Chronically ill in big law

Not trying to post a sob story or get sympathy, just genuinely looking for advice.

A few months into 3L (after committing to $200k+ loans and biglaw) I was diagnosed with a degenerative condition that will result in my having a considerably shorter lifespan. Not short enough so that I could drop out of life tomorrow, but short enough so writing off 10-15 years of my life to a soul-crushing grind isn’t something I’m super inclined to do. It also is accompanied by a host of extra-curricular activities, including lots of doctors appointments, a commitment to 7-8 hours of sleep a night, and a regular strength training schedule that’s about 4-5 hours a week (which will help slow the progression of the disease).

Between that, plus time I refuse to compromise with my spouse and family for holidays, I can work about 60 hours a week. So far I’ve had a very charmed existence in biglaw, and have rarely had to work more than 50/week, typically much, much less. Recently though, I’ve gotten much busier. Maybe it’s a function of now being more mid-level than junior and having more responsibility, maybe people like my work more, whatever it is, I’m now starting to get a lot more work, and I’m hovering at the the threshold of starting to get increasingly unwell from the demands (missing doctors appointments, etc).

I actually really enjoy my work (litigation) and my colleagues, and don’t want to leave. I also come from a first gen family that can’t help me with my loans (and who I already give financial help) and since I won’t be here as long as I’d like, I would really like to put away and earn as much as I can in the time I’m here.

All of this is to say, any advice on setting boundaries? I am pretty tickled I seem to be doing reasonably well in the pie-eating contest and getting more pie, but I also don’t want to sacrifice my already tenuous health. Is there a way to set boundaries while remaining highly regarded? I would like to stick around at least another 5 years, so want to do more than “coast.”

Author: SunAccomplished1013