Finding My Own Path.
I am not living the life that was planned for me. Upon showing some scholastic agility when I was a child, I began being told that I was fit for great things by a lot of people. Parents, teachers. I was a bright child, and I had accomplished progenitors, at least on my mother’s side. I was told from an early age that I would be following the path laid for me by one of two men, either my grandfather, the civil engineer and real estate developer, or his brother, the professor and mechanician. For some reason, their other brother, the physician, was left out.
But I never could quite live up to those expectations. I was good at math, but I wasn’t a prodigy. By the time I went to college, I wasn’t too keen on pursuing civil engineering anymore, a feeling reinforced by my mediocre accomplishment in those classes. I switched over to systems engineering in a fit of tears, certain I was destroying my mother’s dreams for me. She surprised me, supporting the move and being pleased I’d found a path I enjoyed. I think we’d have had a different conversation if I’d chosen, say, theater.
But in systems, I was still considered something of a high-potential asset. My advisor pushed me on toward a doctorate. He offered me a position as a graduate student in his lab. Columbia University, the school my great uncle taught at, did the same. I was offered a position before I ever even applied for one. The took me to a vast computer lab and told me it would be “mine”.
I had, apparently, chosen my great uncle’s path toward professorship and academic achievement as an adult. I accepted my undergraduate advisor’s position, and went to work on a doctorate. A year later I decided to quit. A year after that I decided to un-quit. I passed my qualifiers, barely. I had begun drinking in earnest now. I slowly made progress on my course work and research, gradually sinking further and further into suicidal alcoholism.
Just as I was ready to abandon everything again, my advisor wrestled a dissertation from me, and ordered me to defend it. I didn’t want to. I knew it wasn’t any good. But I did it. And I passed. And then I just sat down. I was ostensibly trying to start a consulting company. But I wasn’t really. I had enough money to live on, because I was highly privileged. And so I was unemployed, drinking as hard as I could, and married to a woman with a child who both deserved better.
No one believed in me anymore. Least of all myself. Not my wife. Not my stepson, not my parents, not my advisor. I didn’t even apply for any positions. Not that I’d have gotten one. I started a business and pursued nothing. I drank and drank and drank. Everything was falling apart. Until the day came that I couldn’t anymore and I had to let it all come apart and I left for inpatient rehab.
I was offered a job while I was in rehab, as a technician for the chief of staff of a small local hospital. At less than half of what I thought I “should” be making. But the good thing about alcoholism, and recovery from it, is that it makes you humble. I was willing to do anything to return to a state of dignity and value. So I took that job. It started after a bunch of paperwork snafus when I was about six months sober.
I was suddenly able to contribute. It was difficult and disorienting. I wasn’t good at real-world work, and my boss was sort of nutty. But I made it. Within 18 months, my salary had more than doubled, and I was made a principal investigator. Suddenly I was doing work I understood, enjoyed, and was good at. I learned a lot of things very rapidly, like how to write for medical journals and grantsmanship.
I got a couple of grants. I published a couple of papers. I did some things wrong, not understanding the IRB process and the internal rules about submitting manuscripts. I was censured, but not harshly. Luckily, my research doesn’t expose any human subjects to risk of harm. But eventually, my funding ran out and I needed to find a new position. I moved out to MECMC, and started building a different kind of enterprise.
Now I’m doing work I care about at an institution I love. I’m not a professor. I’m not a civil engineer. I do mentor students from time to time. I publish work that’s of no interest at all from a theoretical perspective, but is useful for learning to improve hospitals and the care they provide. As I’ve said many times: I’m not interested in convincing other engineers to do what I do the way I do it. I’m interested in convincing physicians and administrators that what I do exists and is a good investment.
I disappointed a lot of people to get where I am. I was expected to achieve in different ways. To make theoretical contributions. To be better at math or business. I was expected to be rich and renowned in my field. I’m not any of those things. I don’t mind that I disappointed people’s visions of me. And yes, I’d love to be rich and renowned. But I’m not and I won’t be.
What I am is a productive, contributing engineer. Mediocre but effective. With other dreams and aspirations now. That are not professionally oriented. Sunday, I compete in a triathlon. I am part of a flourishing relationship. I travel the world. My alcoholism disappointed a lot of people, and derailed my progress toward their goals for me. My recovery has allowed me to focus on what I want to do, what I want to build.
