Tank Heaven for little Grills

I love Boise!
Like Paris in the past, Boise is not just a place.
It is a symbol, the incarnation of who I am.
In Boise, I grew into who I am. Medical provider, ultrarunner, husband.

Running in the foothills makes me so content. I cut my teeth on this granite soil. Looking down on Hull's gulch and the Treasure Valley brings back such memories. Trails beckon some new, some with myriad memories, strewn across the hills like dirty pearl necklaces.

I am thankful to have this long weekend off, to be able to visit friends and family, to have a future to dream about in Durango, Colorado.

[the title: my favorite sign ever, in Boise, of course]

The Bell Curve

I grew up in a liberal arts family.
Science and math were casually dismissed as foreign, unimportant or something about which to have distrust.

When in HS or so, I began hearing of this bell curve. This powerful entity that so simply reduced all populations to this perfectly circumscribed distribution. Tyranny of Republicanism, I shouted. How can you dictate how people will fall on a mathematical model? Growing up in an insulated, extemely well educated town, I thought for sure the bell curve was a lie. I had never even met someone who was "stupid!"

Fast forward some years. After taking physics, AKA applied mathematics, I realized the power, the beauty, the usefulness of calculus.

When I began taking my pre-med classes, I found myself for the first time at the far right of the curve, rather than in the plump apogee of its wide girth.

Drinking from the garden hose in medical school, studying my gluteus maximus off, I had a realization. You are always on a bell curve. In each given subpopulation, there is again a bell curve. When at one point you were at the far right, suddenly in a new group, you could be at the far left! Med school offered a huge realization that your position on the curve changes dependent on the population.

As a runner, in particular, an ultrarunner, I routinely accomplish objectives as part of my training that are lifelong bucket listers for others. I run a marathon every weekend.

I have always known that I was not a particularly physiologically gifted athlete. Sure, I can suffer through interminable runs and sometimes even do them faster than at snail's pace. However, I have always been well aware that I was not endowed with freakishly awesome physiology.

Intellectual knowledge of a fact is one thing. To be slapped in the face, roughly, in a raw manner, experientially, is another matter entirely.

Last weekend, I ran with JG. Young, motivated, intelligent and a hard-worker. Yes, all those things that I am not!

As my buddy Geof and I raggedly panted, WALKING up the 10-15% grade, JG slowly but effortlessly floated up the hill.

We all know that there are Lance Armstrongs, Tergats and others out there with insane physiology but it is a different thing entirely to be on the same hill and see what it really means.

I am firmly ensconced on the bell curve not at a ragged end but so sadly, right in the center. Mediocrity. A curse.

At least I have a lot of company though!

Hundred in da Hood

Saturday AM, I toed the line at 0500 in the cold and dark. My partner Geof and I were ready to blast off at the pace of a banana slug.

Olga said "go", holding the official race time keeper which looked suspiciously like a beat-up Timex.

Geof and I have become friends and evolved into running partners. He's perfect: ruggedly handsome, self-deprecating and reliable. We run well together- but he always beats me at the end!

We ran well once the sun came up. As always, it was trying to run at a good pace with flashlights.

I never feel good in races. In fact, if I just don't feel bad, that's good.

I kept feeling strong and motivated. Geof and I kept reining each other in, thinking of the 100 miles to go.

I would lead him on the flats and down hills and he would lead me on the uphills.

Geof apparently grew up in same toxic soup that I had. He was a master at self-deprecation- just like me. The best defense is an offense. Insult yourself before anyone else can! We both excel at this and passed the time insulting ourselves for the other's enjoyment. What can I say? We're both givers!

The day was sunny and quite cool.

We ran well to mile 28. I had already had two bouts of diarrhea. The second time, I had to wipe my arse with my running hat because I had lost my T.P. I had literally become a shithead.

Geof and I teamed up with powerful Pam. We talked the miles away. Except for a moment of mental weakness around 40, I continued to feel strong and positive- a rarity for myself.

We were welcomed by Craig Thornley et al at the mile 45 aid station. He always does a great job and knows what to do. The bad news was Lemiti was not to be a true AS and we had over 10 miles to go to the next aid.

The day became increasingly hot. Geof and I kept running and running and running. My Garmin watch told me that maybe we hadnt missed the next aid station but my empty water bottles, gel flask and Geof's increasingly negative, worried and gruff utterances said otherwise!

