Your burnout isn't noble—it's stupid

I am having an elderberry-flavored soda; he is having a regular beer. He is a gifted surgeon, my mentor and colleague. I am a green youngster just beginning to grasp the grueling work conditions I have gotten myself into, starting residency at the major surgical department of a university hospital.

He tells me the story of how one day he told his wife he thought he was burned out. Apparently, she laughed and said it was impossible. He asked why. She replied, "You are not burning for anything."

That story stuck with me. It took me years to understand why.

The Misconception of Burnout

It’s not just the silent epidemic of burnout among surgeons and the rising number of suicides, especially among young physicians (Shanafelt et al., 2015). Nor is it only the "burned out" part—the phrase has become a buzzword. It's the "you are not burning for anything" that lingers. It hints at a common misconception: that the extinction of the flame—or burnout—is an immediate, visible event. In reality, it’s more like a slow suffocation; the flame dims as oxygen deprivation increases, until, silently, it fades into nothing.

This creates the impression that the flame never existed in the first place, and hence there was no burnout. However, for high achievers, the deprivation starts early on. You could argue that this “strategic deprivation” slightly enhances performance, similar to how increasing L-theanine in Japanese gyokuro and matcha tea is accomplished by shading the tea plants to restrict sunlight. But restrict the sunlight—or, metaphorically, the oxygen—too much, and the system suffocates.

Before that final extinction, there is often an overactivation of the sympathetic fight-or-flight system. Understandably so—you're fighting for survival.

I remember waking up in the middle of the night, kneeling in the middle of my bedroom, my fist hammered into the ground onto my curtains that I had apparently ripped from the ceiling. I had an ultra-realistic dream of a patient with an acute femoral bleeding that I desperately had tried to stop, my jaw hurt from my clenched teeth. That's when I realized something is off, and something has to change.

I lost track of how many shouting matches between (more senior) colleagues I have witnessed, how many overreactions and insults I suffered myself. I've seen surgical instruments flying through the OR, a consultant circling the table to semi-sterilely kick a co-surgeon, and pictures of holes in walls from frustrated boxing kicks or mangled trashcans absorbing agony.

Even during my parallel studies of medicine and economics—and throughout my intentional leaves from the medical career track—I consciously examined nearly every area of life to figure out what works best for me and why. Many of these learnings turned out to be generalizable.

Based on my experiences and countless conversations with young colleagues, I found myself putting up flyers at Brigham and Women’s Hospital in Boston during my post-doc at Harvard University, advertising “The New School Physician – Secrets to Stay Focused and Prevent Burnout in Today’s Draining Work Environment.”

I was laughed at by superiors, but transformative sessions occurred with those who showed up.

A greek colleague of mine was in tears after our first workshop - he said he couldn't believe that it would be allowed to openly voice these thoughts and how relieving it felt to see that he was not the only one having these experiences. We successfully worked through his insomnia.

Ironically, I later forgot these lessons when I became fully absorbed in my own ever-increasing skill levels and responsibilities. Luckily, I remembered in time—a prime example of how we often know what to do, but need consistent reminders.

From Empty Cup to Roman Fountain

The key concepts underlying all these strategies are the analogies of the empty cup and of the Roman fountain; they complement each other.

“You can't pour from an empty cup.”—unknown

This statement encapsulates the root problem—and the solution—beautifully. If your cup is empty, there is nothing for you to pour.

Roman fountains operate on a similar principle. Traditionally, they have three levels: a top “cup” that, once filled, overflows into the next “cup,” which then overflows into the largest lower basin. The top cup is “Me,” the second “You,” and the third “Them.” If my cup runs dry, there’s nothing to give to others, let alone to my community.

For a while, I collected pictures of Roman fountains—both online and offline. It was a powerful reminder for my own sanity. I had my wife stay stand guard on a street in Rome while I was half-trespassing into a property to get a perfect shot of a impeccable marble fountain at 1.30 AM in the morning.

The obvious question then becomes—what fills your cup? How do you fill your cup?

Take a moment and reflect on that before you continue.

The Four Dimensions of Personal Energy

You have a selection of cups: physical, mental, emotional, and spiritual. Each requires different types of filling. Depending on your current stage and self-awareness, you might already know what each cup should be filled with and how. If not, it’s time to find out. I have some best practices to share that can serve as starting points, additions, or just inspiration.

