September 30

What Doesn’t Kill You Makes You Stronger

Canadian educator Laurence Peter once said, "Fortune knocks but once, but misfortune has a lot more patience." Truth. We try to play safe to avoid adversity in life, even though growth is interminably linked with growing pains in the natural order of things. Instead of fighting adversity, embracing mild stress and minor setbacks can be very good for us in the long term. After all, what doesn't kill you makes you stronger.

An almost lost cause

Emily Whitehead, born a perfectly healthy child, was five when she complained of excruciating leg pain one night. It didn't take long before she was diagnosed with a childhood cancer, pediatric Acute Lymphoblastic Leukemia (ALL). Unfortunately for Emily, she didn't respond to the standard treatments, and her condition continued to deteriorate. That's when her parents, in a throw-everything-but-the-kitchen-sink move, reached out to Dr. Carl June to enroll her in a Phase 1 immunotherapy clinical trial.

Without getting too technical, Dr. June's treatment protocol (CAR-T therapy) involved reprogramming the body's own cells to elicit an immune response to fight the invading cancer cells. While many had previously considered and even attempted immunotherapy treatments, Dr. June's magic was in his method.

Fire with fire

Knowing that HIV is deadly because of its ability to infiltrate its DNA on host cells directly, Dr. June used modified (deactivated) HIV cells as the tool to deliver DNA-altering and disease-obliterating CAR-T cells into the patient's body to fight against cancer. It was a risky ploy pitting one deadly disease against another. It worked.

Emily Whitehead is now a thriving teenager and, with the help of her parents and supporters, a strong advocate for cancer research. Her story received worldwide acclaim—see Oscar-winning director Ross Kaufman's 3-minute documentary short Fire with Fire.

Dr. June's pioneering and groundbreaking research has, in turn, saved many more lives and continues to be the cornerstone of some of the most significant medical breakthroughs of our generation. More importantly, his approach to treating fire with fire underscores an overlooked point: What doesn't kill you can make you stronger. And may even save your life.

The origins

While it's almost cliché to say "what doesn't kill you can make you stronger," the words are a much-quoted and referenced aphorism. Also, sorry to burst your bubble, but neither Kanye West nor Kelly Clarkson can take credit for its origins which go way back. To 1888, in fact, before the world even knew what pop, pop rock, hip hop, pop art (or whatever genre it is that Kanye West croons) was.

In the Twilight of the Idols, German philosopher Friedrich Nietzsche wrote, “Aus der Kriegsschule des Lebens—Was mich nicht umbringt, macht mich starker.” Roughly translated, it means, "In the military school (war) of life, that which doesn't kill me makes me stronger."

Since Nietzsche's time, the aphorism "What doesn't kill you makes you stronger" has not just been widely quoted and alluded to but equally misinterpreted. Nietzsche's intent was not to say that all suffering transforms into strength and resilience. Clearly, suffering can leave a lasting negative impact on a person—something like PTSD would never exist if all suffering were just stepping stones to strength.

What Nietzsche implied, however, was that we may be able to use suffering as a teachable moment that then allows us to build the strength of character and compassion. And we don't have to look far to find out how—Nature has plenty of illustrations of how dealing with minor adversities can improve us in the long run.

In real life

Here are some real-life examples of how mild adversity and stress activate our inbuilt repair and strengthening mechanisms.


Anyone who has physically trained for a sport or fitness in a gym can attest to one thing—delayed onset muscle soreness feels like you are dying. So, why go through the rigamarole? The answer? Microtears. A tear of any sort sounds awful, but the little muscle rips are good for us.

It seems counterintuitive to purposely injure yourself during a workout, but that, in essence, is what you must do to build muscle mass. Source: UHH article on microtears

When we physically work on a muscle, the muscle tends to get tiny tears (microtears). Sensing danger, our brains and the rest of the body send out reinforcements in the form of healing nutrition and increased blood flow to the damaged muscle. This helps not just to build muscle but helps it build back better than it originally was. What doesn't kill you makes you stronger.  

Dietary restrictions

Mark Mattson, a pioneer of the Intermittent fasting movement, published a study that showed how calorie-restricted mice live considerably longer than average. We live in times where food is essentially ubiquitous. So, when the body finds that we are dietarily restricted, our brains activate a mild stress response that works to protect the body.

When the body senses a food shortage, it unleashes protective molecules that don't just calm the stress response but actually repair and revamp metabolic processes to make us function more efficiently and live longer. Eating for just eight instead of 24 hours a day doesn't kill us. It makes us stronger and more efficient.

Career growth

In a study published in the journal Nature, researchers studied the role of setbacks in the lives of junior scientists who applied for prestigious grants with the National Institutes of Health. Here's what the researchers concluded:

Despite an early setback, individuals with near misses systematically outperform those with narrow wins in the longer run. Moreover, this performance advantage seems to go beyond a screening mechanism, suggesting early-career setback appears to cause a performance improvement among those who persevere.

The takeaway

The examples are plenty, but the lesson is the same. Minor adversities in life are actually better for us in the long run. Instead of spending all our energy and resources worrying about failure, we are better off learning to recover from setbacks and move forward.


In his book Spark, author John Ratey MD describes an anecdote where the US Dept of Energy studied the risks of radiation exposure on individuals by comparing two groups of nuclear shipyard workers. One group was exposed to low levels of radiation as part of their job, while the second group wasn't.

Contrary to expectations, the study found that the workers exposed to the radiation tended to be healthier. Later, they established why: the bodies of those exposed didn't just adapt to fend off the toxins from the radiation exposure, but their cells developed protective capabilities to ward off future toxin attacks.

What doesn't kill you does make you stronger. So, even if it is challenging to embrace adversity, it helps not to fight it every step of the way, especially if factors outside our control cause adversity.

By trying we can easily learn to endure adversity. Another man's, I mean. Mark Twain



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