Finally, when we were both out of water and food, and getting increasingly upset, we stumbled onto a dirt road and an AS.

We were at mile 58. The route had not been marked correctly and the first 12 or so people had missed the 55 mile AS. We had run 13 miles without aid.

Geof was feeling bad but he had two great crew to help. His loving wife was sacrificing her time on her birthday. Also, Joe Grant was there to pace him. Joe is a jedi runner who just kicked some arse with scott jurek at the run around Mt Blanc.

I complained a lot, filled up on human interaction, and took off slowly.

Geof and Joe passed me about 1/2 mile from the turnaround at Breitenbush.

Geof and I had run 58 miles together. The rest of the race, I would be alone.

I continued to feel awesome. I came into mile 75 AS where I was sposed to pick up my pacer, Mike Hall. Unfortunately, I was outrunning my predictions for when I would arrive at this AS. I left word for ham radio operators to try to find Erica and Mike so they wouldn't come here.

Erica had repeatedly asked if she could crew me. I feel guilty having her sacrifice her day so she can see me every two hours. I asked her to come see me at mile 75. She passed the day hiking with the babies. Yeah.

A short mile or so after this AS, I dramatically slowed, feeling quite human. I was passed by a guy and then didnt see another runner for about 15 miles. Mark Tanaka passed me at the 91 mile AS. From about mile 80, I was walking. I kept doing the "ultra math" and reasoned that I could walk the whole time and still finish under 24 hours. This had been my goal. For the first time ever in a race, I felt contentment. I was totally happy with myself, didnt mind getting passed- as long as I finished under 24! I went from 10th place to 14th by the finish line.

It became quite cold- around 33o. My teeth were chattering. I finished at 20:53.

This was a huge PR for me. Although I could have run more the last 20 miles and probably kept 10th place and finished just under 20 hours, I was so content.

What is living?

Feeling pensive today.

I just found out my friend, Dave Terry, died unexpectantly on the 13rd of September. Dave was an amazing ultrarunner. He was gifted with a great attitude, longevity in the sport and a love for his work. He was always so very humble, supportive and engaging.

I am sad that I did not get to run with him as he was injured of late.

Unfortunately, he did not make my last Scotch-tasting party, so here's to you!

He died young. It is little consolation but he lived life to its fullest.

Mothers and friends are always telling me to be careful with my life, be careful with my body, my joints.

Live life in a bubble- you may die on the couch from the undiagnosed aortic aneurysm that ruptures.

Live life without abandon and you walk off the highest peak.

Run the life out of your knees doing ultras, you may need a total knee replacement.

Sit on the couch and munch M & Ms, that same total knee is looking you in the eye.


So my compromise, live life to the fullest, but say your prayers, eat your wheaties, wear your helmet and seat belt, then kick ass.

Mt. Hood circumnavigation

Against my better judgment, I decided to run around Hood, only one week after my 100k effort. Mike Hall and I slept at timberline the night before. Mike is a colleague and friend from work. He is a man of few words. He is an Ironman and marathoner but a ultra neophyte. We ate at the brew pub, Ice Axe, the night before. I fell asleep after two stouts assisted with the carbo load. We woke at 4 AM. I slammed a recovery drink and diligently slirped down some Wasp vomit. This “new” Japanese product is amino acids cultivated from WASP gastic juices- called VESPA. These wasps are known to fly at high speed up to 50 miles a day. I thought it was worth a try to see if it truly led to glycogen sparing and increased fat burning. At 5 dollars a slurp though, I was very skeptical.
I felt strong from the beginning physically. No sore or tired muscles. My lower abdomen did not hurt very much. Mentally, I was not committed. I felt like my focus was not there. If Mike had not been with me, I would have probably not started or would have turned around very early. I got a little motivation when I ran into Mike Burke at Timberline. I got a little excited, thinking about future runs and races.
Mike and I made fairly good time to mile 15. Once we passed the meadow where I took a wrong turn two weeks ago, I finally was content running. The meadows were gorgeous despite not being at their peak. We made excellent time to Elliot. We lost at least 30 minutes while we scoped out a safe descent. We attempted to take the original descent. It cliffed out with a scrabble on loose rock and dust. It probably would have been safe to ascend, from the CCQ direction. We finally found the Mazama rope and got down safely. I suddenly lost my umph and got pretty tired at the marathon mark. I think I used up some mental and physical energy with the Eliot crossing then it started to heat up. Oh, that and I had run 27 miles already and 100k the week before!

