S - Sustain the System: How Your Breakthrough Becomes Someone Else's
The L.Y.M.I.T.S. Method™, Part 6 of 6
It was spring break, 2006.
I was home in Colorado, sitting with parents, processing news I had been waiting years to receive. After 50 medical school rejections across multiple application cycles, an acceptance letter had finally arrived. And instead of celebrating, I panicked.
I was older than most incoming medical students. At the age when my peers were finishing residency, I was just getting started. I felt behind. Embarrassed. Like maybe I had waited too long, worked too hard, and missed the window anyway.
I told my mom I wasn't sure I should go.
She didn't argue with me. She didn't lecture me. She just looked at me and said something I have carried with me every single day since:
"Four years is going to pass with or without you. You might as well be four years older doing something you love."
One sentence. Twelve seconds, maybe.
It changed the entire trajectory of my life.
I went to medical school. I became a doctor. I built a career and a mission I am proud of. And nearly two decades later, I still come back to that sentence — on the hard mornings, the doubt-filled afternoons, the nights when I wonder if I am doing enough, moving fast enough, becoming enough.
Four years will pass. You might as well be in motion.
That is the S in the L.Y.M.I.T.S. Method™.
S — Sustain the System.
What Sustaining the System Actually Means
Most people think transformation is an event. A breakthrough moment. A decision made in a single conversation, a single phone call, a single letter of acceptance.
It isn't.
The breakthrough gets you started. The system keeps you going.
Sustaining the system means building the habits, the mindsets, the practices, and the communities that maintain your transformation long after the initial motivation fades. Because it will fade. Life will interrupt. Fear will return. The noise will get loud again. And on those days, you don't need inspiration. You need a system.
My mother's words became my system. Not a one-time pep talk — a reframe I return to every time fear tries to convince me that the window has closed. Four years will pass. The question is only what I choose to do inside them.
That is a sustainable system. Simple enough to remember. Powerful enough to redirect a life.
What My System Looks Like Now
Nearly twenty years after that spring break conversation, my systems have evolved — but the foundation is the same.
I show up every Monday morning for the people who read my weekly email. Not because I always feel inspired. Not because life always cooperates. I flew to Colorado in the middle of a family medical emergency, wrote from a house where the WiFi was down and the hot water heater wasn’t cooperating either, running on very little sleep — because consistency is the system. The showing up — even imperfectly, even exhausted — is what builds something real over time.
I speak. I mentor. I tell my story of 50 medical school rejections and two failed board exams to every audience that will have me — not because the story is comfortable to tell, but because I know what it does to the person in the room who needed to hear it.
I have learned that sustaining a system isn't about doing everything. It's about doing the right things consistently, even when — especially when — conditions are less than ideal.
When Your Breakthrough Becomes Someone Else's Permission Slip
The S step has a second dimension that I believe is the most powerful of all six.
It's not just about sustaining your own transformation. It's about letting your transformation sustain someone else.
I volunteer as a physician mentor for the Urban Bridges Medical Mentoring Program through the I Am Abel Foundation — a Chicago-based nonprofit whose mission is to identify and develop untapped talent in underserved communities and channel it toward careers in medicine and healthcare. You can learn more about their remarkable work at www.iamabel.org.
The students I mentor are brilliant, determined, and deeply motivated. They are also, in many cases, quietly terrified. They have worked hard to get where they are. They have overcome obstacles that would have stopped other people. And many of them carry a private fear that no one has ever told them out loud: that maybe, despite everything, they still don't quite belong.
And then I tell them my story.
Fifty rejections. Two failed board exams. A cross-country move. Years of doubt and persistence and showing up anyway.
And every single time, I watch something shift in the room.
A breath released. Shoulders dropping. Eyes going a little wide. The quiet, visible relief of someone who just discovered they are not alone.
OMG! I feel so much better knowing that I'm not the only one who has experienced this or felt this way!
That moment — that sigh of relief — is why I tell the story. Not for sympathy. Not for applause. Because my struggle, survived and shared, becomes someone else's evidence that the thing they're afraid of doesn't have to be the end of the story.
The majority of those students are now in medical school or have graduated and begun their residency training.
Let that land for a moment.
Students who once doubted whether they had what it takes are now doctors. They are in hospitals and clinics. They are sitting with patients who look like them, who come from communities like theirs, who finally have a physician who understands their lives from the inside.
That is the S step at its highest level. Your breakthrough rippling outward. Your survival becoming someone else's roadmap.
My struggles didn't just build me. They became someone else's permission slip.
How to Build Your Own Sustainable System
You don't have to have it all figured out. You just have to have something you return to.
Your system might be a sentence someone said to you that reframes fear every time it shows up. It might be a morning practice that reconnects you to your purpose before the noise of the day arrives. It might be a community of people who knew you before your breakthrough and will hold you accountable to becoming who you said you wanted to be.
It might be a mentee who is sitting across from you at brunch, telling you they almost gave up — and you get to be the person who says: I know. I almost did, too. Here's what I learned.
The system sustains you. And eventually, you become part of someone else's system.
That is how transformation compounds. That is how one person's story becomes a community's momentum. That is how we change not just ourselves — but the systems that once tried to stop us.
This Is Not the End
This is the sixth and final installment of the L.Y.M.I.T.S. Method™ introductory series.
We have traveled through all six steps together:
L — Locate Your Lessons. The setbacks that were preparing you.
Y — Yield Your Assets. The strengths hiding inside your struggles.
M — Mute the Noise. The voices that don't deserve your attention.
I — Integrate the Insights. Your pain becoming your purpose.
T — Take Targeted Action. Moving before you feel ready.
S — Sustain the System. Building what keeps you going — and letting it lift someone else.
But this series is not the final word on the L.Y.M.I.T.S. Method™. It is the foundation. The six steps are alive — they show up in new situations, new seasons, new challenges. I will return to this framework again and again with fresh stories, new insights, and the lessons that life keeps handing me, usually without warning and always at the most inconvenient time.
Because that is the nature of growth. It doesn't stop when the series ends.
Four years will pass. You might as well be building something.
Thank you for being here. Thank you for reading. Thank you for allowing my story to sit beside yours for a while.
Now go sustain your system. And then — when you're ready — share it with someone who needs to see that it's possible.
Dr. René is a board-certified Family Medicine physician, Fellow of the American Academy of Family Physicians (FAAFP), two-time Castle Connolly Top Doctor, TEDx speaker, and keynote speaker specializing in resilience and healthcare leadership. A trusted medical expert featured on ABC, CBS, Fox, NBC, WGN, and in the Chicago Tribune and Chicago Sun-Times, she created the L.Y.M.I.T.S. Method™ to help high achievers transform setbacks into strategic advantages. She volunteers as a physician mentor for the Urban Bridges Medical Mentoring Program through the I Am Abel Foundation (www.iamabel.org).