Today, I am a sober member of Alcoholics Anonymous. In 8.5 years of sobriety, I’ve built a life that may not be what I was launched into as a child, but it is one that I can accept for myself. I’m useful. I’m a taxpayer. I am functioning in a society that I no longer feel owes me easy success. I used to take two steps backwards for every step forward. Now, I take two forward for each step back. I’m not perfect. But I’m making progress.
I don’t know how my life is going to proceed. Maybe I change jobs again. Maybe I change careers. Maybe I get injured or sick. Maybe. Maybe.
I’ve disappointed a lot of people. And I think I’ll continue to from time to time. That’s what I’ve had to do to find my own path. Most days it’s a good path. Some days, not so much. But it’s mine. I am its author, and I am its only true reader. I have to be the one who can live with the story it tells. Today, I can live with the story I’m writing.
Taper Week.
I don’t feel like I ever did anything particularly strenuous training for this triathlon except the two very long bricks, which turned out to have a bike session three miles longer than the actual race. I’m fit as I can be at this point, and now just need to rest and steady myself for the actual race. This weekend I did two pretty significant final training sessions. BB and I did an 11 mile run on Saturday, and went paddle-boarding Sunday at the DC free paddle-event hosted by North Face, bookended by 8 mile bike rides.
It was hugely crowded, thousands of people lining up to kayak and paddle-board on the Potomac (POHT-o-mac). We joined with our new friends the globe-trotting public health worker and the USMC fighter pilot. I was all ready to be embarrassed about being shirtless next to a Marine aviator three years younger than me, but that didn’t happen. Paddle-boarding was fun, and a decent core workout without actually raising my heart rate at all.
The bike ride was harder: the way there was all down hill, and so didn’t challenge me. But that meant the way home was all up hill. That did challenge me. It ended up taking about 45 minutes to go 8.5 miles, and I was riding BB’s heavy mountain bike. It definitely was a good training ride for the long, flat, hopefully fast ride I’ll have Sunday morning.
It is going to be hot. There’s nothing to do about that. Not only is it the second half of July in Princeton, New Jersey, there’s a full-scale heat wave going on. Currently, the forecast is for the mercury to be tipping 90 degrees right about the time I finish. There are also forecasts of scattered thundershowers, so maybe I’ll get a little rain. Who knows. It’s going to be challenging no matter what.
But more and more, the math looks like it’s my friend. I have 270 minutes to finish the course. Unless there’re some very strange happenings, I should need only about 240 of those, at the most. And if I over heat and can’t do more than walk the 10 km “run” portion of the race, I should be able to speed walk it at 15 min/mi. That will still allow me to finish.
I’m nervous. But I’m excited. I just really want to collect that medal. I want to finish. I want to be proud of accomplishing something hard. And I want to prove to myself that I can do the things I once derided as pointless before understanding them, because I thought myself incapable of them. This triathlon is another chance for me to taste the grapes I once called sour – only because I didn’t realize they were within my grasp after all.
The Second Big Brick.
Yesterday I completed my second (and final) Olympic-length brick prior to the triathlon. 23.5 miles on the X-wing, followed by a 6.2 mile sloooow jog with a couple of walk breaks. The ride took me 88 minutes, for about 16 mph, which means I was reeling off sub-4 minute miles. That’s stellar and I’m very pleased with it. But the run took me 74 minutes. That’s an 11:50 pace, and it wasn’t even that hot. 77 degrees, but high humidity. Race day will be hotter, it looks like.
That’s going to be the way. I am not, I don’t think, going to be able to run the entire run. After a long ride, my body temperature is up, and that spikes my heart rate. Even though I was running at about a 11:50 pace yesterday, my heart rate averaged 177. My heart is like that. It’s difficult for me to maintain a heart rate below 170 during exercise. If I’m doing anything even moderately challenging, it goes straight to sprint-mode.
When it’s warmer than about 65 degrees, it’s just really difficult for me to keep my heart rate down to a manageable number without walking periodically. So that’s what I’ll do. My resting heart rate is down between 48-60, so I’m not worried about my general cardiac fitness. For whatever reason, my body just doesn’t have many gears between “rest” and “sprint”.