Mike and I slogged on. Making reasonable time. We finished at 12:30. Mike did a wonderful job for his first 40 miler. He never complained. For me, I was reacquainted with the humility that can only come from doing something exceedlingly arduous.

Where's Waldo- August 22, 2009

Showed up the night before, early for a change. The prior entire year, I had had no “fire in the belly” for this race as my running partner, Geoff, would say. Last year’s brutal heat and the competitive field made me see this as an onerous training run. I actually got motivated the night before, finally. Woke and slammed some calories. Felt ok early on with cool temps. The day slowly warmed but was very reasonable. I could not run my normal pace from early on. Lots of training at a slow pace and a sore lower abdomen conspired to cause an unnatural, slightly painful stride. After the PCT 50 miler, I developed chronic lower abdominal muscle pain and it had not yet gone away. I felt strong otherwise and ran my own, slow race. An uggy belly hit me at 47 miles, and lasted most of the race. My goal was to finish initially at 11 hrs, then 11:30, then 12:00. I could not run fast enough due to my sluggish core and leg turnover. I finished in 12:30. Overall, a good day. I ran my own pace and had no problems that I could have prevented- except maybe if I tapered!

Fun in the Sun- PDX style

Erica and I decided to spend a week of vacation in Portland, something we have never done.

Thanks to Dave and Cindy Gross, we had reason to see lots of things new to us.

We started off the week with a welcome party, celebrating our Grossest visitors yet.

We visited the Velveteria on Burnside, an awesome museum of velvet paintings.

We went to the beach on Tuesday. I was wearing my "Just Jew it" t-shirt, depicting a slamdunking rabbi when I was pulled over for speeding. I innocently offered that I had the car in neutral, hoping to woo the cop with my gas-efficient ways. Turns out, it is illegal to have a car in neutral. The total cost of the ticket WOULD have been over $400. Thankfully, astonished by our honesty, goodwill and unwavering good cheer, he let us go with a warning!

Wednesday, We went to the Japonese garden. On the way there, I got another flat tire at 30 mph on a hill. The gardens were cool. I ran by the Holocaust memorial on the way to a gellato date. Very moving.

Ran home in 100o heat, good training.

Met Quinn and Cindy at the Lucky lab. Had some great beers and pizza. Talked with a fascinating older guy about yoga, tantra and such. Reminded me of my dad.

Running at the mouth

My training this year has been close to perfect.

Since December 31st, I have been trying to run a 50 k each weekend and rack up 65-100 miles a week, with lots of weeks around 80.

It has paid off. My endurance is better than ever. My recovery is swift. I rarely have DOMS after hard or long runs, even 50 milers!

There is only one thing missing in my training this year and every preceding year, quality miles and speed work.

Now, this season, it is the time for sharpening. In the past, I have always remained blunt, ignoring the whetstone.

Perhaps now, I could try a little...

Numerology

My wife has long noted my fascination, nay obsession, with numbers.

When I was a 3rd grader, I counted 151 books I read that year.

My senior year, I stupidly counted down the days left in Paris, France when I lived there.

Now, I am 1/12 done with my last year of training. 7/8 years down.

I ran 22.25 miles today at 7:50 pace at 85o.

They say you should never wish away time. I am sure end stage patients would readily agree.

My goal this year is to learn as much as possible and merrily witness the days evaporate ( I might count a little!)

PCT 50 miler

New course this year. Wilderness act precludes race being held in Mt. Hood wilderness. Overall, a good performance but felt poor the whole race. It is amazing how hard it can be to run long no matter how many times you have suffered through the same doubts and fears.

What does not kill you, makes you stronger!

Lots of learning

Had a very educational week. Lots of very sick patients, active resuscitation. Lots of firsts. USed methylene blue for refractory hypotension on bypass, glucagon for possible CCB and BB overdose, gave pencillin for the first time.

My post last week on risks and benefits rings true.

A younger woman for diagnostic biopsy. The surgery goes well but has anaphylaxis and ends up intubated over night for a medication reaction. Just a routine procedure, ma'am.

Risk Benefit Ratios- To my co-pilot, Erica

I use the term "risk-benefit ratio" every day with colleagues and patients.

A catch-phrase that paints the picture of a decision or act balanced between different concerns, sometimes with competing issues.

