For many high-functioning, high-achieving individuals, like physicians, rest doesn’t feel restorative. It feels uncomfortable. Anxiety-provoking. Even wrong.

I see this over and over again in my coaching clients, in colleagues, and in myself. Doctors will tell me they’re exhausted, burned out, and desperate for a break. Yet when they finally get administrative time or time off, it often brings guilt, restlessness, or a sense of unease rather than relief.

This isn’t a personal failure or a lack of self-care skills. It’s a nervous system response shaped by our medical culture and broader societal conditioning.

From the earliest days of training, medicine teaches us that usefulness equals worth. This belief mirrors broader American values that prioritize productivity, efficiency, and achievement. We learn that pushing through exhaustion is framed as sacrifice, and therefore as virtue. Productivity becomes proof of usefulness, achievement brings external validation, and validation becomes the measure of success. Over time, this turns into a powerful positive reinforcement loop. Within that framework, pausing feels unnatural: a loss of productivity, a loss of validation, and the looming

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