Is being a professional triathlete performance dependent?

Lately, there has been discussion about the professional ranks in triathlon. In a recent analysis on TRS, Brian Maiorano wrote that he did not include half the athletes racing in the pro division as professionals “because only in the most twisted definition of the word could someone who earns no money be considered ‘professional’.”

In response, Kelly O’Mara wrote that there are many age groupers who continue to dominate the age group scene, qualify for their elite card multiple times, and do not take their elite card because they want to continue to dominate age group divisions. O’Mara argues that there should be a mandatory upgrade system, in which once you qualify for your elite card a certain number of times, you must take your elite card.

While Maiorano implies that there are too many people racing under the “professional” title who should not be there, O’Mara argues there are not enough people in the professional field. As someone who will be racing with my elite card for the first time this November, I thought it would be interesting to delve into what it means to be a professional and how that translates to the sport of triathlon.

I believe there are multiple aspects to being a professional, but Maiorano only focused on the earning potential, stating that the 500 athletes not included in his analysis were not professionals simply because they did not make money that year. However, professional athletes in individual sports are very much like professionals in the performing arts. An actress, opera singer, or artist may go an entire year without a paying job in their field, and they thus have side jobs to support themselves in between. Not having a paid acting job, though, does not keep them from practicing their trade any less, nor does it make them any less professional. Likewise, PhD students are studying to be professionals in a given field, and yet they still work side jobs on the weekend because the stipend is often not enough to support them. Does needing to work a side job make them not a professional? No, it makes them aware that to carry out their research, they sometimes have to work two jobs. In the same way, a professional athlete in an individual sport may have an injury that takes them out for a season. Does their inability to compete and thus not earn money make them not a professional for that year? What about the athletes who are just joining the ranks and hoping to work their way up? Individuals might claim that professionals in other sports are paid, but the only sports in which individuals get paid when not competing or when just beginning are team sports in which athletes are under contract. Running is similar to triathlon, and many professional runners are not able to make ends meet just off of race earnings and contracts. Individual and team sports cannot and should not be scrutinized in the same manner.

How one conducts oneself, self-reflects, and approaches practicing one’s trade is also an important determining factor for being a professional. In medicine, we are held to a very high standard because lives are at stake. Each month, the cases and deaths are reviewed to see if there was anything that could have been done differently along the way. What can we, as professionals, learn so as not to have the same thing happen again? (Note, I did not use mistake because sometimes deaths are caused by mistake, and sometimes it is inevitable.) I strive to uphold myself to the same standard in my life outside of medicine. I approach each training session with purpose. I look back at previous training cycles with my coach, evaluating what worked and what didn’t work – what can be changed to get more improvement, and what should stay the same? This level of self-reflection is paramount to being a professional in any field.

My problem with Maiorano’s argument is that he is using earnings to disqualify individuals from being called professionals, and in the same article argues that there is not enough money in triathlon. I do not think that lack of earnings automatically disqualifies oneself from being a professional, but instead feel that earnings, conduct, and practice need to all be considered. Furthermore, saying that one is a professional athlete once one earns a living is arbitrary. We all know the cost of living varies from person to person and city to city. The ability to earn a living in triathlon might also be hindered by inability to travel to multiple races. I do not believe there is a line that divides non-professional elite cardholders from professional elite cardholders. I think it is a grey area that ultimately is determined by what the individual believes she is, not what other people view her as. If you feel you conduct yourself at the level of a professional, that you are a professional athlete, then you are one.

I do not consider myself a professional athlete just because I have my elite card. I do not know when I will consider myself one, but I do know that it will be my doing. If anything, I consider myself a professional student.

Ironman 70.3 Timberman

Last weekend I raced in my first half-Ironman distance. I learned some valuable lessons in the build-up and during the race, and thought I would share them. As for the race itself, it went fairly smoothly – I swam, biked, and ran what we thought was possible, and won my age group.

