In the moments before her fall, Quinn Dannies felt weightless. She was finally strong enough to complete the climbing project she’d been working on for years. The afternoon was immaculate—the air cool, the light a soft amber.

Pulling through the crux of the boulder problem, her heel wedged perfectly into position, Dannies reached for the hold above. But, as had happened hundreds of times before, she couldn’t stick it. She fell. Unlike those other times, though, this slip would change the course of her life.

After her fall, Dannies’s back felt sore, but in a familiar, nonthreatening way. She had broken her back when she was fifteen, and it’d been achy ever since. Dannies was used to discomfort after being active. And she was active all the time. An avid trail runner, before her fall she was months into training for her first fifty-mile run. She was skiing huge lines in Tahoe’s backcountry. She was sending all of her climbs.

Weeks passed before Dannies realized something was off. It felt like her abdominal muscles had stopped engaging. Six months went by before she came to accept that this was a new injury. She got one diagnosis, then another. Next came a blur of procedures—hip surgery, spine surgery, three or more doctor’s appointments each week, four courses of physical therapy for different muscle groups.

Years went by, and her prognosis remained unclear. Now, during good weeks, she can sometimes run one mile.

“I’m never going to be the same again,” Dannies tells me. “How could I not be scared of that?”

Athletes are not immune from entering what Susan Sontag calls, in her book Illness as Metaphor, “the kingdom of the sick,” a realm she describes as “the night-side of life, a more onerous citizenship.” The story goes something like this: A young person is in the best shape of their life. They act as if they were invincible. They dream with the kind of folly only a young person can sustain. They believe achieving their dreams is not only possible, but inevitable. They are wrong.

Something happens. At first, it’s subtle. Eventually, their imagined vision of the future falls apart. I’ve spoken with runners, climbers, skiers, powerlifters, cyclists, and mountaineers who have been given unclear prognoses with indeterminable timelines after experiencing injury or illness. They are then tasked with figuring out whether to cling to their identity as an athlete or to accept that the futures they once imagined for themselves have been foreclosed.

How are you supposed to learn a new way to survive when the hope of returning to your beloved old life lingers? How do you accept that everything has changed when there’s a chance you could be wrong? Endurance athletes, perhaps more than any other demographic, delight in rubbing up against their breaking points, probing the body’s upper limits. Running, especially, is for masochists. It is mostly suffering. But none of the hours logged in the gallows make it any easier to admit that the defining feature of your life has vanished—and that without it, you have no clue where, or how, to find your center.

Dannies’s injury was instantaneous. Her ability to live within the new confines of her body was not. Did her disability begin the moment the hurting started, or later, when she finally accepted that the hurting would have no end? Did it begin in the moment Dannies fell and tore her hip labrum? Or several years and surgeries later, when a new physical therapist massaged the shredded muscle and told Dannies she shouldn’t be able to walk? Or sometime in the colorless hours after that appointment, when Dannies finally realized that something had gone desperately wrong?

“How do you deal with the grief of having your body taken away from you?” Dannies wonders.

Almost every morning over the past few years, twenty-six-year-old Sawyer Blatz got up before sunrise to run. In the steel-blue morning, he sprinted through San Francisco’s Crissy Field, running through the eucalyptus trees to reach the shore at the exact moment the sun’s first glint of orange burst through.

But in November 2022, Blatz tested positive for COVID-19. His case was minor. For a few days, he was tired and a bit out of breath. He wasn’t worried, even as he continued to test positive for the better part of a month. But at the end of December, everything changed.

“At its worst, it feels like I’m dying, like my body is shutting down,” Blatz says. “In those early months, I did think that was happening. I said my goodbyes to my partner, just sobbing.” Eventually, he realized that this deathlike agony was now the texture of his life.

A longtime middle-distance runner, Blatz can no longer get out of bed without his heart rate reaching the mid-hundreds. He can’t stand long enough to cook or clean. He has to shower sitting down. It has been like this for months. There are no known treatments for Long COVID. For Blatz, there is no end in sight.

“The prognosis is so muddy,” Blatz says. “No one can tell me, ‘You’re never going to run again.’” But no one can say whether he will.

For now, the medical community has yet to develop standardized treatments for Long COVID, a disease affecting millions that often lowers quality of life more significantly than many cancers. Some studies indicate that as many as 85 percent of people diagnosed with the condition remain symptomatic a year after their initial COVID infection. Living in limbo between hope and despair leaves Blatz feeling crushed by the impossibility of closure.

I became sick—initially with a brain injury, then with a flurry of related nervous system disorders—in 2019, although it took years for me to accept it.

The first morning I woke without a screaming awareness of my chronic injuries, three years after I had sustained them, I ran straight from my bed to the driver’s seat of my car and sped for an hour to my favorite trailhead. But I was not the person I had been. I ran barely a mile before I fainted; I was immediately awakened by the sound of a muscle in my ankle snapping. Over time, my ankle recovered, but my confidence in my ability to accurately assess my own capacity did not.

