I’m lying in a hospital bed, staring at the ceiling tiles while I wait for the surgeon.
Metabolic disease stole my feet first. At least, that’s what the doctor called it. Neuropathy and poor circulation were the culprits. Except they weren’t. It was a slow cascade of small, ignorable decisions that compounded over decades. Now they’re deciding how much of my left leg, already dead below my knee, they’ll have to take.
I’ve carried oxygen with me everywhere I’ve gone for almost ten years. The tank sits idly on a chair in the corner while I listen to the constant hiss of the hospital oxygen supply coming from the cannula that irritates my nose and ears.
The last time I went to dinner with my family, my body wouldn’t fit between the bench-back and the booth table. The waitress, showing embarrassment on her face for me, moved us to a table in the center of the dining area. I set the oxygen tank in the chair next to me.
The chair where my wife used to sit.
She’s not there anymore. She sits alone in a memory care center, unable to remember any of the people she loves or who love her except for her father who has been gone for almost forty years. She cries for him every night like a small child frightened of the dark.
I’m waiting for the surgeon.
Except I’m not.
I’m 47 years old, sitting in my home office, drinking a diet soda while “Angelica” from “Pirates of the Caribbean: On Stranger Tides” plays in my headphones. I’m not in a hospital bed. I have both legs, and I’m not on oxygen.
But I’m heavier; thirty-five pounds heavier than I was fifteen months ago.
For a while, I blamed the company I was working for. It sucked my will to live while I worked the kind of hours not even two separate shifts would cover. Then I left and started building something I love. A company with my name and fingerprints everywhere on it. A company that feels alive.
It also wants more, so I give.
In 2022, Tufts University published a study titled, “Only 7% of American Adults Have Good Cardiometabolic Health.” Researchers evaluated blood pressure, blood sugar, cholesterol, adiposity, and cardiovascular disease. Only 6.8 percent of adults met optimal levels across all five markers as of 2017–2018.
I can’t imagine the numbers are better in 2026.
There’s nothing abstract about that to me. It’s directional. For most of us.
The question isn’t whether I want to die. It’s whether I am living in a way that makes decline the default.
There was a time when my body felt like an ally—like my best friend.
One morning, I remember looking down at my Garmin Forerunner 245 and seeing 20 miles logged for the day. I realized, in that moment, that I didn’t actually know where I was. I looked up and oriented myself. I was seven miles from home.
Somehow, while I was lost in my thoughts, my body carried me over twenty miles.
That month, I ran more than 200 miles. That day, I logged 27 miles. There were two 15-mile days tucked into that same stretch of thirty-one days. My lungs were powerful, and my stride was automatic. I didn’t need to negotiate with myself about whether to go. I just went.
I wasn’t reckless either. I was strong; in the best shape of my life at 45 years old. That’s why these thirty-five pounds feel so much heavier than they really are.
It’s stark, frightening contrast.
When you’ve experienced your body at full capacity, mediocrity is betrayal.
Here’s what makes this so uncomfortable to admit. I didn’t wake up wanting to destroy my health. I don’t fantasize about oxygen tanks, amputations, or being too large to fit in a restaurant booth. I love my children. I’ve already seen two of them get married and the three younger ones are growing up just as fast. I want to run with my sons. I want to sit at dinner tables without hissing machines next to me. I want to get down on the floor and play with my grandchildren when they come along.
But my calendar tells a different story.
6 am to 7:30 pm workdays. Saturdays included. The travel season is almost upon me again. There’s stress and diet soda instead of water. Meals inhaled between calls with clients and team members. Runs postponed because there’s “just one more thing” or soul-crushing anxiety.
The company I’m building needs structure, leadership, and clarity. It needs someone willing to retire old versions of himself so it can grow.
But there’s an uncomfortable parallel. You can escape one unhealthy system only to create another. This time, I created one with my name on the door.
The previous company drained me. This one inspires and energizes me.
But both can take everything if I let them.
That’s where the undramatic, crisis-free erosion lives.
The hospital bed isn’t some kind of prediction. It’s a projection of my own momentum.
If I continue to trade sleep for output, movement for meetings, water for caffeine, margin for urgency, what exactly am I expecting the end result to be?
Our bodies are not ideological. My body doesn’t care that I’m building something meaningful. It responds to inputs, consistently and over time.
Calories. Stress. Movement. Rest.
I tell myself I’ll fix it later; after the next product launch; after this round of new hires; after this funding round; after this next season of intensity.
Later is a comforting word.
And a lie.
And trajectories compound.
When I was running 150+ miles a month, I didn’t wake up and decide to run 150 miles or more. I laced up my shoes and ran that day. And then the next. And the one after that. Small (or large) inputs. Repeated.
The current trajectory is built the same way.
Do I want to die?
No, but there’s a more subtle question under that.
Am I living in in a way that suggests I actually want to die the way I described above?
Indifference is one of the best, most patient negotiators.
- You deserve that soda.
- You can skip exercise today.
- The business needs you more than your body does.
- You’ll get serious again next month.
I’ve proven to myself that I can endure 27 miles in a single day. I’ve proven that I can work for 15 weeks straight with little more than 3 hours of sleep per night. I’ve proven I can build a company from scratch. I’ve also proven I can survive environments that leave most people hollow inside.
The question now is simpler and so, so much harder to face.
Will I choose the kinds of inputs that make the hospital scene improbable or likely?
This isn’t a vow to return to 150-mile months. That season may be gone for me. My body’s changed and my responsibilities have multiplied.
But decline doesn’t have to be the accepted default.
I don’t want oxygen tanks, amputations, or to sit across from my children as a diminished version of myself, explaining that the work seemed urgent at the time.
I want breath, strength, and life.
The hospital bed is fiction, but the trajectory isn’t.
And trajectories can be changed.
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