Importantly, filling your own cup isn’t a single “thing” you check off. It’s a philosophy—a way of living. This shouldn’t be confused with selfishness or arrogance. It’s about responsibly tending to your own energetic system and wellbeing, recognizing that your fullest self is of greatest service to others.

“If you would list all the things and people you love, how long would it take you to name yourself?” —[Board at Encinitas café, paraphrased]

How long did it take you?

This is direct feedback on where you currently place yourself and your own needs. Work from there.

The Science of Burnout and Renewal

Recent research shows that chronic work-related stress can elevate cortisol levels, impair cognitive function, and even depress immune function (Smith et al., 2018). Burnout isn’t just about psychological exhaustion but about actual physical changes in brain and body.

Recognition and intentional action are key. Here are seven strategies I have found helpful for preventing depletion and encouraging overflow.

---

Seven Strategies for Energy Renewal

1. You Need More Than Just Function to Flourish

There’s a sneaky myth that being “fine”—just ticking off a checklist of eat, work, scroll, and sleep—is enough. But we aren’t machines. True energy comes from engaging our whole selves: moving, breathing, feeling, sensing. Look beyond maintenance and ask: What actually recharges my system, not just keeps the lights on?

2. Renewal Requires Deliberate Spaces and Rituals

In the hospital, I learned that without intentional moments of reset, chaos fills every gap. The same is true in life. Find your “charging stations”—the sauna by the lake, a walk in the woods, a favorite chair and book, the simple act of mindful breathing. Ritualize them. Make energy renewal as non-negotiable as brushing your teeth.

Science tidbit: Rituals trigger the parasympathetic nervous system, counteracting chronic stress (Porges, 2011).

3. Pay Radical Attention to What You’ve Lost (and Need)

Burnout often creeps in, masked as endless irritability or numbness. Notice those moments—snapping at loved ones or sensing your body’s silent protest. These are signals. Pause and ask: What’s missing? Remember, recognizing the need for rest or play is a strength, not a weakness.

4. It’s OK if Your Cup-Fillers Look Different

Some recharge with yoga; others with rock music and a PlayStation. Recreation isn’t about performing wellness for others; it's about honest experimentation and permission to follow what actually works for you. Try things. Some will stick, some won’t. That’s the point.

5. Micro-Rituals Matter—Start Small, Especially in Busy Phases

You don’t need three hours or a clear calendar. Even brief moments—a few steady breaths, stepping outside, a five-minute foot massage, a quick stretch—can shift your nervous system from fight-or-flight to rest-and-renew. The simpler the tool, the more likely you’ll actually use it.

I had a custom-made cigarette-shaped tube 3D-printed because I realized how smokers always get their 5 minute "fresh-air" breaks. Like this I regularly could do some 5 minutes of conscious breathing while adding the benefits of restricted yogic uyaii breathing to it.

6. Community and Conversation Are Central to Energy

Sometimes, renewal is social. A deep talk with a friend, laughing about stress, or having regular connection rituals can be as revitalizing as time alone. Don’t dismiss the power of being witnessed (or even gently pushed) by others on the same journey.

Denmark has a wonderful tradition of monthly fridays-bar get-togethers at the office after work for example.

7. Reflection Is Your Compass

Regularly checking in with yourself is crucial. Borrow from the “energy audit” idea: ask, “How do I feel? Where's my energy leaking?” Gather this data like a scientist of your own vitality, and let it shape your routines. Each day, ask: What activity energized me most? Where did I feel drained? What’s one small action I can take tomorrow?

---

Overflow as a Practice

As in the fountain metaphor, let your energy renewal practices be the steady trickle that keeps each cup—body, mind, spirit—overflowing. It’s not about grand gestures, but daily—even hourly—recommitment to refilling so you can give from a place of true abundance, not depletion.

“You can’t pour from an empty cup, but you also can’t fill it with what everyone else tells you to. Find your sources. Protect them, fiercely. Ritualize recreation—not as luxury, but as the foundation for everything and everyone that matters.”

The knowledge is out there. The principles are simple, but implementation is not easy—otherwise you and everyone else would have mastered this already.

If you’re like most, you’ll bookmark this newsletter, add it to your someday-to-do list, and move on. But if you reply with “energy,” I’ll send you the info for The Renaissance Society, where we tackle this together, and I’ll help you start right now.

To more in life,

Nicco

Maybe this episode’s song can spark some energy: