Tuesday, February 2, 2016


"You cannot play it fast until you can play it slow" said every piano teacher ever. I tell my medical students and other healthcare students the very same thing. Because it is true. Do not rush through the physical exam when you are still learning. Take your time, starting at the head and noticing every little thing, normal and abnormal from head to neck to chest to thigh to knees to toes.

You notice things when you run slowly. Your weaknesses. Your breath. The color of the dirt under your shoes. The little flower abloom in February in the crack in the sidewalk, which still freaks you out, as you are from Wisconsin, and blooming flowers in February is miracle material.

When you run slowly, you can run forever, or so it seems.

When you run slowly, you lose races.

A doctor in practice, a musician on the stage and a runner in races must go at the appropriate speed. We call it the tempo. Which is the relative speed, derived from Italian for "time" and Latin "tempus". Like tempus fugit (time flies). The temporal lobe of the brain is involved in memory, speech, perception and language. Tempo runs, per Hal Higdon, are the "thinking runner's workout." Run fast, building up to like a 10K pace, and feel some pain. That is my personal definition of a tempo run:"Feel some pain."

How much pain is involved in developing speed in any particular endeavor that is important to you? Well, I suppose that depends on your :
1) talent
2) guts
3) tolerance
4) perception

Which is to say, the temporal lobe, genes, stupidity, and physiology has a lot to do with your tolerance for a good, hard tempo run. And a good, hard race.

When you run fast, you notice what hinders your speed. Today, it was some large rocks that threatened my recently sprained ankle with another nasty turn. Also, a deep lake-like puddle with a squishy mud path along the edge. There was traffic and curbs and hills and potholes and self doubt. Speed is complicated, because we do not want to fall, physically or mentally. We do no want to fail. We do not want to have our Strava feed look pathetic. We have secret goals and when we declare them publicly, people might laugh or scoff. Scoffing might be the worst human attribute ever. Along with taking Donald Trump seriously and lack of compassion toward others. Which, come to think of it, may be one and the same.

I have this patient with Parkinson Disease, who has adapted to the spastic and frankly frightening movements the treatment for their disease has caused. Imagine having your limbs flail everywhere at once while you are just trying to sit still or take a few steps here or there. Imagine the outrage of fellow humans watching you flail. They wonder if you are OK. Are you insane? Are you about to fall down? Should I assist you?

Speed of movement is the saving grace of this patient, even if it scares the rest of us half to death. Speed is a bad drug, v=d/t per Galileo, this and success, in the old terminology of Godspeed.

Once, years ago, I was riding bikes with my eldest child. She is a Zen Master, if ever there was one. She was pedaling along, and I finally lost my patience with the slowness of her progress. As I sped by her, she called to me "Mommy! Just remember, slow and steady wins the race!"

It does, it does not. We are creatures of swiftness, and we are not.

The best runners have the slowest resting heart rates. The fastest way to a demise is to go to quickly on a path you do not understand or revere. Speed with reverence. Speed with respect. Speed with understanding. The only way to success. When you realize nothing is lacking, the whole world belongs to you. Or something along those lines per Lao Tzu.

Steve Prefontaine died at age 24. He is reported to have said : "The only good  pace is suicide pace, and today looks like a good day to die." Is this suicidal ideation or striking fear in the heart of competitors?

For a 46 year old doctor, mother of 3, working full time, overweight, with an autoimmune disease and utter lack of confidence, what does speed mean? You would think being bald and almost hairless would offer some kind of advantage, speed-wise. You would think the discipline gained in practicing piano 8 hours per day and being on call for 48 hours at a time would offer some kind of advantage, strength-wise. You would think that being surrounded by what my daughter has describes as a "book moat" and being the chair of an ethics committee would offer some kind of advantage, wisdom-wise.

All I can say is I keep trying to show up. I find inspiration in the feats of others-local, regional, nationwide and internationally. I would like to find some kind of inspiration from outer space, but my telescopic lens is limited. My imagination is endless though. It sees beyond my physical and mental and emotional and age-bound limitations. I would really like to run a sub 3 hour marathon before I die. Go ahead and laugh at me, because it is a truly ridiculous goal.

And why do I care? "No trophy, no flowers, no flashbulb, no wine". Just going the distance, and going for speed.

No comments:

Post a Comment