Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

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Archive for September, 2017

Contentment, Complacency, and My Fitness Tracker

Where does being content end and being complacent begin? As an older athlete this question is just dogging me. The parallel question might be where is the line between being content and capitulating? These are both, of course, extensions of some of my recent thoughts on balancing the effects of relatively high intensity workouts with the countervailing effects on recovery, plus or minus injury.

There might be a more scientific answer to these, at least in so far as fitness is concerned, and it would come from of all places the fitness tracker world. As it turns out my latest tracker(s) have the ability to measure the beat-to-beat variation in heart rate (HRV). This measurement is a proxy for autonomic nervous system activity. A lower HRV means autonomic stress. If correlated with the previous day’s workout that would argue for either a lower intensity session or rest.

Is HRV ready for prime time? Well, world class endurance athletes and many professional athletes in other sports certainly think so. How about for us, the regular folks hoping to improve our fitness and along with that our health? Dunno. I’m impressed and frankly a little depressed to find that my HRV responded so classically to what was for me an intense WOD yesterday. For this to work one must have the discipline to dial it back if your HRV is low on a particular day (be content with your work), but also the discipline to ramp it up when your HRV is high (fight complacency and go to work).

In a busy life it is likely the second part that will prove the more difficult.

Careless Joy

Quiet house. Quiet lake. Quiet mind? Not so much.

When you are riding high, hitting all of your numbers, looking out over a quiet lake as far as the eye can see and embarking on another stretch of smooth sailing, are you the type that rides the crest of that wave with the carefree joy it deserves? Or are you rather the sort that cannot shake the awareness that below your tranquil waters there lies a hidden reef that portends despair should you happen upon it? The question is more than just the old “are you an optimist or a pessimist” saw, I think. At its core lies one of the keys to happiness: can you live in a happy moment without simultaneously giving space to another darker, sadder moment?

During the dance are you always on edge waiting for the other shoe to drop?

None among us lives a life filled with only joy and happiness. Indeed, there are those whose lives are a proverbial slog from one tragic moment to another. Blessedly, in our developed world, these “treadmills of tragedy” are actually quite rare. Likely as rare as the Unicorn lives filled with nothing but rainbows and Skittles. No, for most of us it’s simply a question of degree leavened by, I dunno, attitude I guess. Do we approach the smorgasbord of our lives as ones of “quiet desperation” as so many novelists propose, or do we rather travel in a state of “careless joy”?

Beth and I are hosted friends this weekend at Casa Blanco, the invitation having come spontaneously months prior and quite amazingly accepted and consummated. The one, a classmate from college, I’ve known for 40 years. The other is my classmate’s relatively new love. How they’ve arrived together at Casa Blanco is quite fascinating. One has lived a life which from the outside seems to have been charmed beyond belief, while the other has struggled mightily to overcome significant childhood traumas. One looks back and muses on choices made and how things might have turned out if present day insights might have been available when earlier crossroads were encountered, while the other has doggedly worked through each treacherous road into and out of those crossroads.

What they have in common, at least this weekend, is the apparent ability to live fully within the joy of whatever moment they are experiencing right now, without allowing the intrusion of the “other shoe”. I am quite sure that each has some something that weighs on the balance toward the negative side of the ledger, but for the life of me I haven’t seen it. Pollyanna or a gift? I’m going with “gift” and furthermore I’m going with being able to watch this couple give themselves completely to each moment we’ve shared as one of the most meaningful “hostess” gifts Beth and I have ever received.

Those couple of things in my life (or yours, or my friends’) that are sitting there ruining your winning streak? That other shoe you just know will drop at an inopportune moment? Meh, they aren’t going away regardless of how you decide to engage with the joyful steps in your life, on your journey. Right now there’s a workout to plan and a lake to jump into. Bacon’s on the griddle while I watch the chickadees eat breakfast. Tapping or shuffling, the sound of the shoes is that of happy dancing, and I am taking my cue from our guests and simply listening.

That other shoe will drop whenever but I’ll likely not notice.  I’ll be too busy dancing to worry about it.

Of Tradewinds and Science

“A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die.” –Max Planck

So very much of what we encounter as we seek any kind of guiding truth is not science at all, but strongly held opinion forcefully presented. Think about it for a moment. Think about a few of the really big issues orbiting the intellectuosphere. Climate change. Health. Fitness. The search for the cure for cancer. Heck, the decision on what to have for lunch. So many opinions…so much money…so little true science.