How (not) to prepare for your first half-iron distance race

1. Get sick. I started my pediatric rotation 8 weeks before Timberman, and by the end of the first week I had a bad cold. I got 3 colds and strep throat in a 5 week period. The week with strep throat saw me train for a whopping 3 hours, and the next week was only 7.

2. Work a lot. For two of these weeks I was on inpatient pediatrics in the hospital. I was at the hospital by 6 am every morning, 6 days a week, working 70 hours both weeks. Most of my workouts were subpar and the fatigue from not sleeping enough showed.

3. Do all of your run workouts in 90+ degree weather. I am not a morning person when it comes to running hard. I can study and swim hard in the early hours, but put me on a track and I run easy pace. So, I was left doing all of my track workouts in hot and humid Richmond weather. I did not hit my times for 4 weeks straight, and only in the last 2 weeks did things start to come together.

4. Be in the midst of a study month for a big exam. I am taking Step 2 of the medical boards at the end of August, and have thus been studying as much as possible. I tried studying in the car before the race, but all I got was carsick.

5. Forget about an important interview. I scheduled a residency interview for August 13th a few months ago. I knew it was August 13th. I also knew that I was supposed to leave Richmond August 13th to drive to Timberman. It was not until 1.5 weeks beforehand that I realized those were the same August 13’s! I quickly rearranged my travel plans to accommodate the interview, and it went well, but I would not recommend it.

How Olympic racing is different from long course racing:

1. Number of participants. I have gotten used to starting in the elite/open fields at most races, and usually have clear water and roads. On Sunday, I was the 18th of 22 waves. I started passing people after 200m of the swim, and never stopped. I have no idea how many people I passed on the bike and run, but it was pretty constant. With the increased numbers, there was also more blocking and drafting I had to avoid. Multiple times I came up behind a group of people riding across the road, chatting. I also came up on draft packs. I made a point to surge past them so no one got on my wheel. I also might have added the occasional reminder that they were not following the rules.

2. Course logistics. Technical courses suit me, but with that comes many turns during which I had to slow down and get in line to get through.

3. I can get through a swim without seeing. Within the first 100m of the swim, my left goggle started to fill with water. I swam as long as I could until my contact got really irritated. I then had to finish the swim (about 1000m) with my left eye shut. I wasn’t sure if my contact survived the water, and I also couldn’t sight well with only one eye (which looked into the sun), so I relied on the direction of the masses. Luckily, my contact was still on my eye at the end of the swim and I didn’t have to re-situate it!

4. Competing with the unknown. In an olympic, you generally know who your competition is. During, I knew where the other 25-29ers were, but had no idea about the other age groups. I found it very hard to compete against people I didn’t know of. One girl in another age group beat me by 6 seconds! Never stop pushing in a half-Ironman race.

***

As always, thank you to my mom for flying out to Richmond for the weekend to support me, the Endorphin Fitness and Richmond community that represented with me, and all of my sponsors – USMES, Scott Bikes, XTerra wetsuits, Primal Wear, Osmo, Rudy Project, and Zipp Wheels.

Two W’s and an AI

It’s been awhile since I posted, so I thought I would do a quick recap of everything.

Training while working 70-80 hour weeks:

  • Food is by far the most important. I carried with me about 1000 cals in my white coat pockets. I used things that could be eaten quickly and had a lot of nutritional value. An example of what I loaded my pockets with – nuts, apple slices, cliff bars, grapes, salmon jerky, and string cheese. Keeping energy levels steady when I did not know when my next opportunity to eat would be was crucial.
  • Commuting – I biked to and from the hospital most of the time, and somedays that was my only workout. I made do by racing the buses, sprinting to see how many lights in a row I could make, and pretty soon I’d done a good selection of zone 5 intervals.
  • OR strength – The ORs are kept very cold, so to stay warm I did calf raises, single leg squats, lunges, and other lower leg exercises during downtime. It’s also a great way to practice staying sterile.
  • Studying – I always kept a question book and my phone with a question app on me. I would often read up on the next case in between surgeries, and did questions during my downtime.
  • Sleep – Without fail, I was in bed by 9 pm, no matter what. You can only work 12-14 hour days, train, and study if you sleep.

