Dr. William Osler

It has been said that “in patience ye shall win your souls,” and what is this patience but an equanimity which enables you to rise superior to the trials of life? Sowing as you shall do beside all waters, I can but wish that you may reap the promised blessing of quietness and of assurance forever, until within this life, though lifted o’er its strife, you may, in the growing winters, glean a little of that wisdom which is pure, peaceable, gentle, full of mercy and good fruits, without partiality and without hypocrisy.
- from “Aequanimitas”, by Dr. William Osler

In his essay, Aequaminitas, Dr. Osler references Antonius Pius, Emperor of Rome from 138 to 161 A.D. Pius was known for an unremarkable reign. Instead of continuously waging war, he built temples, theaters, and mausoleums, promoted the arts and sciences, and bestowed honors and salaries upon the teachers of rhetoric and philosophy. He was one of the world’s first true managers, addressing provincial matters by empowering their governors or local representatives rather then through the more common action of marching armies out of Rome to intimidate and bend will. Pius’ actions indicate that he clearly believed in the possibility of a lasting peace and valued the lives of his countrymen. On his death bed, he uttered the last word of his life, aequanimitas, and in doing so, he created a certainty of his life’s purpose.

Aequinimitas, a term introduced to me last May by Dr. Charles Wiener, Vice Chairman of Education at Johns Hopkins School of Medicine, and his team of doctors an nurses, means imperturbability, unshakably calm and collected. As it applies to the Johns Hopkins School of Medicine, it is described by Dr. William Osler as coolness and presence of mind under all circumstances, calmness amid storm, clearness of judgment in moments of grave peril. More importantly, it is a trait that is held as the premier quality of a good physician. It is also one of the most important qualities of an endurance athlete, and as the Race with Purpose team heads into its final week of preparation before the NYC Marathon, discovering this ability will be the most important activity.

A calm equanimity is the desirable attitude. How difficult to attain, yet how necessary, in success as in failure! Natural temperament has much to do with its development, but a clear knowledge of our relation to our fellow-creatures and to the work of life is also indispensable.
- from “Aequanimitas”, by Dr. William Osler

Dr. Osler continues his essay by making it clear that imperturbability is not something that everyone can master, but for those who can and do, they attain an appearance of confidence, experience and serenity. The process is not easy and requires one to expose themselves to extended periods of hardships and unexpected challenges on a recurring basis under mental, physical and emotional duress. It also requires a deep understanding of how we fit into a larger system. I can clearly see how this should apply to medical professionals and in some cases I’m certain it does. However, the visual that this initially evoked in me was one of Navy SEALs, or Army Rangers. These people are clear of purpose, quietly confident and on the surface quite unremarkable. They command rather than demand respect. These are also the traits of many elite endurance athletes. It’s not that anxiety or nervousness are missing, rather they have mastered the ability to harness that energy and refocus it onto the task at hand, refocus it with a calmness and coolness that becomes contagious to those around them.

As a coach, I have talked often of finding flow, a place where in the act of our choosing, we reach a level of engagement that is completely unselfconscious, removing us from our everyday worries and altering our sense of time. Race day is entirely about execution and the seamless adaptation to a dynamic environment. It is impossible to achieve flow if the mind is cluttered or distracted. Flow is therefore dependent upon imperturbability and together they optimize one’s ability to achieve a higher state of awareness and superior performance.

As endurance athletes, we may not stay up for days or weeks at a time, carry logs through the sand when both our mind and body are far past anyone’s perception of fatigue, or learn how to endure hypothermia, but we can clearly point to a consistent and systematic process of placing ourselves under duress over an extended period of time. Clearness of judgment in moments of grave peril is certainly something we all would demand from our doctors and from those who protect our country. It is also an attribute most competitive endurance athletes would choose to acquire.

