Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

“Fall Down Seven Times, Get up Eight”


By persevering together, we can get through any crisis. We must try our best to face the current challenges with grace and compassion for others.

“Fall down seven times, get up eight.” -Japanese Proverb


Last October, I stood in the chilly rain at six in the morning waiting with over 30,000 people in Washington, D.C. waiting for the Marine Corps Marathon to start. It was my first marathon. I was in a “whatever” mood. I was grossly under prepared and a foot injury didn’t help. I’d decided to reschedule for the next year only to learn it was too late. I was forced to show up. I told myself that I’d just do whatever I could and then take the Metro or Uber home.


“Can’t believe, I actually paid for this,” I said.


The race started. I was running very slow, still in a blah mood, when I started paying attention to things around me instead of zoning out. Fellow runners were of every possible kind—young, old, buff, in wheelchairs, and from every corner of the world. Some were tracking their times, some adjusting ponchos in the rain. Some were blind and being led by others holding ropes!


There were people all around cheering, from sharp-looking Marines to everyday folks standing in the cold rain to encourage the runners. It was crazy—so much energy, so much cheer.


As the distances between runners spread, I paid more attention to the signs and T-shirts the runners wore. “For Dad . . . I will always miss you,” “Running to help cure cancer,” “PETA.”


The majestic buildings in the National Mall and all the bystanders were egging us on to run just a little more. The runners were pushing themselves and inspiring each other to do more.


My conflicted mind about showing up and a shallow mood had turned to a little delight. It was cold, I was soaked, but my spirits lifted. As every mile went by, increasing pain forced me to stop running and walk. I started running as soon as the pain went down. “Come on, Come on . . . you can do more,” was all I heard.


There were funny signs to read. “Smile if you’re not wearing undies.” “Don’t trust the fart after mile 11.” “Keep running, the medals are huuuuuuuge.”


I wanted to stop and give up at least a dozen times, but the Veterans timing us throughout the course encouraged me, and I kept going. The “beat the bridge” timers made sure that I crossed the final timer checkpoint at mile 20. Once I crossed that check point, I was determined to hang in there. I just kept trying.


Today we are in the midst of a major pandemic. There is great stress, despair, and a lack of hope. Some even wonder whether humans and society will survive. Resilience is defined in many different ways, from “bouncing back better,” to “the capability to absorb shock while at the same time retaining function.” There is a lot of fantastic work done to measure resilience in individuals.  In the individual, key factors for measuring resilience are dispositional attitude, family cohesion/warmth, and external support systems.


I survived the marathon by adapting to the situation, staying focused under pressure, receiving constant encouragement, real-time mentoring and feedback, and the ability to see the humorous side of things. If some of these concepts are used by our communities, we can overcome any calamity.


The Japanese saying from which the title is taken is all about persisting and not giving up. Clinicians should try to adapt to new workflows, keep trying their best, and accept our current challenges with grace and compassion for others. That will help people around them find the inner strength they did not know they possessed. It will lead to us fighting this pandemic together as one team. We are a resilient society and the world will get through this crisis.