And then he goes home and tends to one other patient -- himself.
The 33-year-old Nowak is an Ironman triathlete and one of Snohomish County's best at the grueling sport that combines a 2.4-mile swim, 112-mile bike ride and a 26.2-mile run. In August he completed the Ironman U.S. Championship in New York and New Jersey in 9 hours, 47 minutes, 16 seconds, and by finishing eighth in the 30-34 age group -- he was 54th overall -- he qualified for the Oct. 13 Ironman World Championship in Kona, Hawaii.
It was a terrific accomplishment, but one that required an arduous training regimen. In a typical week Nowak pushes himself for 10-14 hours, sometimes more, and nagging injuries are a given.
"I've had just about any injury that a runner or triathlete gets, so I understand what it's like from the athlete's side," Nowak said. "But I also understand what it's like from the doctor's side.
"I'm not," he admitted, "a good patient. I'm good at listening to my body and knowing what's wrong, but I'm not necessarily good at listening to my body and holding back. I definitely push the limits sometimes. And I push through things when medically I know I shouldn't."
Ironic, perhaps, that an orthopedic surgeon would engage in such a physically punishing activity.
"But most orthopedic surgeons live active lifestyles," Nowak pointed out. "A lot of them are former jocks. And I guess I'm trying to continue being a jock. At least I'm not giving up.
"It's just part of my lifestyle. I enjoy running and I enjoy biking. I enjoy being physically fit. I enjoy the challenge and I enjoy competing. I need to do something and I always have some sort of goal."
Nowak grew up in the Chicago area, where he swam as a younger boy and in high school competed in cross country, track and basketball. He ran the Chicago Marathon as a college freshman and has since run 12 marathons, including the prestigious Boston Marathon three times.
His first Ironman was in 2000 and he finished in 11:25:41. Since then he has traveled the world to enter Ironmans in Australia, Mexico, the Canary Islands and Canada. Next month's race will be the seventh Ironman for Nowak, who lives in Mukilteo with his wife, Sangita Patel, and their 21-month-old son.
For a husband, father and doctor -- he is also a team physician for the Everett Stealth lacrosse team, the Everett Raptors football team and the Everett Silvertips hockey team -- the most difficult aspect of Nowak's training is time management.
"It's a constant challenge," he said. "It takes a lot of time and puts a lot of stress on your life, and you just have to find ways to balance it. But between family, work and training, it's very difficult.
"Fortunately my son is very young, so this is a really good time for me to do this. But in the coming years I've promised my wife I'll only do shorter races. I won't do another Ironman for quite a few years."
Motivation is occasionally an issue, too, he said.
"I wake up at 4:30 or 5 o'clock every day to work out in the morning, and there's no question I sometimes hit the snooze button," he confessed with a smile. "Every couple of weeks I miss a morning workout because I'm just too tired or the motivation's just not there.
"I'm thinking, 'What the heck am I doing? I could sleep another two hours if I want.' But after a few minutes I usually remind myself what I'm doing, and then I get my motivation and I'm out the door."
For triathletes, the Kona race is the Super Bowl of Ironmans. A true world championship, it brings together about 1,800 elite triathletes, all of them qualifiers, from around the globe.
"This is the Mecca," Nowak said. "Most triathletes have a goal of one day qualifying for Kona, but only a select few are able to achieve that.
"From everyone I've talked to, the whole island (of Hawaii) revolves around the Ironman that week. Pretty much everyone that's on the island is either there to do the Ironman, to watch the Ironman or they're there to support someone that's doing the Ironman. It's a really amazing event and atmosphere."
Though his initial goal was simply to qualify for Hawaii, "now that I've qualified I'm of course training hard," he said. "I want to beat the time I did in New York. So I'm definitely going there to push myself hard and to see how fast I can go, no question about that."
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