AANS Neurosurgeon | Volume 29, Number 1, 2020


Triathlons and Neurosurgery: Part 1

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Editor’s note:  In Part 1, Dr. Armondo describes why and how he entered the life of Triathlons. In Part 2, he continues that journey and muses on the positive impact on all aspects of his life.

If You Don’t Like What You See, then Make a Change

It was 1994. I stepped on the scale and was in shock – 245 lbs.! I had gained over 70 pounds since graduating from West Point eight years earlier. It was the darkest days of junior residency. Poor eating habits, chronic sleep deprivation and a lack of exercise all contributed. This was before work hour restrictions and more time was spent in the hospital than was rational. I over ate late at night before sleeping, with little to no regular exercise and plenty of stress. My body had suffered and I was just turning 30. So, I decided to start running. It was not pretty. The chub rub alone made it look like I had class III hemorrhage between my legs. Exercise alone would not do it; it was essential to change my diet and sleep routines. The older I got, the more critical nutrition and sleep became. I would not be able to exercise myself out of poor eating habits. As my body transformed so did my mood, energy and enthusiasm for life in general. In 10 months I was back down to 175 pounds and training for my first marathon, with an ultimate goal to compete in an Ironman.

Allow the Right Hemisphere to Create a Solution

Exercise was never just about fitness. It was my therapy; meditation, reflection and ultimately solutions to some difficult challenges arose during running. I found trail running along steep hills and terrain was the most engaging. Rock Creek Park in Washington, D.C., behind the original Walter Reed Hospital, became my retreat. In Philadelphia, running along Kelly Drive and into Wissahickon Park was my escape from the city. My mood became calmer, my hands steadier and my spirit stronger.

Running was easy; shoes, shorts and I was out the door! My endurance and speed improved and I was setting qualifying times for the Boston Marathon with my personal record (PR) of 3:07 in the Chicago Marathon in 1999. But again, my real passion was aiming for an Ironman triathlon. During those runs, my mind would reflect on the challenges of the day. Creative solutions to recent obstacles would present themselves during those strides in nature’s pathways. The right hemisphere was allowed to be free and think creatively as I embraced the beauty of the natural world.

Economy of Motion

As I advanced into the world of triathlons, being a non-swimmer was no small challenge. In the beginning, I was even passed by some water joggers! Eventually, I got better, but there were some funny races with me usually exiting the swim with the elderly men who started 15-20 minutes after me. Tacking like a sailboat and thus never swimming a straight line, I would double the distance of the swim. I worked on my technique and ultimately did much better with time and deliberate practice. My swim times continue to improve with some of my fastest swims in the roughest, coldest Pacific Ocean tides – a wet suit goes a long way for me! Swimming became analogous to efficiency in neurosurgery by:

  • Optimizing body position, hand and instrument use to minimize drag and maximize economy of motion
  • Making each surgical or endovascular movement count and minimizing wasted motion

It was akin to optimizing my swim stroke and body position to minimize drag and maximize thrust.

Forward momentum is the name of the game.


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Arrin | October 3, 2019 at 10:27 am

As a med student with hopes of entering neurosurgery residency in a couple years, and also a runner, I wish there were more resources to learn about the environment and attitudes toward resident health for each program. I have heard from a few people I know currently in residency who are at hospitals that place a priority on residents getting exercise and taking care of themselves, and others I have talked to say their programs don’t make such efforts.

Ryan | October 30, 2019 at 5:18 am

Thank you for the article Dr. Armonda. I’m a 3rd year neurosurgery resident in St. Louis, and your story really hits home with me. I had also put on a lot of weight after residency, but I just finished my first marathon 4 weeks ago and am now training for my first triathalon. Do you have any advice on training for the swim section or just training in general. Thank you again for writing this. It’s great to have inspiration from other neurosurgeons.

Jhon | January 2, 2020 at 12:22 am

I´m an international medical student with a strong interest in Neurosurgery.

By reading Dr. Armonda’s article, I have reinforced my motivation as an ultra-marathoner. Despite medical school’s busy schedule, I have been self-training for 6 years now. Accordingly, I have finished more than 5 marathons and 2 ultra-marathons (including a 70- mile race on the desert in 20 hours non-stop). His experience in triathlons fires up my hope into becoming a neurosurgeon, and at the same time, conserving my discipline in the sports fields despite demanding long hours in the operating room.

I wish you the best Dr. Armonda, keep inspiring us.