Race day I may want to take the ride a little slower and maybe I’ll have more in the tank for the run. Maybe not. But I’m feeling confident that I’ll reach the finish line. I’m annoyed that my pool has been closed for emergency repairs, and so I’ve gotten less swimming in than I’d like. But that is the part I’m least concerned about. I’m a strong swimmer, I’ve swum the distance. I am comfortable in the water.
I have 4.5 hours to finish the race. The swim should take me about 45 minutes, maybe 52 at the outside. Call it an hour. The bike course is 20 miles, and so will take me about 80-90 minutes. Then, the run will take me about 75 minutes. Worst case I have to walk a lot and it takes me about 90. That sums up to 200-240 minutes. Leaving me, at worst (hopefully) half an hour for transitions, which is a very long time.
I’m scared. I’m not as fit as I’d like to be. I’m not good in the heat. I’m slow and soft and weak. My training brick yesterday hurt a lot. Especially in the upper arms and core. I’ve been doing a lot of core work, but 90 minutes on a bike and 75 minutes jogging are going to take a toll on me no matter what I do.
The lesson here is: I can do just about anything if I’m willing to suffer enough. But I can’t do it fast. I was never going to be a great athlete, but I did permanent damage to my ability to compete well with how overweight I let myself get, and smoking and drinking like I did. I have twenty pounds of fat I drag around that I will likely never be rid of barring a famine.
There’s only so much I can squeeze out of this tube-sock full of toothpaste I call a body. Hopefully, it’ll be enough to finish an Olympic Triathlon next weekend. If not, well, then I know something I can’t do. Yet.
Triathlon Nerves.
I’m starting to worry about the triathlon a bit. I had a good conversation with a guy at the running store Sunday. Two years ago he was 402 pounds. Got winded going up one flight of stairs to pee, had to sit down and wait. Decided on the spot to make a change. Now, just a bit more than two years later, he’s run something like 12 half-marathons and a bunch of triathlons. He looked to me like he was down to about 260. He had an irrepressible attitude, and was eager to share what he’d learned. When I told him it was my first triathlon I was training for, he was gregarious, excited, encouraging, and descriptive in his advice about how to approach it.
I’m excited for my race. but I’m nervous too. I’ve read the rules over and over. I’ll probably screw them up. I don’t think I’ll be brushing up against the time limit. But I might. Especially if it’s so hot I have to walk part of the run. I never did learn to change a bike tire. If I get a flat, I’m just fucked. Could be a long walk in with a broken bike. I haven’t practiced any transitions really, but I don’t know how much I need to. I’m not aiming for speed or complexity there.
I’m wearing the same shoes for the ride and the run. Everyone, everyone, tells me I need to clip in to my pedals to go faster. I’m sure they’re right. But clipping in is a safety hazard for me. I’ve done it before. I don’t like it. I fall. I don’t want to fall and hurt myself. I’d rather be slower and less efficient. I’m not aiming for a time. I’m aiming for a finish line. I’d like to reach it without fracturing an ulna.
I’m not really thinking of this triathlon as a race. It’s an obstacle course with three obstacles. A lake, a road, and a path. I swim the first, I ride the second, I run the third. There’s no difference to me in doing the slowly or quickly. The only thing that matters is that I complete each one and reach the end. Focus on the task at hand and finish the mission I’ve set for myself. I can do that, I think, if the heat doesn’t take me down.
Two and a half years ago I wrote about just hoping I could someday finish a half-marathon without walking. Well, I did that my first try. It wasn’t fast, and it hurt. But I learned a lot about myself and what I can give when I decide to give it. But I’ve also learned where my limits are. On my trail half-marathon in May, I couldn’t run the hills in the heat and humidity. I just didn’t have the fitness or the ability to shed heat.
In a week and a half, I’ll find out if I have what it takes to be a triathlete. I’ll find out if I enjoy the event. I’ll find out if I enjoy racing alone for – probably – about four hours. I’ll see if it was worth jacking up my knee, and probably needing to take two weeks off from serious exercise when I’m done. I’ll see.
Why shouldn’t I be a triathlete? I am a soft, doughy, overweight, slow, and unathletic person. And yet I wrangled a marathon from this sad, weak body. An Olympic triathlon should be no harder. It is going to take me a long time, and it is going to be painful and exhausting. And I am going to do it. One stroke. One pedal. One step. After another. If I cannot finish, it won’t be because I didn’t give what I had to give. My training hasn’t been perfect but I think it’s been sufficient.
