What is Peak Performance?

Peak Performance and how to be your best when it matters most

But what exactly is peak performance, and how can I strive to achieve the impossible?

For as long as humans have roamed the Earth, we’ve been compelled to push limits, redefine the rules, and rewrite history. Achieving the impossible? That’s the ultimate frontier. And it starts with one thing: flow.

Flow is where we transcend the ordinary and make the impossible possible. But before we dive into the neuroscience, let’s rewind for some historical context on human performance.

4-minute mile

In 1923, Finnish runner Paavo Nurmi clocked a 4-minute, 10.4-second mile—a record that seemed untouchable. The idea of running a mile in under 4 minutes? It was considered fantasy, if not suicidal. Progress was excruciatingly slow. Eight years to shave a single second. Decades of runners chasing a ghost.

Then, in 1954, English physician Roger Bannister broke the unbreakable: 3 minutes, 59.4 seconds.

It was foolhardy and possibly dangerous to attempt. Some thought that rather than a lifetime of glory, honor, and fortune, a hearse would be waiting for the first person to accomplish the feat.

Neal Bascomb in The Perfect Mile

But the story didn’t end there. Two months later, Australian John Landy broke Bannister’s record. Within a decade, high school students were running sub-4-minute miles.

What changed? Not physiology. The feat hadn’t become easier. The difference was psychological. Bannister proved the impossible was only impossible until it wasn’t. The Bannister Effect was born: once we see someone else accomplish the unthinkable, we start to believe—and achieve—it ourselves.

The 1990s: The Dawn of a New Era

Does anyone remember the 1990s? A time when ski bums with dead-end jobs who slept all day started doing things no one thought possible. This was when a genuine obsession with peak performance was born—not in labs or Olympic training centers but on the edges of cliffs, in the back bowls of mountains, and at the crest of massive waves.

Do you remember seeing skiers hucking themselves off peaks, dodging avalanches, and landing on slopes that seemed barely skiable? Or the X Games, with BMX riders and skateboarders flipping, spinning, and soaring into the stratosphere? What about the first viral videos of freestyle athletes defying gravity with no coach, no trainer, and no apparent safety net?

And then there was the Millennium Wave.

Teahupoo: The Liquid War Zone

If you’ve ever heard the name Teahupoo (pronounced cho-poo), you’ve already felt its gravity. Translated as “wall of skulls,” Teahupoo is not your average wave. Surfers call it “a war zone,” “liquid napalm,” and “a wave for people who don’t care about seeing their next birthday.” Unlike traditional waves, which rise tall, Teahupoo explodes laterally. It’s the heaviest wave in the world—a dense, punishing wall of water breaking just three feet above razor-sharp coral.

Seven days before one of the most famous rides in surfing history, Briece Taerea, a Tahitian surfer, lost his life at Teahupoo. The wave spared no one, and locals knew better than to tempt fate when the surf got like this. But on August 17, 2000, when Teahupoo was “going off,” Laird Hamilton saw what others feared: possibility.

The Millennium Wave: A Monument to Flow

The morning of August 17 was unlike anything anyone had ever seen. Locals were clear:

We don’t ride when it’s like this. Today is unrideable.

But Laird Hamilton had spent his entire life training for days like this. He and his tow partner, Darrick Doerner, were pioneers of tow-in surfing—a technique invented to ride waves so massive that paddling in was physically impossible. With jet skis and tow ropes, they had unlocked new frontiers in surfing, riding waves previously thought unrideable. But this day was different.

Laird towed out to what would become the Millennium Wave, a colossal freak of nature with two separate swells stacked on top of each other. The lip—normally just a thin crest of water—was half the wave itself. The hydraulics of the wave were beyond comprehension. It didn’t just break; it consumed. The barrel sucked in everything around it, ready to crush anything that dared challenge it.

From his vantage point, Darrick saw the wave forming. He yelled back to Laird:

Don’t go!

The team joined in, screaming, “Don’t go!” as the monster wave surged out of the horizon. But it was too late. Laird released the tow rope, defying the warnings. The moment he let go, the Millennium Wave claimed him.

