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June 6, 2016

Health : Middle Distance



Last Thursday we went to see Sam Beam (of Iron & Wine, my favorite musician) perform his duet album with Jesca Hoop at Great American Music Hall.  I can't even begin to describe how much I love Iron & Wine and how much of my life has paralleled his music, but I don't have to try since this isn't really about that.

It's about the fact that after the show, I was listening to his Pandora station, and came across a song by Sea Wolf called Middle Distance Runner. I'd never heard of him or this song, and was quickly drawn in by the simple strings, the clear lyrics, and the easy ache of the sentiment:

"Well I'm so sad tonight
And the words won't come out right
It's been a long day on the track
And it's stamina that I lack

So won't you run to me tonight?
Tonight we could pretend that we're just lovers
But I'll only ever be a middle distance runner

Well my heart is beating hard
And I'm off with a shot at the start
And my legs tremble from strain
But by the finish line I am drained

So won't you run to me tonight?
Tonight let's not talk about next summer
Cause I'll only ever be a middle distance runner."

It was one of those strange moments where something in the outside world reflects something internal that's been going on with me, because I'd been thinking a lot about the relativity of distance lately.  

It's interesting how when you start running longer distances, you keep adding on to what's possible, changing the idea of what's "long" and thereby your goals.  I've personally always thought of myself as a middle distance runner, enjoying the sliver of six miles.  Lately, on long runs, it takes about six miles before I start even enjoying the run; it's become the beginning where in the past it was the end. But compared to ultra marathoners, my middle distance is short distance; for sprinters my middle distance is long distance.  

And it makes me wonder what it is that drives us to run any distance--the number? The feeling? The story?



On Sunday I had the longest run planned to date--fifteen miles.  Having run several half marathons I didn't think the stamina issue would be difficult, just adding on a couple miles to a distance I've done before.  

The first few miles were boring city blocks getting from our place to the Embarcadero waterfront, and there it opened to breeze, sailboats, and the smell of shucked oysters.  It was warm and crowded, but I hit my stride here right around six miles and my muscles loosened, and I knew I'd be able to finish the run.

Then the inside of my right foot started to ache each time I placed it down.  I adjusted my laces, thinking there might be too much pressure.  When it continued, I stopped to massage the area, hoping it was just tight muscles.  But after resting and starting again, it actually hurt more.  I could run painfully on it, but worried that continuing the run would put my foot out of commission altogether, I called for an uber home at eight miles into the run.

I'm pretty disappointed that this injury put an end to something I knew I could otherwise finish. I also know that going into this training, I told myself over and over that injury was very likely and that I wouldn't push anything for a one-time race that might cause long-term problems.  I knew that while physically I felt like I could train for a marathon over three months, the best way to prevent injury is to take about three times as much time and I chose not to do that.  So going into this, I rationally knew this might happen and that I had decided beforehand to accept it if I had to stop.

It's a hard decision though, because you never want to feel like you're "just" a middle distance runner. We place a lot of pressure on ourselves to do everything to the utmost and extreme.  It's one of the reasons primary care is hard, because it doesn't feel satisfying to address only one of a dozen problems that each patient has.  It's one of the reasons taking care of yourself is hard, because it always feels like there's more to improve and accomplish.



Patients often comment to me that they miss the way medicine used to be, when doctors would visit patients at home and have hour-long visits with them. I definitely agree that we need more time with patients. But I also think that it can be misleading to say that it's just because we don't have enough time.  It's also that, as a society, we've continued to cram more and more expectations into the time we do have.  If we could miraculously extend our visits to half an hour instead of fifteen minutes, I would bet that we'd be expected to do more, rather than do better.

And more distance is just that-- more, not necessarily better.

My foot is still hurting and it may or may not recover in time to continue the training needed to make a marathon distance.  The pain reminds me of the sacrifices we make for more distance, and when this sets us back, it can be good to invest in the quality of the step instead of the length of stride.*


(*coincidentally, a piece of advice for running post injury is to take shorter strides).








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