. Compare this to your patient satisfaction scores, which capture the one person who was upset about their copay and did not read your note before rating you one star.
5. You are allowed to eat a banana at mile 7, or, frankly, whatever and whenever you desire. In clinic, eating is a theoretical concept. Lunch exists on the schedule in the same way that adequate visit time exists on the schedule.
6. Your heart rate monitor gives you real-time, objective feedback on your performance. Your clinical director’s feedback, by contrast, comes on a rare occasion when both of your schedules align, and is delivered at a mandatory meeting you did not want to attend. Any feedback is based on metrics and comments that offer no visibility into what actually happened at your visits.
7. The hierarchy is clear: you, the road, gravity. No senior management explaining, with great confidence, how you could be managing your time better, seeing more patients, and of course, making more money for the clinic.
8. What you listen to is entirely your choice. Nobody is requiring your attendance at a mandatory training on a topic you already know, delivered via a recorded module with a comprehension quiz at the end.
9. Hitting the wall is recognized as a physiological event, not a character flaw. In medicine, the equivalent is called burnout, and if addressed at all, is managed by a wellness committee that meets quarterly and has ordered a new brand of herbal tea for the break room.
10. You receive a medal at the end. A physical medal. That you can wear in public, with no one asking whether you took too long or your VO2 max was sufficient to justify it.
11. No post-race documentation. You complete your race and there is no note to write afterward. No attestation, no addendum. Strava does it for you.
12. 13.1 miles is a fixed, knowable number. Your patient panel is not.
13. When it is over, it is over. You cross the line, you stop running, and you eat pretzels. Nobody asks you to run one more mile before you go home. Medicine has an inbox with 34 unread messages, six of which arrived during the race.
13.1. The author acknowledges that work funds the running shoes, the race entry fee ($135), the post-race burger and fries, and the recovery massage gun.
John Wei is an internal medicine physician.