You may die from your surgery, but if you don't have it, you will die anyway.

We want to make your surgery safer by sticking a needle in your neck. We could cause a complication but it is unlikely and it will end up safer for your procedure.

All good unless you are the "one percent" who get the complication!

Expand this to Life and the act of living.

Critics point out that dangerous or thrill-seeking activities risk death.

Devil's advocates remind the above critics that driving is dangerous, an earthquake can attack you on your porch or sudden death can occur for any number of reasons.

Where does this ratio lay? Where should it lay for a given individual?

Spendthrift blowing money with nothing to show on retirement or frugal investors living on beans and rice, unhappy all of life but with one million in the bank.

My good friend died on an Alaskan peak but when he drove, he behaved like a fearful grandma.

Run hard until your knees blow out or let your knees blow out from traumatic arthritis from your complacent obesity.

Strive to find that sweet spot where you are living life rather than prolonging the onset of death or hastening the black shroud.

Contentment

Nice start to the new academic year. Excited to progress, solidify my knowledge and judgment.

My running is going great. Occasional L knee pain and deep buttock pain. Running close to 90 miles a week routinely. Not feeling overtrained at all.

Family is doing well.

It's a all good.

Nice Holiday Weekend

Satisfying liver transplant on Thursday. Pt did very well over the weekend.
Enjoyable hike with the family near Hood on Friday. Babies in tow.
Long, hot run in the Gorge on Saturday.
No-hitter on call on Sunday. Ran 10 miles around the neighborhood.
Landscaping is finished at our house. As always, I am always resistant to new ideas. Erica was right- the house looks really nice.
Met the new anesthesia residents today, as a group. Hard to imagine we were there just a few years ago- feels like a thousand years have passed.

Post Fourth

Enjoyed watching the fireworks last night with Galactic and Berf.

Nice day. Sunny with a little breeze. Ran laps in the neighborhood around the house while on Va Spa call.

Nice weekend!

Chi Chi's retirement

Went on a nice hike the family yesterday in Salmon creek. Chi chi began limping after three miles. She has been becoming less able to hike with us for a year or more. Today was her retirement day, unfortunately. I carried her home four miles in my arms.

Happy Fourth of July

Ran from Eagle Creek to Wahtum Lake. On the way back from Wahtum to Herman Creek, found the last traces of Gorge snow at 4200 ft. Descended down Herman creek to the PCT. Doused my head with water at every creek. Finished up at Eagle Creek with nearly seven hours of running in 90 degee heat. 33 miles felt like 40 plus. So run 30 miles then repeat x 100 days... Doesn't sound very appealing or doable!

First day of CA-3 year

Today was my fourth out of five "senior" years in my life. The next will be when I draw social security.

Two great thoracic cases with Griffee today.

Ran two hours in the heat after work. Felt good. Nothing better than new shoes.

Tomorrow- The Beginning of the End

Tomorrow begins the last year of my seemingly interminable training. 365 days to go. Tired legs on the run home today. Nice walk in the neighborhood in the sun with the family.

Great day

Busy day at work. Took call for a colleague. Had a productive conversation with a representive at Smile Network. We may work together for my fund-raising idea.

While running home, I was paged back to hospital for a pediatric trauma. Sprint to the tram from Hawthorne bridge. Finally, I do some speedwork. Pt doing well.

Post Call?! Perfect day

Slept all night at home. My pager never went off- yes! Played with chi chi for twenty minutes. Ate breakfast with some darn good coffee.
Studied and cleaned.
Ran 33 miles in the heat. Took ten minutes off last week's time. Felt great during the run.

Two days left of CA-2 year.

Beautiful R2 call

I had a wonderful evening last night roller skating at Oak Bottoms. My dear sister, Lily, her husband Galactic Phil Collins and my wife made me go. I fell once, visions of not being able to perform laryngoscopy shrieking through my head. Soon enough, I was passing pre-teens like they were standing still.

Today, a few quick cases, then home to run in the sun. I am sure tonight brings much trauma and suffering but I can hope to sleep all night!

Meditations from the Breakdown Lane

A wonderful book by Shapiro. A Zen Buddhist who ran across the USA unsupported in 1980 before cool running gear existed. His title is fabulous. I thought my title would be a good rip-off- prevent me from getting sued, reflect my nature while running and maintain a hint of Sri Chimoy spiritual adventuring while running