Treading Water

Aakash Shah
4 min readMar 7, 2023


It’s been almost nine months since I’ve written anything. In that time I: moved in with Nithya, finished wards and medical intensive care (MICU), trained and ran a marathon, matched into a hematology/oncology fellowship, proposed to Nithya in Morocco, and went on a trip to Japan. Phew. That was a mouthful. However when I look back at this list, I really just see a series of checkpoints or milestones.

I used to think of life through the lens of checkpoints. After each checkpoint, I thought I would be incrementally happier.

Once I finish this exam, it will be easier. Once I finish my internship, it will be easier. Once I finish my MICU block, it will be easier. Once I finish my last twenty-four call, it will be easier. Once I finish residency, it will be easier. On the personal side it’s no different. Once we move in, things will be easier. Once we get engaged then it will be easier. Once we get married, then it will be easier.

Now that I’ve made it towards the end of my twenties, I see that happiness is in no way tied to completing the prior checkpoint. What I really feel is that feeling of treading water. As long as I keep moving my arms and cycling my legs then I won’t drown.* Put another way, the more checkpoints I complete, the closer I am to being “successful” or “happy”.

A decade has passed since I was a teenager. A decade. That means I’ve been treading water for a long time. I’m tired of treading water.

Now, I know I picked a career that requires individuals to prioritize delayed gratification, or as my economics professors would say, “discount the present”. A relationship is no different. A successful relationship is when both individuals give 100% and only after years of work do you fully see the benefits, or as my economics professors would say, “realize the gains”.

All of these life updates, both professionally and personally, reinforce the feeling of treading water. Professionally, I’m ready to move on to the next step, but in my case, the next step (i.e. fellowship) looks eerily similar to my current step (i.e. residency). Personally, Nithya and I have already started building the foundation of our life together, but the next step (i.e. getting married) will not significantly change our current day to day life. The feeling of treading water has no end in sight.

We exist in a gamified world where we get rewarded with a push of dopamine once we beat a level or pass a checkpoint. In essence, I was/am being rewarded for treading water. But what is the final level/checkpoint? Does it even exist? What is the purpose of treading water? These are the questions that surfaced immediately after I crossed the Chicago marathon finish line. In short, my question to the world is “So what?”.

The answer to that question (now that I’m reflecting) used to be yes. It’s what drove my Type A personality. I wanted results. But, now that I’ve accomplished many of the things my high school self wanted to accomplish, I see that my happiness has not proportionally risen. To get out of this mentality, I realized that I needed to change my lens and focus on the present. Be more mindful. Live in the moment. Insert your cliché quote here. But somehow these quotes finally resonated with me. I can finally “realize the gains” through the process of living.

Here are some moments that give me joy. Moments that I know take a few seconds to process and accept that I truly feel happy. Walking through the hospital while teaching two interns, one sub-intern, and three medical students. Reading on my couch with the sun on my back as the breeze from my open balcony door gently wafts over me. Running without any music and taking a second to smell the spring flowers. Asking my patient what their goals are then reflecting on that deeper conversation. Looking at Nithya smile when she opens the apartment door as she comes in for a ten second hug.

These are the moments that have made life stop feeling less like treading water and more like floating on an idyllic river. As I enter the last year of my twenties, I know that my high school self would be proud of the man I’ve become. Now it’s time to make my thirty-nine year old self proud.

* I like this analogy because growing up my parents made me take swimming lessons and at the end of each level we would have to take the proficiency test. Part of that test was treading water for an X amount of seconds that progressively got higher the further along the course we got. Well, I sucked at treading water. My arms and legs would thrash to no avail. Anyways, that’s why I chose this simile.