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AANS Neurosurgeon | Volume 28, Number 1, 2019

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Triathlons and Neurosurgery: Part 2

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

Sometimes You Have to Go Slow to Go Fast

Over time, cycling became my passion. During the past 25 years of racing, my run times slowed, but my bike times improved and, as a result, my overall times got better. Developing better pedal power was directly related to riding more intervals with other, faster riders. Most of my rides were alone, outside, in nearly all weather conditions and in hilly terrain. Mental toughness was gained during these most challenging conditions. Heat, cold, rain, humidity were all just variations of the same theme – getting outside of your comfort zone, pushing beyond your limits just a little each time.

The downside was I would go too fast during the bike leg! As a result I would typically “blow-up” on the run. Hammering a 56-mile bike leg at 23-24 mph came with a significant cost, especially for the Half-Ironman, when you are facing a 13.1-mile run. A bad day would be a run time that nearly matched my bike time! I had to go “slow” to go “fast” – conserving my energy for the rest of the Ironman, otherwise I would suffer the consequences. As in surgery, taking one’s time to go “slow” allows the case to go “fast” or smoothly minimize any redundant motion. The operation, as in a triathlon, is dependent on perfectly pacing oneself throughout the entire case.

Work Smarter, Not Just Harder

I began to race and train smarter. It was not about logging miles as much as it was the purpose of that particular workout, during that part of the season. The seasons break down to off-season, base building, build, peak, taper and recovery. The rest and recovery, including sleep, nutrition and injury avoidance, have become more important with age. Although the fast-twitch disappeared with age, the use of interval training and balanced workouts allowed me to improve my overall times in my age group. Pacing, hydration, electrolytes and mental focus became the pillars for performance. The race distance, terrain and weather were external variables, some of which you can train for and others you have to adapt to by working on mental fortitude. No two races are ever the same, even on the same course.

Just like variations in neurosurgery, at some point you have to expect the unexpected and work your way through it. You could encounter:  

  • A tide or current not in your plan made for a longer swim;
  • An unusually windy bike course poses even more of a challenge; or
  • Rain on a hilly course slows progress.

Training in the heat, rain, snow, hills and adverse conditions provided a veritable bank of resilience to draw from. Much like neurosurgery training, identify those items one can and cannot control and nevertheless accomplish the mission. List the potential obstacles for each patient with that particular disease. Know the “terrain,” not just the “map,” since the map may be wrong. Ultimately, immersion, incubation and insight are all part of the learning process. Take the time to study the case before, during and, most importantly, afterwards to see what was done, what could of been done better and what should be done the next time.

Be Part of Something Larger than Yourself

My most incredible races were not the fastest ones, but the ones that were part of a greater purpose. Racing for former patients at the Boston Marathon years following the Boston bombing was one such example. Racing the SUPERFROG 70.3 Half-IRONMNAN to support the Navy Seal Family Foundation was an incredible experience in one of the toughest races. Swimming in the Pacific Ocean around 60 degrees with a six- to eight-foot surf, biking into the wind in a four loop bike course and running in the sand for a least half of the 13.1 mile run leg made for a challenging course. The tribute to fallen Navy Seals over the past two decades was humbling, inspiring and motivating. They made the ultimate sacrifice: I could easily embrace a little misery to help fundraise for their families.

Never for yourself, but for those you serve. In both military and civilian neurosurgery, be it in the combat theater or state side, it’s about giving back and doing more than the status-quo. Set the example of how to pass on the hard-learned lessons and create an environment of:

  • Selflessness
  • Mental toughness
  • Physical fitness
  • Instinctive fortitude

This comes from sports, but translates to neurosurgery, making outcomes possible that were previously unattainable. Ultimately, it is about being a powerful member of a team and remembering the patient and families that entrust their lives to us.

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