Even more than that, scientific truth is continually bludgeoned by the one-two punch of politics and commerce. True science has always been held hostage by those who have vested interests in what constitutes the prevailing truth at any given time. How many promising avenues of inquiry have been blocked, and how much time has been lost because of the failure to pursue additional lines of inquiry that ran counter to “consensus”? One need only think of inflammation in vascular disease or alternatives to “fat in the diet is unhealthy”, both squelched along with the careers and reputations of their proponents while the single consensus theory was pursued. Why? Alternate theories or parallel theories would siphon the spoils from those who fed at the consensus trough.

It’s quite tempting to hold that this is all relatively new, that it is a function of our highly developed Western societies. Tempting, but ultimately false. Has there ever been a time in recorded history when a new scientific truth has upended orthodoxy and there has NOT been an attempt by the entrenched to not only stop an new line of inquiry but also destroy those inquiring? Think Galileo. From where I sit it seems as if a substantial majority of truly disruptive new scientific truth has arisen from the ranks of those who stood aside the prevailing winds and charted their own course.

What does this mean for each of us as we sit in our own little boats and sail along? The trade winds of consensus are strong, and it seems the weaker the science behind them the stronger they blow. It’s fine to allow these to fill your sails, of course, for the majority of them do in fact propel us along a true course. The best course, however, may lie in the breezes that cross the trade winds. Those tiny little gusts that represent the true essence of real science–skepticism accompanied by inquiry, followed by proof–will ultimately propel us to the proper destination despite the power of the commerce attached to the trade winds.

Every now and again the Newport to Bermuda race is won by a rebel who went off alone and discovered a new truth about sailing. We should be open to the possibility of a new scientific truth in all parts of our lives, lest we find ourselves far behind, capsized in its wake.

Or worse yet gone, as Planck suggests, long before we ever had a chance to benefit.

Evaluating Risk in the Mature Athlete

“Achieving a risk level of 0.00000% is costlier than 0.0%.” –Saurabh Jha (on Twitter)

Think about that for a minute. It was written in the context of medicine and medical care, but we should think about risk in the context of our CrossFit or fitness practice, too. Beth and I had a really nice conversation with my sister-in-law Amy (of Champlain Valley CrossFit, home of Games champion Matt Fraser) about CrossFit for the masses. The specific topic was how many CrossFit WODs should regular folks, especially–ahem–more mature regular folks be doing each week and what sort. In a way it was a discussion about managing risk.

As I’ve gotten older my ability to challenge my body without incurring minor injuries has declined. At the same time, my ability to recover from those injuries has declined apace. A far more mundane, but equally actionable observation is that I do not recover from the intensity of the WOD as quickly as I did 5 or 8 or 10 years ago. In other words, there is some risk in continuing to do CrossFit in the same way that I did in years past.

There is a flip side to this, of course. Prior to embarking on my Crossfit odyssey I would be incapacitated with back pain 2 or 3 times each year. Since January 2006 that has occurred precisely once, and that was because I deviated from standard-issue CrossFit to join a friend in his Oly workout while visiting. I am struggling to create a regular workout schedule since CrossFit Bingo/Comet CrossFit closed. Without question I am not as healthy as I was at this time last year.

Each of us is a study group of one, each with a personal risk/benefit ratio that can only be discovered by at the very least coming right up to the edge of “too much”. The more experience you have the more confidence you probably have in your own ability to determine where that is. Others can, and should, put the responsibility for charting that course in the hands of their CrossFit or other trainer. Once identified, though, it makes little sense to flirt with the flame of “too much” when there is so much to be gained from “enough”.

For me what that means is continuing to pursue at least the maintenance of my functional strength by continuing to follow the latest version of CFSB from The Brand X Method(R). I find that 2 high intensity WODs, 3 at the most, is what I can handle each week. As much as I hate to admit it, long brisk walks are becoming a staple of my fitness and health plan. I should probably ask Abbie the Wonder Dog to join me on those.

Nothing is completely safe; seeking yet another zero after zero after the decimal point before starting treatment means never starting. Once effective dosing is established, in medicine or in CrossFit, one must judiciously minimize risk, but not to the extent that the benefit cannot be achieved.