Armed Forces Championships
Armed Forces Championships took place in Hammon, IN and was hosted by Leon’s Triathlon. Leading up to the race, I was at Fort Bragg in Fayetteville, NC for an Acting Internship (AI) in Family Medicine. An (AI) is the step between being a 3rd year medical student who knows very little and being a first year resident who knows a bit. I had a great time working with the faculty and residents at Ft. Bragg and learned a lot. The environment at Ft. Bragg also lent itself to great training. There are TWO outdoor 50m pools for lap swimming, and many roads and trails with little to no traffic around the drop zones and firing ranges. I could run for miles and only be disturbed by horseflies.

Armed Forces went very well for me. I found some good feet early on in the swim, and managed to relax and let her lead us in. I started the bike in a pack of 4, a little over 2 mins down on the leaders. We worked well together, and our pack grew to 6. I started the run about 90 seconds behind the leader, and got to work. I took over the lead just before mile 2, and never looked back. The icing on the cake was seeing my Army teammates come in 3rd and 5th for the overall title.

This slideshow requires JavaScript.

Challenge Williamsburg

After Armed Forces, I had a week to recover for Challenge Williamsburg. My mom and oldest sister came from Portland, OR to visit me and watch me race. I always love having family at races. Living 3000+ miles away from our families makes it difficult for Richard and I to see everyone, and the extra support is always appreciated.

The swim was the least violent I have ever been in. I immediately fell in behind two girls (one of whom I swim with at Peluso Open Water), and let them lead me for awhile. I couldn’t hold their pace the entire way, and lost their feet around a buoy. I still came out of the water near the front in probably my best swim of the year. The long run to transition allowed me to make up ground on the girls ahead of me, and within a mile of the bike I was trading the lead with another girl. We worked together well in a legal pack with some men, but unfortunately, I spaced out at about 10 miles and the group was down the road. I spent the rest of the ride on my own. I started the run 2 mins down from the lead female, and managed to take the lead at mile 2. I knew that there was a very fast girl behind me, so I kept the pressure on for the final loop. This 10k was my slowest ever in a triathlon, but the hilly trail terrain combined with a super humid and hot day made it very difficult. I have no idea how the half participants ran in that heat!

pic14

Pediatrics

I am now on my final rotation of 3rd year, which means I only have two tests left in medical school! I had originally thought that summer would be a great time to do pediatrics because I would have a lower risk for getting sick. But within my first week, I came down with a head cold, and in my third week am battling a second cold. I guess I’m learning how to effectively blow my nose on the bike – always a necessary skill.

As always, thank you to everyone who supports me and believes in me – my family, my coach Kyle, my training partner Julie, USMES, and Endorphin Fitness for keeping my bikes in top shape.

“But it’s good for me”

I recently finished my Surgery rotation, which consisted of 4 weeks on GI/Bariatric, 2 weeks on orthopedics, and 2 weeks on ear, nose, and throat. I loved being in the OR. I also loved clinic, and seriously considered changing my career path to Surgery. However, my triathlon had to take a back seat during my 12+ hour days, and I found myself being unhappy when I was not in the OR. Surgery made me take a step back to evaluate what makes me happy, and I find sport to play a pivotal role in my happiness. I love being part of a team and training and interacting with people outside of medicine. Don’t get me wrong, I love my medical peers and supervisors – they are awesome people – but being able to not talk medicine is fantastic. When medical students hang out, we talk about studying, interesting cases, and how stressed we are for the upcoming exam (there is always an upcoming exam). I also love getting away from academics for at least an hour a day to just be and think about whatever I want. Triathlon has become my therapy during medical school.