The final period of training just prior to our race is called the taper. By its very name it sounds unremarkable. It is a period during which we convince ourselves that less active down time is necessary for our muscles to recover, our soft tissue to repair and during which fuel is allowed to accumulate for our upcoming event. In truth, for many, the taper is a frustrating, disturbing and unbelievably unsatisfying experience. After months of hard training, and with this stale and unpalatable after-taste we toe the start line expecting to perform at a superior level. Unfortunately, the taper has become the final part of training that even many experienced athletes simply don’t know how to make productive.

Previously, I’ve written about the benefits of making your taper more effective by maintaining your intensity while simply lessoning volume both in terms of overall time spent on training and the time and distance of individual workouts. I’ve also commented on the benefits of spending time on flexibility, core strength and visualization. Two articles that address this can be found on the Race with Purpose website: Tackling the Marathon Taper, and The Final Week of Taper. For those who have mastered the tactical recommendations in these articles, consider using this time to work on mastering what may be the toughest skill of all, aequanimitas.

In a true and perfect form, imperturbability is indissolubly associated with wide experience and an intimate knowledge of the varied aspects of disease. With such advantages he is so equipped that no eventuality can disturb the mental equilibrium of the physician; the possibilities are always manifest, and the course of action clear.
- from “Aequanimitas”, by Dr. William Osler

Presumably you have done the training and you have studied both the course and your competition. You have left nothing to chance. Continue this process by identifying previous times when you have acted with equanimity, when you have found evenness of mind under the most stressful of circumstances. Perhaps your experiences will come from your training; just as likely, you’ll find experiences from other parts of your life. Remember what it was that allowed you to maintain your focus, to stay calm under pressure and to act with objectivity and precision. The objective is to develop self confidence in your ability to draw upon this skill and to apply it consistently without exception.

Consider spending your taper week identifying what it is inside of you that gives you the strength to deliver unquestionably regardless of the conditions. I promise you that time spent doing this will leave you empowered and energized, not usually the adjectives used to describe a typical taper. Discover what it is inside of you that gives you the confidence to not only separate yourself from your competition, but to render it irrelevant. On race day, as you stand on the starting line waiting for the cannon to sound, recall the words of Dr. Osler and know that you will race with patience, calmness and serenity. In short you will find your flow and your course of action will be clear.

Erin Strout, journalist extraordinaire and do-it-all for Race with Purpose reminds me not to bury the lead, so here it is. Last night Wally was discharged from the Animal Medical Center. After signing over the house for collateral, we carried Wally out in his carrier and back to the familiar surroundings of his home, you know the place where Henry and Little Girl and Wally all ignore each other.

Animals are amazing. Monday, Tuesday and Wednesday this cat was on death’s door. According to his vets, he was near dead. On Tuesday when Dr. Fox told us that his heart rate was at 260 beats per minute and it was expected that it would freeze and stop at any point and we were told that they would not try to resuscitate him, we were devastated and really had to stay focused and positive. It’s now Sunday and he is jumping on and off of the bed, hopping over fences and seems to be back to his normal self, albeit he has three sets of medication that he takes and we had to stay up last night counting his breathing to make sure it wasn’t becoming faster than expected - a sign that fluid was building up rapidly. We have to bring him in on Monday to get more fluid drained out of his lungs but all in all, I find it mazing that animals can bounce back so quickly, while a human would be laid up in bed either immobilized, completely fatigued or worse yet, mentally defeated. Animals just don’t seen to have that option. We can learn a lot from them.

So an update to the Cadence Kona Challenge. Again not to bury the lead, I was not selected as one of the 10 finalists. I did give it my best effort and felt I left it all out there. I have Wally to thank for that as I had his picture binder clipped to the stand in front of my bike and on the deck of the treadmill. I definitely dipped into that pool a number of times during the tests when I felt like crap.

I won my heat on the bike and ran pretty well on the treadmill with less than fresh legs, but apparently it wasn’t meant to be. It was a great experience, I got a lot of testing for free and the people were all incredibly supportive throughout the experience. At the end of the day, if the goal was to have 96 people leave the site feeling like they were all winners, even though we weren’t ultimately selected, Cadence and their sponsors (Zoot, Suunto, Cyfac, etc…) did just that.

