Vol State participants check in twice daily to confirm they've reached specific mileages, allowing them to stay in the race. Participants can do the event "crewed," with the support of an accompanist in a vehicle, or "screwed," relying only on themselves.

Wurzbacher had her sights set on completing a "screwed" event. In 2021, her fourth attempt, the then-72-year-old began on her own but fell on the first day. She was often unsure how far along the route she was, which made her anxious. Walking alone, the "FEAR monster" stoked her stress.

By day five, she decided that switching to "crewed" and being able to finish the race was better than not finishing at all. Enter friend and fellow journey runner Paul Heckert, who strictly monitored when she walked, ate and drank. After Wurzbacher completed Vol State that year, she still debated whether she could do it "screwed." "I'd been trying to do that since 2014," she wrote in "Tipping Point." "Eight years! That's longer than I had to wait to get into medical school." But she was determined.

Wurzbacher went into serious planning mode and adjusted to attempt a "screwed" walk the following year. She did well that year until she reached the "Bench of Despair" at approximately 182 miles. Knee pain, sleep deprivation and extreme heat began taking their toll. She accepted a friend's offer to come crew for her and contacted Jan Redmond Walker, driver of the event's "meat wagon," which drives the route and picks up runners who want to quit or are behind. Walker's arrival was among the "turning points" in Wurzbacher's life.

"Why on earth are you switching to crewed?" Walker demanded, recalls Wurzbacher in "Tipping Point." "You are NOT behind. You've done consistently well enough at this point that there's no reason you can't continue this way." Dumbfounded, Wurzbacher canceled her crewing friend and mustered onward, newly uplifted.