Tomorrow I do my last big brick: 23 miles on the bike, 10 km run. It’s going to be hot, and my only goal is to finish it in a time that will work for the race. Hopefully about 95 minutes on the bike, and 70 on the run. We’ll see what I can do.
It’s OK that You Don’t Understand.
I had a sadly frustrating conversation yesterday in which a naive young man asserted that alcoholism is caused by “society”. He seemed to think that the onset of alcoholism coincides with “life getting too hard” and that that is “society’s fault”. That if “society were fixed” then “becoming alcoholic in the first place” could be “prevented”. Now, these assertions fall into that vague category of being so absurd, nonsensical, and nebulous as to not even be wrong. Something has to be coherent before it can be wrong.
But it’s worth examining anyway. First of all, I hope it’s obvious that alcoholism and the circumstances of a sufferer’s life are unrelated. Alcoholism hits rich and poor, every race, gender, ethnicity, and background. Alcoholism is a disease which is at least partly heritable, and does not discriminate on socioeconomic status. It is a mental illness with both physical and genetic components. If alcoholism is more frequently diagnosed among poorer people (and I don’t know if it is or it isn’t) then I guarantee the discrepancy is at the diagnosis level, not the incidence level. The rich simply have more resources available to prevent consequences of alcoholism like homelessness.
So while this person was woefully misguided about what alcoholism is and what causes it – and further about what is an isn’t society’s responsibility regarding the difficulty of life – the are coming from a good place: they want to find ways to prevent people from suffering the effects of alcoholism. That’s nice. And their lack of understanding isn’t relevant to the niceness, or probably even the ability to work towards, that goal.
Some days it seems that the people who least understand the realities of living with alcoholism, whether the alcoholic is in recovery or not, are the medical professionals and scientists who study the disease. The more I learn about how people study alcoholism from a neurochemical perspective, the more I am convinced that as interesting as this pursuit is, it will never produce meaningful approaches to relieving the suffering of alcoholics.
Similarly medical interventions. Now, obviously, I received, benefitted from, and endorse medical intervention in the early, detoxification phase of sobriety. Detox can be lethal. Medicine and doctors save our lives in this stage. But medicine has very little to offer the alcoholic when it comes to staying sober in the long term. In fact, generally, medical approaches will, I believe, derail sobriety more often than they aid it. We alcoholics love to drink, and to blame others for our continuing to drink. And a doctor whose treatment “fails us” is an excellent scapegoat.
That doesn’t make the doctor responsible for our continuing to drink. They merely get recruited into our disease as a way to convince ourselves that drinking is an acceptable option for us. Similarly, “society” – whatever that means – cannot be responsible for our inebriation. It can at worst be a scapegoat we employ to justify our drinking.
This naive young man’s description is precisely what I’ve heard from so many alcoholics still in denial about what they are and what they need to do: “My life got to hard,” they wail. “If your life was like mine, you’d drink too.” You can hear this over and over again from alcoholics who continue to drink, as well as from those of us who’ve recovered describing our once-drunken selves. We love to blame society for our drinking. We recover, if we ever do, when we stop blaming others and recognize that our disease and our behavior combine to compel us to drink.
Science and medicine have, perhaps implicitly recognizing that they have little to offer the alcoholic, changed the definitions of alcoholism. You won’t find that word in the scientific or medical literature anymore. They prefer “alcohol abuse” and “alcohol dependence”. But changing the words, they redefine what it means to help us; they try to make their interventions look better by reporting “decreased abuse”, as if my life is better when I binge three times a week instead of four. As if I’m healthier in mind and body if I suffer cravings after a day rather than an hour.
The only help that we alcoholics truly need from “society” is to stop viewing alcoholism as a symptom of a moral weakness and a tendency to indolence. If there were fewer barriers to summoning the courage it takes to walk in to your first meeting and ask for help, I think a few more of us might recover. Maybe.
But make no mistake: most of us die. Most of us will always die. And regardless of any magic pill or revolutionary treatment, most of us will continue to die. Because most of us prefer alcohol to life. And you can’t cure that. And it’s not society’s fault. And it’s not medicine’s fault. And it’s not science’s fault. It’s our fault. And it’s the fault of nature and luck.