Of late, though, I have found myself defending my decision to compete in triathlons. When fellow medical students, residents, and attendings find out I do triathlon, they often question how I find the time for it and question my dedication to the field of medicine. My usual response is triathlon and racing is a part of my life I cannot imagine living without. It keeps me happy and motivated in school. It provides structure, normalcy, and regular contact with non-medical professionals. I remind people that many medical students have families. No one questions a student for taking a few hours to go to the park with her child. I remind them that I choose to spend my few hours when I’m not studying, training. If anything, triathlon is helping shape my interests in medicine.

In the same vein, when an administrator found out I do triathlon, he questioned how it was helping me become a better physician and implied that I was not focusing enough on school. I brushed off the conversation, but it got me thinking about the larger picture and my mental health. It is estimated that 1 in 4 medical students have a major depressive episode during medical school. According to the American Foundation for Suicide Prevention, physicians have an increased rate of suicide compared to the general population, especially women. Female physicians commit suicide 2.5 to 5.7 times as often when compared to the female general population. During orientation, we had talks from student health, counseling, and well being about the rate of depression and suicide, and that they were all there to help if we ever felt overwhelmed. I believe that the best way to fight depression for me, is by being proactive. Exercise is associated with increased well-being, and triathlon makes me happy. While some individuals will doubt my ability to do school and sport, I know there are many who support me and will continue to surround myself by those who currently do.

Monument Avenue 10k Race Report

pic3

I love the Monument Avenue 10k. There is always someone to race against, the crowds are great, and the course is fast. I went into the race with only two run sessions under my belt, and didn’t put any pace goals or restrictions on myself, mostly because I was unsure of how my body would feel. I am in the middle of my Surgery rotation, which has me gone from the house 4:30 am – 7 pm most days. My training is thus high in quality and low in quantity during the week. The early mornings combined with long hours on my feet seeing patients and in the operating room mean I am constantly tired.

pic4

I always start a few rows back from the front at Monument because I tend to get pulled out too quick. I went out strong but conservative, and settled in with a group at about 1 mile. Luckily, they were taller than me and sheltered me from the wind. We went through 5k in 18:57. I decided to see what I could do and picked up the pace. I got passed in the last mile by another female, but had nothing to react, and finished in 10th overall, 7th in the collegiate race. The 37:26 is a PR for me, but more importantly, I ran it during the busiest part of my year. I am very excited to see what I can do rested with some proper track workouts under my belt. I’m also excited for what this means for my run in a triathlon.

Shout out to my husband for having his first race back after injury, and thank you to US Military Endurance Sports and all the sponsors for the continued support!

Dear patients, thank you

Disclaimer: All patient identifiers and specifics are omitted to maintain patient confidentiality and comply with HIPAA.

***

I wake you every morning at 6:30 AM to examine you and see how your night went. In the afternoon, I take you for a walk around the unit to help you maintain your strength. We talk about the business you used to own, your family, and your favorite sports teams. When we return to your room, I help you finalize your applications for healthcare and food stamps (I know you cannot afford the 3,000+ calories you eat in the hospital.). Back in the team room, I find a small amount of research on a novel therapy, and suggest it everyday for over a week. When all other causes are ruled out, the attending agrees to try the new therapy. Within 24 hours you have improved and you leave the hospital soon after.

You taught me to fight for my patients.

***

As I read through your referral documents, sadness washes over me. You are 89, with metastatic lung cancer to the brain. I prepare myself for goals of care discussion – an 89 year old individual rarely has the health and strength to go through radiation and chemotherapy. But when I walk into the room with my attending, you look 70. I learn that you have zero health problems, you are active in your community, live on your own, and still drive. Your memory, concentration, and math are incredible. After the exam, we discuss treatment to keep your symptoms at bay. Everyone knows we cannot get rid of the cancer – it is too far along – but we can make your life relatively normal. You will dance at your grandson’s wedding.

You taught me to treat the patient, not the number.

***

You came to the psychiatry residency clinic for a new patient evaluation. Within an hour, I know more about you than your best friend does. I am surprised by your willingness to tell me your secrets, but at the end of the session, I see a weight lifted off your shoulders – you are no longer carrying the burden alone.