As the wave rose behind him, Laird faced what should have been certain death. The barrel began to close, threatening to swallow him whole. In a life-or-death moment, Laird did something no one had ever seen before. Instead of dragging his backhand along the face of the wave to stabilize himself—a standard move in surfing—he reached forward. With his front hand, he grabbed the wave itself, using the raw power of the water to steady his board.

It was a move born of pure instinct, a split-second decision in the depths of flow. No one had trained for this. No one had ever done it. But somehow, it worked.

And then, the lip came crashing down. Witnesses described the sound as a megaton bomb detonating on the reef, the spray shooting 60 feet into the air. Everyone watching was certain Laird was gone. Seconds passed. The mist began to part. And there he was—standing tall, arms raised in triumph, riding out of the impossible.

Danny Way: The Great Wall and Flow

Imagine this: You’re staring down a 200-foot ramp perched above the Great Wall of China. The challenge? Make the leap of a lifetime, five seconds of free air to land safely on the other side. Someone has already died trying a similar stunt.

Now imagine this: The day before, you attempt a practice jump, crash hard, and tear your ACL. Your ankle is fractured. You leave the hospital against medical advice. You climb back up the next morning, every step on that swaying scaffolding reminding you of your broken body.

And then? You do it. You leap. You land. And you break two world records.

Danny Way explains it best:

You want to know how I did something like jump the Great Wall on a fractured ankle? I can’t really answer that. All I can tell you is what I already told you: when I’m pushing the edge, skating beyond my abilities, it’s always a meditation, in the zone.

There’s our answer: flow. An altered state of consciousness. Complete immersion. Total focus. And yet, for many of you, this is where I’ve already lost you. “Don’t talk to us about altered states of consciousness,” you’re thinking. “How does this apply to medicine? I’m interrupted every 30 seconds. I’m not riding waves or jumping the Great Wall.”

Fair enough. But here’s the thing: there are lessons to be learned. In resuscitation, haven’t you seen teams that felt fluid, where everything just clicked? And isn’t it true that our healthcare system—broken as it is—needs change? Let’s be real: no one’s going to fix it but us. Flow might be your answer if you’ve ever felt like you’re too burned out or overwhelmed to make a difference.

The Science of Flow: A Game-Changer

What if I told you the Navy SEALs have adopted lessons from these athletes? So have Google, Goldman Sachs, Deloitte, and Formula 1. Why? Because the data is clear:

• 500% increase in motivation and productivity
• 200% improvement in learning and memory
• 430% boost in creativity and innovation
• 100% increase in meaning and purpose at work

Imagine applying these stats to medicine. Creative solutions for bed blocks. Optimized patient care. Reclaiming your purpose. Learning new skills or passing exams with ease instead of burning out at 2 a.m. over a textbook. It’s not just possible; it’s proven.

Chasing Flow: A Rabbit Hole Worth Entering

Flow is no longer some abstract ideal. It’s a science. Thanks to researchers like Steven Kotler and his team at the Flow Research Collective, we now understand the neurochemicals, neuronal pathways, and biology behind it. Their mantra is simple: “Biology scales, personality does not.” In other words, there’s no one-size-fits-all solution. But by understanding what’s happening in the brain, you can discover what works for you.

In future posts, I’ll dive deeper into these lessons and tailor them to medicine. Together, we’ll create a resource for ourselves, our peers, and our trainees. A living, breathing blueprint for using flow to thrive in healthcare. Along the way, I’ll share my personal journey: from a single email and a pint in a pub to reading The Rise of Superman and finding the key to peak performance.

This isn’t about wellness weeks or self-help platitudes. It’s about unlocking the tools to reignite your passion for medicine, prevent burnout, and reclaim your time. If I fail? Call me out. Our careers—and our lives—are too important to get this wrong. Have your own flow tips, let us know, this series will be a live document.

So, suspend your disbelief for a moment. What if the impossible wasn’t impossible at all?

What if you could get there, too?