It’s OK if you don’t agree. Because it’s OK if you don’t understand. We alcoholics don’t need your understanding or your guidance to recover. If you want to help, hold us to the same standards you would anyone else. Don’t condemn those of us in your lives who still drink as moral cowards. But don’t excuse our behavior because we have a disease. You have the right not to participate in our illness. Recognize you can’t cure us. And then let us know that getting help is not weakness, that recovered alcoholics can do anything normal people can.
“Society” – whatever that is – cannot prevent alcoholism. But it can welcome those of us who return from it. And in so doing, may encourage a few more of us to do so.
I Don’t Know How to Help.
I’m a coward. And my privilege allows me to be a coward. I suspect that to some people this post is just going to come off as another white man complaining about this not being about him. That’s ok. It’s not my intention to write that post, but this is a post about my own thoughts and feelings, and not about what I think other people should do or not do. As such, this post is about me. It’s about my process as I try to navigate how to participate in a social movement that isn’t about me. That’s difficult to get right, and I’m sure I’ll get it wrong in some ways. I’m going to try. Maybe I shouldn’t. I don’t know.
I’m a coward because I want to be able to participate without criticism for when I get things wrong. I want to be able to make a contribution and yes, I want the social recognition that comes along with making a contribution. This is often called “cookie seeking”. Well, yeah. I like to be recognized when I participate constructively. I am not good at being selfless and altruistic.
The big social movements in my circles are about justice. This morning the headlines are about the Black Lives Matter campaign, the murder of innocent black citizens by police, and the murder of innocent Dallas police officers at a Black Lives Matter protest. I don’t have the first idea how to contribute to a just outcome here. I’m sad and confused and angry and demoralized. And I’m afraid. I’m afraid for the lives of black Americans. I’m afraid for the lives of my brother-in-law and my niece and nephew who are African American. I’m afraid for the reaction of police to Dallas. I’m afraid for the lives of police officers.
There are other (intersecting) social movements as well that I’ve written a little bit about, especially as they intersect with academia. LGBT participation. Sexual harassment and sexual violence against women. Bias in funding and publishing. All of these issues seem, to me at least, to roll up into a basic question: Why can we not distribute societal resources evenly, and treat everyone with equal measures of dignity and justice?
I don’t know. And I don’t know how to help.
I fear being publicly criticized. So much that I often feel criticized even when I just imagine how it might happen. It prevents me from taking stands. I was told yesterday that this is a normal psychological way that people keep from making mistakes. I believe that. But I also believe that it’s how cowards like me justify not making a difference.
But navigating a posture of contributing is damnably confusing for me. I am often told that as a white man, it is my responsibility to stop talking and start listening to people of color, and women, and LGBT voices. There is no shortage of white male voices: mine won’t be missed. And that’s perfectly reasonable, and I try to do that. I have a number of people in my community and in my life whom I can listen to, and I do that.
I am often told that as a white man, if I don’t speak up against racism and sexism and homophobia that I am part of the problem. That those communities and other white men need to see white men speaking on behalf of those not afforded our privileges. I don’t know how to reconcile this advice from that of the previous paragraph. But I try. I’ve written about these issues before, and will again. And I know I get things wrong.
The advice I think I understand the best is to amplify the voices of the communities most impacted by injustices. To use my voice and my privilege to point out the opinions and presences of those aggrieved by societal injustice. This seems reasonable to me. Though I have also been told that this can simply be co-opting and appropriating black and female voices. I confess I don’t really understand what appropriation is.
So I don’t know what to do to help. Perhaps it is simply not in my power to do anything. Perhaps I should retreat into the position that Alcoholics Anonymous takes: we neither endorse nor oppose any causes. The only way I truly know how to help is if someone comes to me with a drinking problem. And if they do, I don’t care what color, creed, or politics they have. I can help, and I will. I know what to do.
I don’t know how to participate in the big movements of social justice. I feel adrift and superfluous. Maybe that’s because I’m superfluous. But I’m open to suggestions. How does someone like me – white, male, privileged – help? How do I participate? Or is now the time for me to step back, shut up, and let other people’s voices be heard in their entirety. No interruptions from people like me?
