"You really need to get to the gym." My attending yoked upward on the Richardson retractor I was holding. My deltoids were burning and the thick abdominal wall I was pulling on was steadily sinking at a rate inversely correlated with my rising lactate. Trembling as I engaged muscle groups hitherto unknown to me, I did my best to dutifully observe the chief and attending operating peacefully, harmoniously, elegantly, their minds and bodies completely at ease and in flow. Later, while putting in postoperative orders, I wondered how I could possibly squeeze in gym time between work, eating, studying, and, of course, that little matter of sleep. Among the many casualties strewn along the path that had led to this very moment, physical fitness loomed large. It was not just that I was tired (like every resident on Earth), I was truly out of shape. Worse than that, I was imbalanced: I could walk up and down the halls of the hospital for hours with little need for rest, food, or a bathroom, but a 30-minute exercise video felt like endless torture; I could do antigravity rounds all day long, but I could not run a mile; I could carry all my groceries up to my condo in one trip, but a single pullup? Forget about it. What hit hardest was that I, a medical professional, did not even know how to begin to remedy this problem. So I ignored it, until a couple of years ago when, while trying to reset my garage door, that old familiar deltoid burn returned with a vengeance and with the added threat of serious injury.

After the garage incident, as I googled "personal trainers near me," I asked myself: How did I get here? The answer was pretty obvious: I had invested a lifetime dutifully filling out the mold of a bookish overachiever whose good genes were the only thing staving off actual health problems. For me, gym class was primarily an exercise in avoiding getting sweaty between math and Spanish. By high school, I had figured out how to dismiss P.E. from my schedule altogether.

I think I speak for all Millennials when I say that no standardized test was more baffling than the Presidential Physical Fitness Test. Picture it: the year is 1996, Bill Clinton is alternating between enjoying Big Macs and jogging along the Potomac in oversized sweatsuits, and I am a sixth grader, hanging on a pullup bar for as long as I possibly can, wondering how this will impact my "permanent record." At that time, the Presidential Physical Fitness Test included six measures: push-ups, pull-ups (both modified for girls if needed), sit-ups, a standing broad jump, a 50 yard dash, and a 1 mile run. The highest performers were awarded a special certificate, and alas, that achievement was well outside my merit-based existence. Although this national endeavor was (mostly) well-intentioned, between its inception in the 1950s to its retirement in 2013, rates of childhood obesity and related consequences of the metabolic syndrome continued to rise. 

So if we're not inspired to prioritize physical health as kids, when do we finally get to learn the habit? Maybe it should be in residency, which is like middle school, only worse. A mentor of mine, a former Notre Dame football player, used to say, "Surgeons need personal trainers." More than that, surgeons need other surgeons to model good behavior. Indeed, surgery is a uniquely physically demanding specialty. Standing for hours on hard linoleum in awkward positions, craning your neck while wearing a headlight, the medial thumb numbness from grasping a laparoscopic instrument just so, even manipulating multiple pedals and hand controls on a robotic console — we subject our bodies to interesting stresses to best serve our patients. Repetitive stress injuries in surgeons are infrequently reported, but they are not rare. We all know a peer or mentor who has had spinal issues or joint pain, perhaps even needing some kind of intervention themselves. We watch them sacrifice their bodies for the play and we naturally are drawn to do the same. As a resident, I denied myself the "princess pad" meant to ease the pain in my feet, I felt too shy to bother the anesthesiologist to raise the OR table height, and during a year of mostly home call, I spent more nights in scrubs on my couch than in my bed. I neglected myself beyond the point of ordinary sacrifice. At graduation, when the word my program director chose to describe me was "dedicated," dismay nearly eclipsed my pride. Yes, I was a confident, well-trained young surgeon, but it had come at a cost, and I had some cleaning up to do in all other aspects of my well-being.

Many physicians, not just surgeons, struggle with their own physical health. What starts as a joke in our earlier days (the hypochondria of "Medical Student Syndrome") becomes very real as life takes its toll—muscle aches and joint pain might be later eclipsed by hypertension, diabetes, and other largely preventable diseases. Our mental health also takes a beating through training and beyond, and only recently have we been encouraged as a group to talk openly about the struggles of depression, anxiety, moral injury, addiction, and burnout, particularly as the field continues to transition further toward corporatization. It is hard to stop and ask ourselves honestly: What are we chasing? And is it worth our health? We are, after all, also human beings. And if we have all the insider knowledge and still fall victim to the perils of modern life, what chance do our patients stand?

I feel that my impact as a steward of health could be small but meaningful. I talk honestly with our residents and students about my bad habits in residency and the fact that I now invest time and money in a personal trainer. Yes, this is a luxury that residents (whose salaries can barely cover the astronomical cost of childcare) likely cannot yet afford. But there are ways around this: vocally encourage trainees to spend their free time doing physical or outdoor activities, emphasize the importance of weight training (especially for women), install exercise equipment in the hospital, protect their duty hours, and speak openly about the ways we prioritize our own health. Some programs, including ours, will automatically sign interns up for a PCP — they can opt out if they want to, but it's one less thing to have to set up when moving to a brand new place to start the next busy chapter of life. 

Role modeling also makes it easier to discuss these issues with my patients. When appropriate, I share my own struggles with weight, strength, and flexibility. I discuss the perils of energy bars we ate as residents on the go, highlighting the hidden sugars that led to my "chief-year-15." I demonstrate simple stretches to ease back pain and stiffness they might encounter during postoperative recovery. I share simple core engagement exercises that I do myself, and encourage adding low-risk home remedies for everything from muscle aches (ice packs) to nausea (ginger tea). In being an open book, I am trying to make my uphill health journey amplify its impact beyond my own body.

For now, this journey regularly brings me to an intimate concrete box of a gym in Phoenix. It’s a cool pre-dawn morning and I am staring at an aggressively knurled pullup bar, clearing my mind of anything besides gravity-defying thoughts. My trainer pats me on the shoulder and says, "Just do one, take a rest, and do one more." Without giving myself too much time to hesitate, I grab the bar and pull myself up. As I lower down my trainer shouts, "One more!" And up I go again, much to my surprise. When my feet finally touch the floor again, I'm panting both from maximum effort and maximum elation. I take a breather and look around — my co-early birds are other physicians, science teachers, data analysts, and other erstwhile nerds. We've all found our way here somehow.

Dr. Priya Rajdev is a surgeon specializing in minimally invasive abdominal wall reconstruction and benign foregut surgery in Phoenix, AZ. She is passionate about medical education, health literacy, and the importance of play in daily life. She enjoys gardening, reading, celebrating everyday absurdities and serendipities, and improv comedy. Dr. Rajdev is a 2024-2025 Doximity Op-Med Fellow.

Illustration by Jennifer Bogartz