Reframing Fear

  I am standing next to Dr. Jordan Metzl, a sports medicine physician at the Hospital for Special Surgery, who is passionate about preventing injury through fitness. Last month, I took a 4-day vacation at Canyon Ranch, Lenox, MA. It combined my favorite aspects of vacation: exercise, learning and growth, interesting people, and tasty, healthy food.

Reframing Fear: Introduction

Because I went with a group of friends, the weekend chose me. Nevertheless, it exceeded my expectations largely because of what I learned from Jordan. Jordan believes that most sports injuries occur because of inadequate muscle strength, which leaves tendons and ligaments vulnerable to injury. Two points that he made: all stretch goals trigger some fear and intensity matters, left a lasting impression on me, as described below.

All stretch goals trigger some fear

I realized that the reason that I plateaued in my fitness program was that I let fear of injury dominate my routine. Jordan taught me to embrace fear. He felt that goals that do not trigger fear reflect a play-it-safe mentality rather than the BHAG (big hairy audacious goal) that Collins and Porras wrote about in Built to Last.

Jack Canfield wrote that F.E.A.R. is an acronym for Fantasized Experiences Appearing Real.  Most of our fears do not materialize. They are a manifestation of our egos, that exist to keep us comfortable and feeling in control.

So what is wrong with feeling comfortable and in control? Nothing, provided that opportunities to grow and develop do not pass us by because we fear failure. To paraphrase Dr. Peter Sengewhen the pace of change on the outside exceeds the pace of change on the inside, the death of the organism is near. We know this to be the case in shock and multi-system organ failure. It is not as clear in organizations and personal growth because of the power of denial.

Guilty as charged. I get comfortable in my routines till they become ruts that require dynamite to blow me out of.

Intensity matters

On my elliptical trainer, I pushed up the resistance to maximize the calories burned. Unfortunately, I could not sprint at that resistance, so I never elevated my pulse sufficiently to gain a true cardiopulmonary benefit. We have two types of muscle fibers: Type I are for endurance, Type II for sprinting. Unless we sprint, even for a minute or two, we do not recruit Type II fibers.

Reframing Fear: The relevance to healthcare

From time to time, I ask myself, “What’s holding me back?” Once I ask “why” multiple times, I realize that it is not healthcare reform, regulation, or decreased reimbursement, but self-limiting beliefs that trap me into thinking, “I could never do that.” Reinvention requires courage, the willingness to reframe fear as growth about to happen, rather than as failure. Learning is never failure.

With clarity, come the resources we need to succeed. Successful change agents recognize that they can’t do it alone and seek out mentors to guide them and help them see beyond their blind spots. Clarity also triggers passion, which Dr. Jade Teta describes as the ultimate time management tool.


In QuicksilverO’Brien and Shook list the four fears (p.130) as:

  • Appearing stupid, foolish, or idiotic
  • Being unmasked as a pretender or a fraud
  • Feeling like an outcast
  • Looking weak, powerless, or ineffective

Having our feet firmly planted in mid-air triggers these four fears. Joe Tye wrote that action is the hack-saw that breaks the prison bars of fear.

As the photo below shows, I challenged my fear by participating in Dr. Metzl’s Ironquest workout, inspired by Jordan’s, “Do what you can” approach. I am overcoming fear and some soreness to change my workout regime and intensity with my trainer, in pursuit of my new goal to be a poster child for reverse aging. I want to live long enough to inspire my as yet unborn grandchildren when they become teenagers. That will be my payback to my kids.

Dr. Cohn in front row after reframing fear by participating in Dr. Metzl’s Ironquest workout


To obtain the 10-Step Guide to Physician Reinvention, please click here.


To paraphrase Harvard Business School Professor Rosabeth Moss Kanter, change is disturbing when it is done to us, but exciting when done by us.

I wish all of you continued success as you navigate the white water of change. Please share with me your progress and learning and contact me anytime that I can be of service to you.

Kenneth H. Cohn, MD, MBA, FACS

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