When Being Tough is Not Enough

The body doesn't heal itself through sheer force of will.

Photo by Lucas Favre

The morning before the race, the doctor delivered bad news.

“Honey,” she said, hand on my leg, “it’s not happening.”

It was late May, and I had been training since the New Year for a half marathon. Steadily, I increased the number of miles until seven was short and eleven easy. Noise-canceling headphones pumped boundless energy into my body. All the while, my right knee ached. I kept running anyway.

The year was meant to be a big one. I turned 40 in January. I was already signed up for the real deal — the famed New York City Marathon that takes place every November. It was one of those life bucket-list experiences I was determined to check off as I hurdled over the fabled hill. I had meant for the half to serve as a stepping stone. There was no time to slow down for a pesky knee.

Running was a practice I had turned to and abandoned countless times, going back to middle school. But this time, after years of not running, I had climbed aboard with a greater earnestness than ever before. Because there was something else. I had made a commitment to stop getting high when I started running again. And the race was to take place nine months to the day I flushed the habit that had long since become destructive. So running the race, I knew, would be a moment both sentimental and symbolic, even if only to me.

As the race approached, knee pain hung around as a minor annoyance. I gave it no attention.

I ran obsessively — five or six days a week — my new go-to euphoria. That I replaced one compulsion with another didn’t particularly concern me, even as I was running my body into the ground. Surely the powerful jolt of endorphins I had already come to rely on was a healthier alternative.

I was feeling confident and ready. A music playlist was set for the race. But I was on a short run the day before — a final warm-up — when I heard a pop and felt a snap and had to stop. Mid-stride.

Suddenly unable to run, barely able to walk, I limped the two miles home. I went to a walk-in clinic, hoping to confirm I had nothing serious to worry about. The doctor poked and prodded and pinpointed the pain, which had become significantly worse. She said, “No way.” I pretended to agree.

Then, I ran anyway.


The morning of the race, energy pulsated through a crowd of thousands. The sky was gray and the air cold and misty — not ideal weather — but the mood was more like a block party on a sunny afternoon. I stood, surrounded by runners as eager as I was to get going. From the moment we started — a wave of people, flowing into the park together — sharp pain like shards of glass shot through my right knee. At mile two, I stopped at the medic station for a tight support wrap and popped four aspirin. Then I ran the rest of the race — all thirteen miles.

Screaming supporters with brightly colored signs lined the Coney Island boardwalk and buoyed us toward the end. It was intoxicating, and I sprinted the last mile. The minute after I leaped across the finish line I collapsed, grabbed the sideline fence and cried. It was a blurry combination of excitement and accomplishment, both actual and figurative. And, above all, pain.

With an ice pack strapped to my knee the rest of the afternoon, I sat at a bar with my running partner and we toasted beers and I told myself it was worth it.

Except for weeks after the race, the pain hung around and steadily worsened. I had an MRI and an X-ray. Then, at a visit to an orthopedic surgeon, I learned the truth. The repeated pounding on concrete during training, and not paying attention to the building pain, was a trauma that eventually caused a piece of my kneecap to crack off. It hung on by a literal thread — the pre-race pop.

Continuing to run was, the surgeon said frankly, “foolish.”

If my knee injury would require surgery at first was uncertain. Two months in a knee brace that locked my leg straight and made walking painfully slow was. And no more running.

I hobbled out of the surgeon’s office that afternoon wearing the knee brace. People hustled by in front of the medical building — on the same sidewalk where not long before I would run past. I stood there, unsteady, feeling weak. Dodging the crowd required a nimbleness I no longer had.


You don’t realize what you take for granted until you no longer can. To be sure, having limited mobility is one of those times. On glorious summer afternoons after that visit to the surgeon, I would sit looking out the window, leg propped on a chair, and wonder again if running was worth it. The Marathon later in the year quickly drifted into an impossible dream. And it didn’t take long after I could no longer chase the rush that had become my latest fix — a rush I’m convinced comes with no other exercise — for a crushing weight of frustration to take its place.

I tried to force myself to get out and be around people. Close friends and family who would see me in the knee brace — clumsily maneuvering between close-set restaurant tables, or getting bumped along a crowded subway platform, or clutching the rail and clamoring narrow flights of stairs to a walk-up apartment — smiled and shook their heads.

It was my own fault, and they knew I knew it. I would smile back and roll my eyes, thinking I could disguise the disappointment I felt in myself.

Meanwhile, a surprising number of strangers would ask, “What happened?” And often, after I answered, came a follow up. “Why did you run the race?”

“I have grit,” was how I usually responded, trying to laugh. That word grit echoes in the zeitgeist. So it seemed like an easy way to shrug off further questions from people I didn’t even know.

Determination and resilience together create grit. Grit is the first woman ever hired to lead a team of chemists who works twice as hard to prove herself in an industry still all too absent of female peers. Grit is the player in the pick-up game who endures humiliation through countless air balls but watches and learns from the others until three months and twenty games later he swishes a basket. Grit is, well, Hillary Clinton.

We bounce back with grit. We admire those with grit. Joke as I might, what I did was not gritty. The body doesn’t heal itself through sheer force of will.

Sometimes in the mornings, as I would strap the cumbersome black contraption onto my leg and lock it in place, I caught myself obsessing that I might never run again. But I would try — with varying degrees of success — to head off the anxiety and counter my self pity with empathy; for others in pain, for those who have never moved with the freedom I’ve been privileged with, whose injuries are more severe.

I don’t consider myself someone tied to tired expectations of masculinity. But I also reflected during that time about the ways we carry ideas into adulthood. As children, many of us — particularly boys — are told to “be tough” or “toughen up.” I observed this, time and again, during the dozen years I was an elementary school teacher. In essence, children hear — ignore the ebbs and flows of life. We impart this lesson at kids’ peril. Much as I hate to say it, I myself unconsciously summoned that misguided wisdom from boyhood.

Faced with an injury, I ran despite the pain because of stubborn determination to push through and tough it out.

After two months, the leg brace came off. Another X-ray revealed that by destabilizing it, my knee cap had begun to fuse back on its own. When the surgeon displayed the image on a screen in his office, I had to marvel at the body’s miraculous mechanics. It seemed I had dodged a bullet and avoided permanent damage.

I’m grateful. Still, the pain occasionally lingers. I’m running again, though shorter distances. Only time will reveal if I can run again without pain. I forfeited my spot in the November marathon. To lace up and be able to train for it sometime in the future would feel tremendous. It may happen. I need to be okay that it may not.


You tend to notice more when you slow down.

As I walked around my neighborhood during those interminable months wearing the knee brace, I would notice paint chipping off storefront signs I had passed every day for years when I was the one hurrying past. I noticed the wide variety of trees in the city. Sidewalk cracks between mislaid sheets of concrete stood out. I was careful to avoid them.

What I noticed most was why I finally noticed those things. Each laborious, lopsided step I took reminded me of one thing I didn’t expect to face in my 40th year — what we would all do well to recognize in life. The limit of being tough.

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