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Your work world is built on endurance, intensity, and mastery. The culture is 'always on,' and you were trained to perform in conditions no one would call normal. The work is supranormal. It sits at the edge of reasonable and regularly exceeds what is sustainable by most standards. High performers like you often find themselves on an above-the-fray pedestal, expected to be tireless and self-sacrificing. Supranormal work can unlock extraordinary performance, but the cost adds up if it goes unchecked.
In this episode, we look at where this culture came from, the cortisol spikes that shape your days, the hidden curriculum of self-sacrifice, and the countermeasures that keep you from burning out. It is a straight look at the supranormal experience and what it takes to do this work without losing yourself to it.
Awake + Aware | Our 2026 Retreat
Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited.
Learn More Here
🎓 P.S. This is a CME event.
We discuss:• Why medical culture expects you to perform inside conditions no one would call normal
• What makes supranormal work different from ordinary high-stress work
• How the “always on” ethos formed and why it persists
• The hidden curriculum of self-sacrifice and the pedestal of being above the fray
• Cortisol spikes, sympathetic load, and what chronic activation does to your body
• Why self-preservation feels selfish in medicine and why that belief is wrong
• The roots of modern training from monastic care to Halsted’s cocaine-fueled stamina
• Why emergency medicine is an outlier in burnout, longevity, and physiological strain
• The concept of parasympathetic nurturing as a countermeasure
• How mindset changes biology and shifts performance
• What it takes to last in supranormal work without losing yourself
By Rob Orman, MD4.9
112112 ratings
Your work world is built on endurance, intensity, and mastery. The culture is 'always on,' and you were trained to perform in conditions no one would call normal. The work is supranormal. It sits at the edge of reasonable and regularly exceeds what is sustainable by most standards. High performers like you often find themselves on an above-the-fray pedestal, expected to be tireless and self-sacrificing. Supranormal work can unlock extraordinary performance, but the cost adds up if it goes unchecked.
In this episode, we look at where this culture came from, the cortisol spikes that shape your days, the hidden curriculum of self-sacrifice, and the countermeasures that keep you from burning out. It is a straight look at the supranormal experience and what it takes to do this work without losing yourself to it.
Awake + Aware | Our 2026 Retreat
Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited.
Learn More Here
🎓 P.S. This is a CME event.
We discuss:• Why medical culture expects you to perform inside conditions no one would call normal
• What makes supranormal work different from ordinary high-stress work
• How the “always on” ethos formed and why it persists
• The hidden curriculum of self-sacrifice and the pedestal of being above the fray
• Cortisol spikes, sympathetic load, and what chronic activation does to your body
• Why self-preservation feels selfish in medicine and why that belief is wrong
• The roots of modern training from monastic care to Halsted’s cocaine-fueled stamina
• Why emergency medicine is an outlier in burnout, longevity, and physiological strain
• The concept of parasympathetic nurturing as a countermeasure
• How mindset changes biology and shifts performance
• What it takes to last in supranormal work without losing yourself

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