When I ask these questions, and confess these fears and inadequacies, I am often scoffed at. I’m a grown-up, I’m told. Figure it out for myself. It’s certainly no one’s job to teach me about their community’s experience, or the right way to contribute. But I don’t know the way forward. I don’t even know if there is a way forward.
I’m a coward, perhaps, because I am afraid to just forge ahead and do what I think is right. Help as I can and accept that I’ll be criticized. Well, I’m a coward. I want to help, though just as much I want to get credit for helping without taking any actual risks.
And all of this confusion and indecision is a product of the fact that these injustices are not visited on me. I am afforded protection and given the benefit of the doubt by police. I am not discriminated against at work. I am not subject to threats of sexual violence in the workplace. I have a pedestal of privilege that stands me above those floodwaters. I feel like there should be some obvious way for me to use that pedestal to elevate others.
I don’t know if there is. I don’t know how to help.
We Don’t Know Anything about Diet and Exercise.
Let me amend the title a bit: we know lots about diet and exercise. We know that eating fewer calories and getting more exercise will help us keep from becoming obese. We know that eating lots of vegetables and fruits provides a lot of nutrition – especially micronutrients (vitamins and minerals) – for not too many calories. We know that eating lean animal proteins helps us build muscle. We know that we need fats in our diets but that some fats are better for us than others.
What we don’t know is anything very specific about diet and exercise. We don’t know much about specific foods (eggs and coffee for example, have dueling studies every damn hour it seems like) except insofar as they contain specific macronutrients (protein, carbohydrates, fats) and micronutrients whose functions we (basically) understand. We don’t know how diet and exercise interact to influence weight beyond basic thermodynamic calculations.
There are at least three fundamental reasons for this. The first one is the human body. Calculating calorie intake and outflow are essentially impossible, in a general sense (meaning, no one equation works for a large group of people). If I eat exactly one hundred grams of peanuts, and you eat exactly one hundred grams of peanuts, and the peanuts are all perfect clones of one another, you and I will still absorb different numbers of calories from the handful. This is due to many things, including how much we chew, how acidic our gastric juices are, and how fast our peristalsis goes.
The same is true about exercise. Two people of similar fitness levels running the same distance in the same time will burn different numbers of calories. Maybe only slightly, but tiny daily differences in average calorie consumption/burn can be the difference between losing ten pounds in a year, and gaining ten pounds in a year. There are about 3900 calories in a pound of pure fat. So the difference between gaining ten pounds and losing ten pounds in a year is only about 200 calories a day.
Now, add to how variable the body is (meaning, your body might not have the same governing thermodynamic equations as mine), just how plastic the body is. Your body and my body not only start out different, they change differently in response to exercise and diet. Some people can become obese and not become diabetic. Others will become diabetic despite not ever being obese. Some people will easily lose weight by increasing exercise with an unchanging diet. Others cannot lose weight by exercising and must restrict caloric intake.
As we exercise, we get in better shape, but we also become more efficient: our bodies get better at using the calories they have, so to keep losing weight (if that’s your goal) as you exercise, eventually you will have to eat less too. Our bodies are very well made to accumulate and store energy for times when not much food is available. Some are better than others, and we can influence how good they are at it by training it. Overeating “trains” the body just as much as exercise does, and our bodies adapt to the environment they find themselves in.
These two inter-related problems – body variability and body plasticity – confound studies of both exercise and diet. They make the data extremely noisy. What this means is that even if the studies are correct with regard to general trends (like say, diet being more effective than exercise at reducing weight in a cohort of obese individuals), they may have no relevance to whether diet or exercise is more effective for you personally.
Think of a similar problem: suppose a study showed that a group of 10,000 children taught algebra in third grade were 10% more likely to get college degrees than a group of 10,000 children who got ordinary third grade math. This might well be absolutely true at the cohort level. But it doesn’t mean that teaching those kids algebra did anything. It could be that it simply allowed us to identify that some kids were more academically capable than we thought they were and invest more resources in them. And it really doesn’t mean that teaching your child algebra in third grade is going to make them 10% more likely get a college degree. Kids are all different. You could be doing harm to your kid, by forcing something on them too early, making them think that academic achievement is too hard.