Better Understanding Conflict of Interest By Studying Bias

So much strum und drang in the air. So many panties in a bunch. The offensitive are on the warpath about, well, everything. We seem to have a surfeit of ethicists among us, proclaiming in nearly real time where anything and everything fits on some mythical ethics grid. To them I offer my own filter, the question I ask before I expend an iota of energy of any kind on the type of “news” that has them all so agitated:

Is what I am viewing unethical, or simply unseemly?

Ethics is a synonym for morals. As such it should be universal and timeless. Ethics should bear nothing in common with fashion.

Speaking of which, it is fashionable in pretty much any field in which expertise can be obtained and the label “expert” attained to lay waste to those so acclaimed by accusing them of having a “conflict of interest”. Traditionally this meant that one might enjoy some sort of tangible gain by trafficking in one’s area of expertise, thereby rendering the expert’s stated opinions somehow tainted. Of late it means that being employed by someone with whom your critic has a beef means your standing to hold an opinion at all is nullified.

Nonsense.

We would be a wiser society if we instead made an effort to sort through the biases held by experts in any field. To demand that one not express any opinion that would support your employ should disqualify the individual who holds such a position, not the expert. To look at the bias that may be present in any expert opinion allows the audience to better evaluate both the veracity of the opinion, as well as its relevance to their own situation. For example, in my day job I have a strong bias to treat any condition that produces meaningful symptoms in my patients.

In truth, in many of the general categories that I cover my remuneration is identical whether or not I treat. Those who bleat on about conflict of interest would seek to nullify all of my thoughts simply because I make my living in the arena on which I opine. Again, this is silly. It is far more useful to read my professional writing through the prism of my pro-treatment bias. In so doing it is far easier to compare and contrast my public opinions with others in my space who may differ. Do they differ on substance, or do they differ because or a countervailing bias?

This is not to say that conflicts of interest do not exist, or that if they do exist that they are never a problem. If you have invented a medical device and choose to use your own device rather than a competitor’s you have a COI. Disclosure of your COI should be mandatory (I disclose all consulting contracts around prescription drugs, for example). If they are of equal quality (equal safety, equivalent outcomes), the COI is mooted. If your device is much more expensive (thereby generating much more income to you), your conflict of interest is unseemly but not necessarily unethical. It should be obvious on its face that using your invention if it is less effective (or Heaven forbid, unsafe) is unethical.

Expertise exists everywhere. Here, on CrossFit.com in the fitness world. Would you disqualify Greg Glassman because CrossFit has been a successful business? How about Jeff and Mikki Martin who have launched a business in the same space? Is their competition a conflict that nullifies their contributions to youth fitness? Among the bureaucrats at the EPA in the care of the environment. Do they not have a contribution to make despite their tax-supported position? Is their (presumed) anti-business bias a reason to dismiss all federal policy? Among the various and sundry talking heads on all of the financial offerings on cable news channels. Don’t you really want them to be rich and successful, especially if you are going to follow their advice?

If we seek to understand the biases that exist underneath the opinions of experts we can better evaluate the conflicts of interest that they inevitably carry along with those opinions. From there is is an easier task to evaluate the character of those conflicts, and better decide whether or not we accept their guidance.

Getting paid to be an expert and to share your expertise is only a meaningful conflict of interest if it is unseemly or unethical, not just unfashionable.

 

Ghosts in the Attic: Lives Remembered

An attic is in many ways similar to the vast storage facilities that lie hidden beneath and above every museum you’ve ever visited. The exhibits you walk through are like the life you see being lived right in front of you. If you are an experienced museum goer the existence of that treasure trove of unseen artwork is something you know is there somewhere. For the archivist, all of that art is there for the asking.

A life remembered lives in the attic or the basement or the back of a closet in the remotest room in the house. Beth spent 3 long days and nights pulling together the totems of her parents lives from the nooks, crannies and crevasses of what is literally the Hurst family ancestral home. No fewer than 4 generations lived significant parts of their lives in what was once a tiny one-room schoolhouse surrounded by Amish and Mennonite farms. What an incredibly daunting task, that.

Hearing her tell of her task (we were “together” on speakerphone) was what it must have been like if you could have been an open ear at the excavation of St. Paul’s Cathedral in Rome. The attic had an attic; each closet had a closet. Every step further into each space unearthed another layer of the family’s history. Here a deed to the original schoolhouse, there the wedding certificate for her great great grandparents. Was her Dad a good student? Well, he had a pretty solid 3rd grade judging by his report card.

