I run. I doctor.

As an Internal Medicine resident I penned a letter to the Nike corporation suggesting they sponsor out internal medicine team. Sports companies sponsor amateur teams from Little League to college. It seemed reasonable the best known sports company in the world may want to throw its sponsorship in the direction of some underpaid, overworked residents, especially when I imagined the TV commercial.

University Hospitals of Cleveland, 2 AM .…Any day

….the camera catches the bottom the green scrubs, the tail of the well worn white lab coat a glancing view of the Nike swoosh as it pans the ankles and feet of medical residents in a dimly lit room. You can barely make out the tired voices….

Resident #1: “Ms. Murphy spiked another fever. I need to draw blood cultures after I get the ABG on room 545, and check the PTT on 318. Only 16 hrs and my 36 hours are over. Then I can sleep in my own bed.”

Resident # 2: The Chief Resident called – we have an admission in the ER. A 78 y/o woman with urosepsis and a change in mental status; another sleepless night.”

Overhead announcement: “Code Blue!!!, 8th floor Lerner Tower, Code Blue!!!

The camera catches four figures scrambling out the door, stethoscopes in hand, rounding the corner. When they spot another medical waiting at the elevator they crash through the door into the stairwell and furiously climb flights of stairs, beads of sweat forming as their breathing becoming simultaneously more rapid and audible. Springing out of the stairwell the four heroes dash into a patient’s room as the crash cart slides in, and other team members collapse into the small patient room. The four residents take their positions: chest compressions, airway management, vascular access and the senior resident at the head of the bed barking out commands. They work  feverously works to regain a pulse while the other medical team, the one waiting at the elevator, watches helplessly from outside. As the cardiac monitor acknowledges the beep and digital display of a heartbeat, across the screen in large letters:

Save Lives.

Just Do It! Then the Nike swoosh and …fade to black.

I never received a response.

Now my rounding looks at lot like my running. No sprinting to codes, just the long plodding of more miles; caring for patients with chronic illness. The punishing 36 hour shifts have given way to years of patient medical practice.

I now take call from home, but needing to round at two hospitals this past Sunday. The Steamtown Marathon is two months away and I am in the midst of increasing mileage. No time to take a weekend off. At 4:45 AM I rolled out of bed, and by 5:25 I was starting the first steps of 17 miles. A quick shower, a 2 minute breakfast, and then out the door to start hospital rounds.

At the end of the day I am fatigued and can feel the ache in my legs, but I am satisfied my miles and my medical advice have been solid. And satisfied from a day of physical and mental work. Hopefully both result in positive outcomes.  

I have no true aspirations for a professional sponsorship – at least not from running. At one time it was fun to think about a completely different biathlon: running and saving lives. But those days are long gone. I run. I doctor. Two separate events that keep me whole.

Slackers

Each athlete, whether amateur or professional, has the athletic standard they can reach and the level of competition they achieve. The great assumption is we will all work to the best of our ability; however, our mental and physical state along with our previous experiences limit what we can achieve. Malcolm Gladwell writes on this very topic in “Slackers” (New Yorker July 30, 20120), when he highlights the career of running great Alberto Salazar and reviews his new memoir. Gladwell muses that Salazaar is an anti-slacker (my term, not his), who in his prime, worked beyond the expectations of his coaches and co-runners – sometimes to his detriment. Steve Prefontaine ran times far quicker than would be calculated by his vO2 max.

I incorporate the idea of the slacker in my training runs. As my weekly mileage increases and the workouts increase in intensity I hope I will be able to run at the level of competition I have set for myself.  In the last 2 months before Steamtown my goal is to minimize my slacking. Every long run – no slacking. Each interval or hill workout – no slacking. Every lost toenail, blister, sore muscle – no slacking. I have run enough to understand the challenge. Now I just need to run the very best I can.

Pho- It heals what ails you.

My family has amended the old comedic adage of “take two aspirin and call me in the morning” to” take two Tylenol and 24 ounces of water and let us know how you are doing.” The modern adaptation comes from a family of NSAID allergies and the realization the majority of our families’ headaches and general malaise is from not drinking enough water throughout the day. Yesterday posed a particular challenge to keeping hydrated. I woke yesterday morning with what I was calling a “dry throat.”  I had no malaise, chills, fever or other symptoms of an infection. Recognizing this may be the first sign of an infection, but unwilling to admit it less I miss my Sunday long run I convinced myself that a few gulps of water a 2 Tylenol would fix the problem.  And 6 miles into my 13 miler I was feeling good and pleased I had not succumbed to some false symptom.  By mile 10 I was holding my own as Tony and Frank were also beginning to struggle through the humidity. I finished the run ok, but immediately felt like I had finished 18 miles. I knew something was wrong when I didn’t feel I could enjoy the normal post run coffee with my friends. Let’s pause here and stress the gravity of the statement. Many athletes have their routines. Here is what goes through my head on a long run: miles 1-4: catching up with the guys; miles 5-10: absolutely nothing to completely banal thoughts like – oh, that’s a nice tree, because this is my meditation time; and from mile 10 till the finish each step, every breath is one step closer to a large cup of coffee.   So not going for coffee was a sign of serious distress.  I headed home with a burning in my throat that made swallowing difficult, and within a couple of hours sneezing and a runny nose began to appear. Two Tylenol made little difference. And tea or orange juice faired only slightly better.  My dilemma was clear. I needed hydration but each swallow burned. I turned to my fail safe approach to hydration – pho.

Pho is a Vietnamese soup. Granted any chicken soup may have helped, but pho has become my family’s favorite for cold and flu season. A large bowel of vegetable pho gives plenty of hot water, vermicelli noodles, a vegetable (or chicken or beef) broth and a heaping of vegetables all for under $7. It’s also not as salty as most restaurant versions of chicken soup.  While not a complete cure I felt much better post-pho. If there is a point to this tale it is the importance of hydration and use of good quality soups to keep us healthy. Every culture has its favorite soup, and I am not turning my back on chicken soup with matzoh balls (lest my grandparents turn in their graves), but if you find yourself under the weather, or in the need of tasty hydration, pho may be the fix.

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