Most people think progress stops because of big obstacles. A major setback. A bad decision. A lack of resources.

I don’t buy that.

As someone who’s spent years in high-stakes environments—military medicine, trauma care, and academic leadership—I’ve seen something different. What really slows us down isn’t one big problem. It’s the build-up of small, almost invisible ones. I call them micro-resistances.

They’re the little things that go unnoticed. A pause before starting. A moment of overthinking. A browser tab opened when you should be focused. A sigh that says, “I don’t feel like this right now.”

They seem harmless.

But they’re not.

I’ve seen this in the operating room. A nurse slightly unsure of a step. A resident hesitating just long enough to ask, “Should I wait?” Those micro-moments—those tiny hesitations—can delay decisions. And in emergency care, seconds matter.

In the broader world, the effects are slower. But they’re just as powerful. In fact, they might be more dangerous because they’re harder to see.

Here in Cincinnati, we pride ourselves on grit. On showing up. On building something real. From the doctors at UC Medical Center to the artists at Findlay Market, people are doing meaningful work. But even in a city like ours—one that values effort—these micro-resistances sneak in.

They look like small doubts.
They sound like internal monologues.
They feel like drag.

You might not notice them at first. But over time, they pile up. Suddenly, the project you were excited about no longer moves forward. You’re not sure why. You say you’re “just busy.” But deep down, something else is going on.

So how do we fight back?

First, name the enemy.
Call it what it is—mental friction. The tiny static that slows your brain. Not burnout. Not fear. Just little pauses. Little tugs in the wrong direction.

I’ve trained trauma teams in high-pressure environments, from Cincinnati to military deployments. What I’ve learned is this: you can’t fix what you don’t see. Once you start noticing those moments of hesitation, you get some control back.

Next, stop trying to crush them all at once. That’s not realistic. You don’t need perfect focus. You just need forward motion.

One small example:
When I feel that moment of pause—when I want to check my phone or walk away from a task—I do something tiny. I say out loud, “Start the clock.” Then I give myself five minutes. Just five. No pressure. The goal isn’t to win. The goal is to begin.

Cincinnati taught me that progress isn’t flashy. It’s not always about huge wins. It’s about the willingness to return. Again and again. Whether that’s in a hospital, a neighborhood cleanup, or a solo project that nobody sees.

This city runs on quiet resilience. And resilience doesn’t always roar. Sometimes it’s a whisper that says, “Just five more minutes.”

Let me be clear: this isn’t about toxic productivity. It’s not about turning yourself into a machine. It’s about noticing what’s real.

A distraction is real.
A sigh is real.
That feeling of “I’d rather not” is real.

But they’re not fixed walls. They’re just fog. And once you see the fog, you can move through it.

Another strategy I’ve used—and one I share with young professionals in Cincinnati—is something I call deliberate tolerance. That means making peace with friction. Not trying to eliminate every challenge. But choosing which ones to face.

If I’m training a team, I’ll say: “Don’t wait to feel perfect. Start with the resistance present. It will shrink once you move.”

Often it does.

A final thought from the heart of the Queen City: progress doesn’t always look like progress. Sometimes it looks like confusion. Or boredom. Or repetition. But underneath all of that is movement. Quiet, steady, powerful movement.

We talk a lot about innovation in Cincinnati. New buildings. New companies. New ideas.

But innovation starts with awareness. Especially self-awareness.

Jay Johannigman believes that what holds us back isn’t failure. It’s the stuff we never even notice. The half-decisions. The almosts. The background noise that shapes the whole day.

If you can learn to spot those—if you can name them and gently lean through them—you’ve already won. Not once. But over and over.

Because that’s how real progress happens. Not in a burst. But in a quiet return to the task.

That’s how we move forward in Cincinnati.

And that’s how I keep moving forward, too.