You taught me to never take for granted or underestimate the trust patients have in their healthcare team.

***

Everyday I see and help treat individuals who do not have to let me examine them. They tell me their secrets, show me odd rashes, lumps, and bumps, and let me see them at their most vulnerable. Without patients, my education would be four long years of memorization, and I would lose the most important part of my education. I would not learn how to tell a patient’s family that Grandma will pass away soon. I would not learn how to ask the “sex, drugs, and rock and roll” questions. I would not learn to treat everyone, not just the patient. My patients teach me so much, and for that I am forever grateful. Thank you, to everyone who makes the choice to come to a teaching hospital instead of a private one. You are the teachers of the next generation of physicians.

In any relationship, there must be trust. There is trust between patient and doctor and there is trust between athlete and coach. The patient wants to feel better, and the athlete wants to get faster and stronger. Once the doctor or coach has accepted responsibility for their charge, it is taken for granted that even on a personal level, they will do their very best for their patient or athlete.

The more medicine I study, the clearer it is that trust and constructive social interactions underpin successful practice in any field. I have been a part of smoothly functioning medicine teams and teams that stumble through morning rounds due to differing opinions. Likewise, we all know the great success stories of sports teams coming together to overcome great odds (US Men’s Hockey team winning gold in the 1980 Winter Olympics, anyone?), and we have all witnessed teams crash and burn. This is why I am so happy to be on the USMES team and coached by Kyle Pawlaczyk – I have found a team and coach I embrace and trust, who provide incredible support, and stand behind my goals of being a professional athlete and doctor.

Richmond Half Marathon

I went to bed Friday night hoping that the weathermen were wrong and I would wake-up to 40 degree weather. Unfortunately, my wish did not come true. The race started in 28 degree weather and it never really warmed up.

My time goal was to break 1:22. I knew it was a lofty goal and would take a good day with proper execution to run that time. My coach and I agreed to run 6:20 for the first mile, and ease into the pace of 6:15’s/mile. I also know that the course lends itself to a negative split and to not worry if I got to the 10k mark with time to make up.

racing2

My first mile was perfect at 6:21. I decided to stay at the current pace and hope that warming up more would help me get the pace down. I bounced around between 6:15 and 6:28 for the first 6 miles, mostly due to the slight up- and down-hills, and I went through 10k in 39:41. I had settled into the pace and started to work through the field, running behind two men that would speed up every time I tried to pass them. They would sprint for 10 seconds, I would work up to them over the next half mile, and it would repeat. During the race I found it annoying, but in hind-sight, I think it helped me because I had something to chase. I finally got past them by mile 10 and worked on the next guy, who did the same thing. I went through 10 miles just under 1:04, needing to run 19:10 for the final 5k to break 1:23. I put my head down, and started to run 6:10’s. Luckily, a guy came up on me around mile 11 and helped push me. Without him to hang on to, I don’t think I would have run as fast as I did. I finished the race in 1:23:05.

racing1

While I did not meet my time goal, I am very happy with my first race for USMES. I PR’d by 52 seconds on a very cold day, and my previous PR race was in perfect conditions. I also competed well over the last 3 miles and adapted well to the race in front of me rather than focusing entirely on a time goal.

This race wraps up the 2014 season. While I did not accomplish every goal I set last winter, I think I made many improvements that will help me in the future. I have gotten into a rhythm for training while being at the hospital so much. Before this year, a 12 hour day almost always meant that I would be spent mentally and have an awful workout. Now, I can still focus and have a good session at the end of the day.

I also feel my mentality has shifted this past year. I now see a path to racing at a level which before felt too far away due to a variety of reasons. My coach and I work very well together, and the people around me are incredibly supportive. With patience and hard work I truly believe that I can succeed in triathlon and longer running races. Being selected for the USMES elite triathlon team has also vindicated a lot of hard work which we have all put in.

Thank you, to everyone. I am excited for the winter training ahead and the 2015 season. But first, a couple weeks of recovery, family time, and tests.