2025 Gratitude Reflection: The 30-Year Overnight Success

People ask why I have not quit yet.

But a lot of people ask. What they are really asking is how someone stays upright after decades of pushing against systems that move slowly, resist accountability, and often reward silence over honesty.

I understand the confusion. Shallow online metrics and materialistic rankings can create the illusion of arrival. I mean, I get it.

• #3 oncology voice on LinkedIn globally.

• #1 cancer patient advocacy voice in America.

• #1 independent healthcare podcast.

• #1 bald Jew writing this article

It certainly sounds like I won something, doesn’t it? What I won was endurance through stubbornness and a music degree that taught me repetition creates rhythm.

These “accolades” can make it look like something finally clicked or that a finish line appeared. What they hide is the time dimension. The years of repetition. The long stretches where nothing moved, or moved so incrementally it barely registered.

Most so-called overnight success stories are simply the visible tip of work that took ten, twenty, or thirty years to compound.

The truth is that optimism never carried my work. If really know me, you know it’s been nothing less than my cynical, captious and cockeyed pessimism.

I learned early that optimism collapses under pressure. What lasts is expectation management. I assume systems change slowly. I assume progress requires repetition and memory. I assume that saying the same uncomfortable thing clearly, over and over, eventually lands.

That mindset came from music long before it came from advocacy. Musicians understand that you play the same passage hundreds of times before it sounds natural, and thousands of times before anyone calls it effortless.

Patient advocacy—nee all advocacy—follows the same rules.

You keep telling the truth until someone finally hears it.

I did not come up through nonprofit culture. I came up through storytelling, composition, and performance. Those disciplines taught me to sit with discomfort, to refine without applause, and to keep going because the work itself demands it. You learn that repetition is not redundancy. It is how meaning sharpens. How purpose identifies.

What actually keeps me grounded has very little to do with platforms or visibility. It’s my kids, my family, and my inner circle of friends who knew me when I had a fabulous Jewfro. This was all long before Stupid Cancer (except the kids part,) long before podcasting was a word, and eons before anyone was an “influencer.”

It is these things that keep me oriented to who I was before any of this became work, and they remind me that I am still the same person who survived something that should have ended everything and decided to speak honestly about it.

One thing has become clear after 25+ years in advocacy as I prep for my first book launch while returning to my roots as a classically-trained concert pianist:

You do not need to know what to do in some grand, abstract sense. You simply need to know what you can do.

You need to understand your lane and accept it without apology.

My lane involves telling the truth out loud. It involves saying what many people think but cannot safely say. It involves absorbing backlash so others do not have to risk their jobs, funding, or credibility. And the feedback I hear most often is not praise, rather, honest recognition. “You’re saying what’s in my head that I cannot say out loud.”

That tells me the problem is shared, and it tells me why this role exists.

American Healthcare is sitting at an unprecedented breaking point, and everyone can feel it. Patients, families, advocates, researchers and clinicians feel it. Visibility brings resistance. Clarity creates discomfort. Silence extracts a higher cost than conflict ever could.

I accept that “floor is lava” tension not because I enjoy it (I mean, to an extent I do), but because someone has to stand in it.

What keeps me sane is knowing who I am and why I speak.

I do not confuse attention with alignment. So, while external validation fluctuates, my purpose does not, because when you know the difference, the noise loses its power.

This work continues because the conditions that require it remain. I will keep doing the part I know how to do for as long as it is necessary and useful. There is no finish line here. There is responsibility, continuity, and commitment. There is only the next hill to ascend.

Most meaningful work only looks like overnight success in hindsight. From the inside, it feels uneven and unfinished. Confidence replaces doubt gradually. Imposter syndrome lingers longer than anyone admits. Ownership arrives when you stop asking permission to occupy the space you have already earned through years of showing up.

So here is the part worth saying out loud to each other.

• It is okay to pause.

• It is okay to breathe.

• It is okay to look back and acknowledge how much ground you have already covered before deciding what comes next.

Reflection does not equal retreat. Rest does not cancel commitment. Perspective keeps people in the work longer than pressure ever will.

So to all of my fellow patient advocates for whom Sisyphus remains a mere inconvenience, this is for you.

For those of us who have stayed, quietly or publicly, inside the bowels of institutionalized systems that congenitally resist change, the reminder matters that it is not you who lags behind. You are not failing because progress feels slow. You are participating in work that requires duration, memory, and patience with yourself and others.

You know... that whole “moral arc of the universe” thing.

We keep going by knowing our lanes, doing the work that belongs to us, and allowing timing to unfold without forcing false urgency. We keep going by recognizing that none of us carries this alone, even when it feels solitary.

That is how people stay. That is how people last. That is how we do not quit.

The real revolution happens when patients are in charge of their own outcomes.

Happy Holidays and Happy New Year!