Cohort studies don’t really tell you anything about individuals unless the effect size of the intervention is much greater than the noise in the data. So for a lot of medical interventions, we can be very confident that things that work at the cohort level work at the individual level. Especially things like surgical interventions. People with burst appendices who have a surgical repair live a lot longer than those who don’t. Like, many years compared with a few days. But for lots of things, all we can really say is that “when lots of people like you take this medicine, they seem to live longer/healthier/happier than the people like you who don’t take this medicine.”
The next, and probably bigger, problem with these longitudinal studies of diet and exercise are data reliability. The vast majority of studies – and all studies that last longer than a few weeks – are based on self-report of food consumption and exercise. They additionally require self-report of times of onset of other conditions that confound the studies (diabetes, heart disease, cancer, etc.). Self report is notoriously unreliable. I’ve worked with self-report data when I was doing diabetes research. It’s ghastly.
People do not weigh, measure, and record everything they eat. And even if they did, variations in the foods would mean that that wasn’t perfectly accurate. And even if they were, our bodies are so variable and plastic that it wouldn’t be very accurate. But nevermind all that because in these studies, we don’t actually know what people ate. We don’t actually know how much they exercised.
The only thing we know for sure is that the data is wrong. People exaggerate the healthy foods they eat. They exaggerate their exercise. Even when they’re just wrong, not lying. But people lie. Lots. Usually, I think, people lie to their doctors in ways that they think makes them look healthier. But they may not be correct about that. They may be making themselves look less healthy. We can’t ever know what these lies are, or by how much. We can’t know how much the honest people (not as many of us as we’d like) misestimate their consumption and exercise.
These problems: individual variability, body plasticity, cohort noise, data reliability, combine to undermine the credibility of all studies of diet and exercise. The general trends identified in these studies are probably usually accurate. But specific numbers cannot be reliably applied to you personally.
Here’s what we know about diet and exercise. Don’t eat too much. Get plenty of fruits and vegetables. Lean proteins. Unsaturated fats. And keep moving. Moderate exercise is good. More is better. Vigorous exercise is really good, but don’t go crazy because you can get injured. Especially don’t just jump right in to a lot of vigorous exercise if you’re in poor cardiovascular condition. Ramp up. Sudden changes can be lethal. Talk to your doctor about your diet and exercise. Find what works for you.
Use your diet and your exercise as tools to improve your life, and meet your goals. If that’s weightloss, great! If that’s being able to walk around the park without chest pain, great! If that’s finishing an Ironman in less than 10 hours, great! If that’s maintaining where you are, great! And you know what: you don’t have to have any diet and exercise goals. And anyone who judges you for that can go fuck themselves.
We know at the population level that people who are fitter and have basically good diets live longer and have higher reported quality of life. If you want those things, working toward them is not complicated. But it can be difficult. And it can be expensive. But there are no guarantees. Sometimes fit people with great diets die young. Sometimes obese, sedentary smokers live to be 100, happy as clams.
Nothing we learn about diet and exercise is going to be a magic pill for being fit and sexy and long-lived without discipline and effort. Ever. So make your decisions, and then work the best towards them that your circumstances allow. And don’t worry about the numbers* bullshit.
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*Meaning, don’t worry about numbers like “Eating bananas twice a week makes you 15% less likely to have a stroke!” Absolutely do pay attention to numbers like your blood pressure and glucose and cholesterol. Those are your numbers, and they matter. Talk to your doctor.
Two and a Half Weeks.
It is less than three weeks until my triathlon, and I feel like my fitness is there to finish the race. I hope so, anyway. I can do the full distance in each of the events, and I can do the bike/run brick. Add the swim, boom. Ought to be doable. I’m only worried about one thing.
The heat.
I overheat easily, and I sweat a lot when it’s hot. Right now it’s in the mid 90s in the afternoons. There’s no reason to believe that July 24th will be substantially cooler. This is the East Coast in summer. It gets hot. It stays hot. It might be 85 degrees by 11 am on the day of the race, just as I’m getting ready to run.
If it’s that hot – the current forecast for the day has a high of 85 for whatever that’s worth this far out – it will be a long difficult slog. I mean, it was always going to be a long difficult slog. But it might be a nauseating trudge, rather than a challenging swim/bike/run. I don’t want to hate it. But I’m not afraid of it being hard.