It would be one thing if, after my disastrous injury, my body had been the only casualty, but so much more than that was affected.

Among the many types of disability and chronic illness, painand fatigue-based conditions are in their own category. Many people I know with other types of disabilities take pride in their identity. Permanent conditions can offer a new type of identity marker, and afford a sense of location within rich histories of resistance to the structural discrimination that disabled people face. As the social model of disability would put it, individual limitations are not the cause of disability; social limitations are. And so pride offers a route to belonging as well as a framework for navigating what writer and activist Eli Clare calls “the daily material conditions of ableism: unemployment, poverty, segregated and substandard education, years spent locked up in nursing homes, violence perpetrated by caregivers, lack of access.”

But pride feels more complicated for people whose conditions are characterized primarily by physical agony. I’ve been reporting on these types of conditions for years, and I’ve never met someone who didn’t wish that they were better. In this context, unlike with other disabilities, the word better isn’t meant pejoratively. My life was better before I became disabled. The limitations do come from within my body. Their exact location keeps changing. I keep trying to find them, but I end up failing and feeling worse.

For athletes facing this conundrum, there is no clean phase change. There is no haven in a new identity. There is resistance and pain and self-alienation. I have become a new type of person, and I will spend the rest of my life wishing I had not.

Running is a way of making geography. To revisit the same trails again and again can transform the feeling of being in a place into the feeling of being of a place. Running provides a sense of belonging. It’s often your social network, the way you fill your calendar, the way you structure your life, the reason you decide to move somewhere or to stay. It’s a way to navigate small talk—an easy answer to give a stranger at a party.

“What’s your deal?” someone might ask.

“I'm a runner, I do all the sports—that’s my thing,” Dannies tells me she always used to say. “I had the shorthands that came with that—you knew my worldviews and my values.”

I ask her how she’d introduce herself if we met at a party now. “I’m still working on that one,” she says. “I don’t know. Who I am feels less accessible.” Injury has a way of reconfiguring a person’s identity. Blatz asks, “How do I even fill out my Twitter bio when I’m 1 percent of who I once was?” Is he still a runner? What does that word even mean?

I ask Travis Hardy, who is thirty-six years old and has been sick with Long COVID since April 2022, what running meant to him. Hardy used to be a marathoner; the half marathon was his sweet spot. For the first time in our hour-long call, I hear a laugh that doesn’t sound like it’s accompanied by a disclaimer, as if to say “How novel it would be, to have the unbridled bodily freedom to just do something, anything, casually.”

“It was just something to do,” he tells me.

But now there is barely anything Hardy can “just do.” He tells me that he and his partner, who also has Long COVID, walk a cumulative half mile per week. He feels well for so few hours each day that the energetic cost of watching a movie or walking around the block can derail the rest of his week.

When I follow up with Hardy a year after our initial conversation, he tells me that after ten months of training, he and his partner are now walking half a mile per day. They try to increase that amount by one-twentieth of a mile per week. It is not a replacement for running, but to live with a chronic condition is to become an expert at negotiating between one’s wants and one’s capacities. It means constantly hacking away at the richness of one’s life—there is nothing casual about it.

For the roughly eighteen million Americans with Long COVID—and at least nine million others with related post-viral conditions like myalgic encephalomyelitis—symptoms worsen significantly following exertion.

“I sit at the kitchen table for lunch. Twenty-four hours later, [the consequence of doing so] hits me,” Blatz says. For Blatz, small undertakings like this can make the world too bright and noisy to bear. For days he stays in bed with the curtains drawn, alone with his grief. Knowing that these are the stakes of even the most minor exertions, what risks are worth taking? What might an athlete wager?

There is no universal experience following what I’ve started calling “The Big Sick.” Access to care differs vastly across racial, socioeconomic, and gender lines. For instance, all of the women I spoke to for this piece commented on the way medical gaslighting compromised their healing; none of the men did.

But every person I spoke to was quick to name the same themes: that they feel unseen; that any sense of certainty they once had in themselves, in their futures, has withered away. They spoke of how agonizing it is to conjure up hope because of the way chronic illness and injury make it impossible to have aspirations that don’t also feel like liabilities. Even inconsequential dreams start to feel like new opportunities to be let down.

I ask Dannies if she has a clear sense of what she is working toward, after so many years of false starts. “At this point, I don’t know what the far side looks like,” she says. “I don’t know that I would know it when I got there.”

Dannies is running again. She puts on the running vest that signals her belonging among long-distance runners and then struggles to run a mile, feeling “like a fraud.” Slowly, she’s learning to give herself permission to turn into some new version of herself—to live in that hurting place. To be visible as one of its residents. To find belonging there, too.