I have to give a shout out to Bill Porter from Suunto who was my own personal photojournalist/TriScoop heckler throughout the event and to Bill Risch and Cindy who came out to cheer me on. A great highlight was being able to interview and then run with Samantha McGlone who is the70.3 distance World Champion and who came in second just a few weeks ago at the Ironman World Chamionships in Kona. This was her first Ironman race, how crazy is that?

In case you are interested, and in the spirit of full disclosure, here are the results from my tests:

Bike

Functional Threshold Power = 257 watts (up from 225 in 2005)
Functional Threshold Heart Rate = 161 bmp (up from 146 in 2005)
Max Power = 340 watts (up from 300 watts in 2005)
Lactate Power to weight ratio of 3.02

Run

Functional Threshold Pace = 8 mph (down from 8.8 in 2005)
Functional Threshold Heart Rate = 165 bmp (down from 170 in 2005)

Weight = 187 lbs (up from 183 in 2005)

Resting Heart Rate = 48 (up from 42 in 2005)

So all in all, I’ve become a little more efficient and picked up a little power on the bike along with some additional weight - not exactly a good thing, and slowed down a bit on the run. I’m pretty pleased with this after spending the past two years focusing on everyone else’s training but my own. So it’s in writing, I’m looking to drop to 176 lbs and move my threshold power up to 275 by this summer. Given that I did the treadmill test right after the bike test, I’m alright with the numbers here, especially after popping off a 19:30 5K last weekend. The drop in weight will pull me under 40 minutes for a 10K this spring and give me a solid base to build from.

Friday:

Cindy and I drove into the city this afternoon. According to Dr. Fox, Wally is improving slightly in terms of the fluid in his lungs, the fluid in his heart and his heart rate. That said, one of the four chambers of one of his lungs collapsed. Given everything else that could have happened thus far, his doctors felt that was manageable. Before I go any further, let me give you a little background on Dr. Fox, Wally’s surgeon.

In case you’re thinking that I’m just some crackpot pet owner who’s just ebulliently thankful to the doctor who has helped to give our Wally the chance to live out the rest of his life, here are a few of Dr. Fox’s accomplishments:

Dr. Fox was one of the lead investigators studying the harm done on search and rescue animals involved at Ground Zero. He is a board certified cardiologist with more than 30 years experience and is the Director of AMC’s Caspary Research Institute. He has a long term relationship with the NYPD serving the needs of their canine officers. In short, he’s a rock star of vet. Cool with me and very cool with Wally.

Many years ago, my sister was playing football on the Santa Monica beaches in California. She laid herself prone to catch a pass and went face first into a volleyball standard, shattering the zygomatic arch and pulverizing the other bones around her eye in the process. Essentially, she turned her face into mush. The good news is that she was playing with some of her law enforcement friends and she was whisked away to nearby Daniel Freemon where there just happened to be one of the best surgeons in the world with repairing and reattaching nerves and rebuilding the structures supporting the eyes. He just happened to be lecturing there. He cut her skin on the top of her head, peeled it forward to gain access to her facial area and picked out the tiniest of bone fragments for hours, before molding bone from the back of her skull into a fake arch to support her eye.

Who knows if that was luck or if there was another reason that Stephanie injured herself on the day that he just happened to be in town lecturing at that particular hospital? Whatever it as, we were grateful and in that same way, we are grateful that Wally is being looked after by Dr. Fox. Even cooler because his name is also that of an animal.

Tomorrow, I’m scheduled to compete in a triathlon event called the Cadence Kona Challenge, an event sponsored by Cadence Cycling Center in NYC and Philadelphia that selected 100 people from across the country and Canada out of a group of 1500 to come to New York to test themselves by cycling and running. Based on the performance tomorrow, they’ll whittle the group down to a lucky 10 who will show up on Sunday to do more tests on the bike, treadmill and in an endless pool. Then a lucky 6 will go on to represent Cadence Cycling and a number of other very prominent sponsors as they train for Ironman 2008.