And the pictures! Oh my, yes, there were pictures. Beth and her sisters fell straight down the Schaeffer family tree. Who knew how much they looked like their Mom when they were all younger women? I got to see pictures of the stunning beauty I fell in love with some 35 years ago, a literal restoration of the portrait in my mind’s eye of our days of courtship. Treasures unearthed in the attic.

Stories, journals, histories, legends…they all came out of the attic’s attic and emerged from the closet’s closets. Beth’s “legs” fairly buckled under the responsibility of curation. What to keep? What should go? They are the last of their line, these Hurst sisters. Whatever was consigned to go would be forever gone. There are no more attics; there will be nothing to curate. She felt the presence of not only her parents but of their parents, and theirs, and theirs as well.

Is this nothing more than a melancholy musing on memory and loss? Maybe. There was a lesson in there, though, one that Mrs. bingo and I stumbled upon as we “walked” through those archives together. It didn’t have to happen like that. As it turns out each attic corner, each tiny closet contained notes and stories that lead, like so many tiny treasure maps, to the next discovery. Why had my in-laws not taken us all in hand and walked us together along those pathways? For sure there were stories that should have been buried elsewhere, art not meant to be seen by generations hence (note to self: remember this lesson when it is time), but still, we thought of the joy we could have shared had we just known these treasures were there to share. That’s the lesson my friends, one that Beth would agree afterward was worth the lonely emotional lifting she did as she curated a life remembered, archived like so many art treasures in the attics and closets filled over generations and hidden from view.

Someone may be alive today who’s been filling those attics. Find them. There is joy in the attic. Like so much that is joyful, to share your discoveries with those who created them is just too wonderful to let it pass now that you know that you don’t have to. Ask your parents or grandparents to take a walk with you in the attic. Together.

 

In Which Pooh and Christopher Robin Reunite

Christopher Robin: “I’m not going to do Nothing anymore.”

Winnie the Pooh: “Never again?”

CR: “Well, not too much. They don’t let you.”

Toddlers rule the world. Seriously. Beth and I are watching the Man Cub and his tiny baby sister (“Pippy”, at least for now) as their parents take an afternoon to be the young couple that they are. A two year old is nothing but non-stop movement, all curiosity and instant gratification in a tiny bundle of Brownian Motion. There’s no sorta minding the toddler while you “get stuff done”, either. When it’s your turn on watch you are either on them like a hawk or you beg to be relieved of duty.

We are (mostly) blessed that our little guy is also quite bright and very verbal. It makes the time quite a bit more enjoyable while simultaneously taxing. “What is it?” pops out every 2 or 3 minutes, and every activity is preceded by an announcement–”I gotta do whatever”–and then accompanied by “play by play”. The announcements are quite handy in that they let you know where the next disaster is headed so that you can be ready to avert.

Having said all of this I am nothing short of astonished by how much more I am enjoying this stage than I did with my own kids. Don’t get me wrong, the sense of discovery and the unconditional love were there when my kids were toddlers for sure. The difference in the experience has everything to do with me: I have given myself permission to enjoy it this time. On Sundays now I muse whenever, whereas if I were a muser back then I would have tried to muse while on duty, an impossible task guaranteed to increase frustration and diminish the joy in both activities.

Therein lies the key, the gift of grandparenthood: you realize that you really do have a choice. If you are wise (or live with a wise spouse like I do) you give yourself permission to do what once upon a time felt like doing Nothing. It’s not, of course. Not for you and not for your little one. For you the gift is to re-live the wonder of discovery in a child while you witness the purity of the experience your grandchild is having. What your grandchild receives is you. All of you, all to themselves, for what feels like to them at the time like all the time in the world.

In the end the most fortunate among us are those who get to live in the chapter that A.A. Milne never wrote. The one in which Christopher Robin realizes that “he” has become “they”, and that it is only for him to decide that it is time for him to return to the Thousand Acre Wood. In the guise of his grandchild he will find that Pooh is still there, that he still loves Pooh and Pooh loves him. There to sit doing what “they” would call Nothing.

With his grandchild at his side, to sit together doing Everything.

 

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