I am afraid of not pacing well, running too fast, getting sick and being unable to finish. I’m thinking about a hydration pack, so I’ll have water handy for the entire run. I am worried about looking a little silly being the only dud with a hydration pack for the run. But I guess it doesn’t matter if I look silly if I can finish. Crossing the finish line is all that matters.
While I have incorporated a few speed goals into my running – I am very proud of breaking two hours for the half-marathon – mostly, I am all about collecting finishes. Grabbing another medal to hang on my wall, and another race run with BB and another experience of pushing myself and not breaking.
And you know what? Maybe I break this time. If you never fail, then you never pushed yourself to the limit. If I never fail, I didn’t take on big enough challenges in life. I can’t promise to finish everything. But I’m someone who starts things. I try. I engage. I assume risk and confront hardship.
And I usually find a way to finish. And I think I will this time too. I hope so. But this is one of the bigger challenges yet. And I don’t know what’s going to happen. But whatever happens, giving up without trying won’t be the result. I’m going to go fight for the finish line. I’m going to go try.
An Olympic Brick.
Yesterday I did two of the three events I’ll have to do July 24th. I rode my bike 23 miles, followed by a 10km run. All told it took me about two hours and forty-five minutes. And it was hard. It was about 81 degrees, and moderately humid. The bike ride was ok, although I stupidly took an excursion that had me going up a ridiculous hill at mile 10, in heavy traffic. But my X-wing is a good bike, and I was able to conquer all the hills and make it back home again.
The run, well, that was hard. I wore my hydration pack, and sucked down about a liter of water during the hour and eight minutes I was out there. It was just hot. And the triathlon is likely to be at least that hot, or hotter. I actually gave up at mile 5.8 (of 6.2) and walked for a hundred yards before deciding I had to finish the brick as I planned. I picked up the pace again and made it home a soggy mess.
I will not be breaking any records this race. My wave starts at 0830, and I have to be off the bike course by 1130. I have three hours to swim a mile and bike 23. Then, I’ll have until about 1pm to finish the run. I’m expecting the swim to take me about 50 minutes. The bike to take me about 90, and then the run? Well the run might take me 75. Add in ten or so minutes for transitions, and I think I’m looking about three and a half hours. Maybe four.
That’s slow. But I think I can hit the cutoff times. All the work I do, and the truth is I’m not in very good shape. I’m a poor athlete, untalented and getting old. I’m not surrendering to my own limitations though. I will never be great. I will never even be good. But running, I have gotten to the point where I am slightly better than average, on a good day. I doubt I’ll do enough triathlons to reach that mark. But I’ll finish.
Probably.
Trending Downward.
I’m not feeling great. My relationship is good, and my fitness is going reasonably well. Other than that, I’m not feeling good. I am selling a house, living in another I don’t like, my half-brother was diagnosed with thyroid cancer, and my father with congestive heart failure. My job is going middlingly at best. For three years I was the golden boy. Now I’m an underperformer. I’m not good at management. And I don’t like it.
My department is changing in a way that makes me not enjoy working here as much. Our new engineer, starting in August, is better than I am. More accomplished and further in his career. I will not be the natural person to lead an engineering group anymore. And that’s probably wise, institutionally: I am not a good leader in this environment.
I’ve capped out, I think. And I’m ok with that, I guess. I don’t like watching peers get promoted while I stay stagnant. But maybe I need to let go of that ego and settle into a place where I’m good at what I do. Maybe I need some other kind of change. I just don’t know.
Before changing jobs, and moving to ECC, I had settled in to a position where I felt I could accumulate prestige and satisfaction simply by getting new grants and writing papers and eventually I’d become an important researcher. It might have been true too. The VA liked my work, and I was doing a decent job getting funding. But life changes. I had to move on.
Now I’m doing a halfway decent job doing the things I need to do to advance, but I’m not sure I like what I’m advancing towards. It makes me tired and unmotivated. Lots of meetings and agendas and not much actual work. I don’t value the things I’m being asked to do to advance my career. If this is what a promotion looks like, I’m not sure I want one.
But staying still isn’t an option for anyone for very long either. Get pigeon-holed in a place, and you get stagnant. The organization moves beyond you. You become redundant, unnecessary. I feel like that right now. I’m not contributing in a way I like to contribute. I’m sludgy and dull and pointless.
I’m ready for something else. But I don’t know what else to go looking for.
Infactorium 