I appreciate the acknowledgment, and I definitely appreciate the swag, but based on what I saw this evening at a champagne-laden soirée for the semi-finalists, I have no business being in the same room with these folks. I’m going there to enjoy the experience, yes, but I’m also there to highlight the major impact that these adult athletes can make by helping to get kids healthy and active, supporting their ability to live long fruitful lives and positioning them as contributors rather than drainers of our healthcare system. The people in this room are from multiple generations and exemplify what it means to be healthy, balance priorities, extend oneself, and live life to the fullest.

There are clearly athletes with a lot more genetic ability, talent and recent training than me. I’ve never been genetically gifted and I’m a fast-twitch athlete at that. My genetic gifts lie in the area of eye-hand coordination and street saviness. How I had a father who was a world-class swimmer and I swim like a crustacean is beyond me. Any modicum of success that I have had in the past has been due to drive, determination, strategy and the sheer willingness to outlast anyone believing and proving that I can endure a greater level of pain than most.

Therein lies the rub. All of this depends upon serene focus, and quite frankly my focus right now is on our cat, laying in a glass submarine in intensive care on the upper east side with his celebrity cardiologist. On the other hand, I can say that I’ve never felt better than I do tonight about his prognosis but I’d still rather be with him than on a bike or on a treadmill doing something that quite frankly seems to be pretty self indulgent.

So how then do I regain focus, and what exactly am I focusing on. It’s the classic black box scenario. I know I have to perform two time trials tomorrow, and then suck up to the judges who are indeed humans. How they make their decision is anyone’s guess and quite frankly the criteria hasn’t been very well articulated. Hey if they’re looking for an over 40, fast-twitch coach who spends his time being sarcastic and hopefully helping adults and kids to pursue their lives more effectively, then I’m your guy. You notice nowhere in there did I say “athlete”. Oh yes, there was a time many years ago, when I thought I was the shit. I strutted around Los Angeles with guys who’s names you would immediately recognize for their athletic accomplishments. And, yes, I was one of THOSE guys. But that was a loooooong time ago. Heck, we have team members who weren’t even borne when we were terrorizing the courts at Pauley Pavilion, Venice, Adams, and Beverly High. But here I am, saying “Sometimes you just have to say What the FU$% and take some chances.” to quote Tom Cruise in what was his first and best role as an actor. But that was before all of this happened to Wally.

So then, how does one perform when performance requires focus and one’s focus is clearly elsewhere. Well to begin, it requires acceptance that my focus has indeed shifted. Instead of fighting it and viewing that shift as a weakness or sign of failure, accept it first and foremost. Second, figure out if there is anything or anywhere you should be to be more productive around that core issue. In this case, at 11:45am tomorrow morning, not really. Lastly, make your distraction your focus. I know that my strength is in enduring. I’m sure others out there have similar abilities to do this, but knowing what Wally has endured himself has now become my strength, and they simply don’t have that. Seeing Wally with a catheter stick out of the top of his neck, and witnessing every labored breath he takes, I am embarrassed to think that somehow 35 minutes of exercise could be considered endurance. Endurance is what Wally has been going through each and every minute of everyday since this began. Thinking that comfort is an entitlement is both selfish and ignorant. Not once through this entire process did Wally ever complain, ever feel sorry for himself or ever think “Why is this happening to me?” And, yet, that reaction is so common place in the generation of people of whom I am a part. It seems to be even worse with the GenY’s and the Millennials.

So tomorrow, I will ride and I will run and I will do what is expected of me regardless of conditions or circumstances. And if I become complacent in my determination, I will recognize it for what it is, an aberration. And I will focus on Wally knowing that the sooner I finish, the sooner I can get out of there to spend time on the true priorities. Sucking up to judges won’t be one of them.