Out of Patients EP456: Fitz Happens: The Marvelous Fitz Koehler

Fitz Koehler built her career teaching people how to take ownership of their health long before cancer forced her to test every lesson she ever taught. She is a nationally recognized fitness expert, race announcer, founder of Fitzness, creator of The Morning Mile, and now a breast cancer survivor who has lived through the very system she spent decades helping people prepare for.

I wanted this conversation because healthcare has an uncomfortable habit of swinging between magical thinking and helplessness. Either we pretend we can biohack our way out of disease, or we surrender every ounce of agency the moment a diagnosis arrives. Fitz lives somewhere in the middle, and that tension deserved a real conversation.

She said something that stuck with me. Her philosophy is to prepare your body for hardship before hardship finds you. Not because fitness makes you invincible. Quite the opposite. She did everything “right.” She exercised, ate well, understood physiology, and still found breast cancer just weeks after a clean mammogram. Cancer did not care about her résumé.

That is where the conversation got interesting.

We talked about the difference between preventing disease and preparing for it. We talked about exercise oncology, survivorship, and why movement during treatment can be as simple as stretching in the shower or doing leg lifts in bed between vomiting episodes. There is something refreshingly honest about someone who rejects miracle supplements, wellness snake oil, and social media hacks while admitting that some days success simply means getting out of bed.

Then we took a hard left turn into one of my favorite stories. Before she became the voice of marathons across America, Fitz worked at Cinnabon, fought as a competitive kickboxer, and somehow ended up in a martial arts movie with connections to Jean Claude Van Damme. I honestly did not expect my research for a cancer episode to include Bloodsport, bar fights, and Telemundo, but here we are.

The biggest thing I took away surprised me. I have spent 30 years talking about the failures of American healthcare. Fitz reminded me that personal agency still matters, even when the system fails you. It will not stop cancer. It will not guarantee a better outcome. It can give you a stronger place to begin when life throws the first punch.

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