Medical Teammates

(To mark twin 50^th anniversaries in 2017, as a fulltime running journalist and as a marathoner, I am posting a piece for each of those years. This one comes from 2008.)

ONE DAY before my 65^th birthday I felt great, as young and healthy as anyone could expect to be at this age. On the birthday itself, both feelings changed dramatically. A visit to a urologist that day led to a diagnosis of prostate cancer, and all the tests and treatments that had to follow.

My first reaction, not counting the initial uncertainty bordering at times on panic, was to keep this condition secret from all but the immediate family. That would have been a mistake. Even this relatively mild form of cancer is too big a burden to bear alone.

Fortunately I was far from alone. This is the most common cancer in older men, matching breast cancer for women in incidence and cure rate.

Both are highly curable if found and treated early, the big “if” that’s the focus of this chapter. If you must have cancer, better to have a common type that the doctors have had lots of practice at beating.

Three of my great friends in running have dealt with prostate cancer. George Sheehan lost to it, but Paul Reese beat it with radiation, and apparently so did Bill Rodgers with surgery. None of them was secretive, so neither was I.

George wrote a book about his final fight, titled Going the Distance. His illness was advanced when discovered, at age 67, and was beyond the reach of standard treatments.

He lived another seven years, mostly actively and productively. He ran his last race in his final year and completed his final book in his last week. He lived a line that he had written about “finding a healthy way to be ill.”

George’s illness might have been discovered in time for successful treatment with a routine PSA screening. That blood test wasn’t common in the 1980s but became so by the 2000s.

A climbing PSA reading led me into two biopsies, a year apart, that both were negative. The third wasn’t.

Now I thank Dr. Sheehan for his inspiration and Dr. David Esrig, my urologist, for his vigilance. His experience told him, “There’s something going on here that the tests haven’t shown yet.”

Paul Reese’s prostate cancer was diagnosed soon enough and treated with radiation. Three years later he became the oldest person, at 73, to run across the United States.

Paul wrote in his book about that trek, Ten Million Steps, that the purpose of his run “wasn’t to say, ‘Look at me, Mr. Genes, Mr. Macho. I didn’t want to come off like, ‘Boy, I had cancer and I’m a tiger now.’

“I was just lucky that my cancer was detected early. It hadn’t metastasized. The early detection and my recovery are a tribute to modern medicine, not running.”

Paul lived another 17 years after his treatment. He died at age 87, from complications of heart surgery unrelated to prostate cancer.

If running protected against this illness, then Bill Rodgers should have been granted lifetime immunity. Few runners have run more miles, faster. Yet Bill has joined this reluctant brotherhood of prostate-cancer battlers.

He went public about his illness in Sports Illustrated. Diagnosis was made as he turned 60, and surgery removed his prostate in 2008.

After reading the magazine report, I sent Bill a note of commiseration. The reply was typical him, deflecting attention from himself toward others. He dismissed his own case in a single sentence: “I had surgery, started back walking a little in a few days and was running in two to three weeks, mixed with walking.”

Bill had a bigger matter in mind: “About 200,000 men will be diagnosed with PC [each year]. It hits men with about the same numbers and lethality as breast cancer hits women. Yet PC research is way lower funded, perhaps at about a third of total dollars.

“I’m working with the Prostate Cancer Education Council, out of Colorado, to try and develop the momentum for a ‘Race for a Cure’ attack on PC by raising awareness on the need for earlier PSA testing (age 40) and research dollars. Would you be interested in getting involved?”

I was, and would after taking care of personal business. Meanwhile I wrote a column for Marathon & Beyond to help break down the reluctance of men to take simple tests to expose this enemy when it’s most beatable.

That piece ended with, “Middle-aged and older men: Swallow your embarrassment and get regular PSAs and rectal exams. Women: Work on your men until they relent.”

MY ORIGINAL diagnosis of early, localized, treatable prostate cancer threatened to become more complicated before any treatment began. A CT-scan revealed “suspicious spot” (as the doctor ominously called it) on a lung.

A first biopsy of that spot was ruled inconclusive. The second resulted in one of the best words in our language: negative. So we returned to treating the original problem, at a stage when it was most treatable.

Before the medical machine sucked me in, I’d planned to run a fall marathon. If you want to make the gods laugh, tell them about your long-range plans. They had other plans for me that season.

I still would train for a “marathon,” except that it was medical and not athletic this time. I would accept the schedule and check off the sessions one at a time, trusting that they’d lead to a successful finish.

Photo: My prostate-cancer “teammate” Bill Rodgers also was diagnosed in 2008.

 

[Many books of mine, old and recent, are now available in two different formats: in print and as ebooks from Amazon.com. The titles: Going Far, Home Runs, Joe’s Team, Learning to Walk, Long Run Solution, Long Slow Distance, Miles to Go, Pacesetters, Run Right Now, Run Right Now Training Log, See How We Run, and Starting Lines, plus Rich Englehart’s book about me, Slow Joe.]

After the Fall

(To mark twin 50^th anniversaries in 2017, as a fulltime running journalist and as a marathoner, I am posting a piece for each of those years. This one comes from 2007.)

THE BOSTON MARATHON is the Olympic Trials of the less-than-elite. You must run a fast marathon before you can run “The Marathon” (that’s how Bostonians think of it, as if no other marathon counted). You have to qualify far ahead of this race itself, and this can happen as long as 19 months earlier.

This means you’re still only halfway to Boston when you better the required time. After you get in, life still has plenty of time to block you from getting there. Consider all that happened in one year to a runner friend from my hometown.

One minute Sandy Itzkowitz looked up a clear road stretching far into a future filled with exciting possibilities. The next instant an unseen obstacle crashed her hopes and dreams.

Sandy was a special-education teacher in Eugene, Oregon. She also was a dancer and a walker-turned-runner-turned-marathoner and ultrarunner.

In winter, before running her first marathon at Napa Valley, she trained with the team that I coached. She came within two minutes of qualifying for Boston, without knowing the time she needed to run for her age, then 52.

Sandy began training for a late-summer 50K, which she finished. Three weeks later she called me on the eve of the Portland Marathon.

“I hear there are still a few spots available for tomorrow’s marathon,” she said. “Do you think I should run it?”

My answer was evasive: “You’ve certainly done the long runs. You decide if you’re recovered enough from the 50K.”

She said she was. The team DVD from that marathon opens with her photo, lighting up the gloomy early morning with her smile while standing with the starting line in the background.

Sandy ran 3:59 that day, punching her ticket to Boston and now knowing what a big deal that is. This was one of her proudest days ever.

Her worst came two weekends later, when her life and plans changed in seconds. She was riding her bicycle in midday light, in clear weather and with no traffic threatening her. No one witnessed what happened, but apparently Sandy hit a pothole, flew over the handlebars and landed head-first.

The results of such collisions are often catastrophic, especially when the rider risks going unhelmeted. Sandy’s helmet sacrificed itself in the fall, or we might be talking about her in the past tense.

Her first memory after the accident was waking up on the road, looking into a woman’s face. By comforting coincidence this first person on the scene was another runner who had trained with Sandy.

Sarah McCarthy, who’d also qualified for Boston two weeks earlier, now happened to be walking in the area. Sandy’s first words: “You look like an angel.”

The first medical report, which flashed quickly among Sandy’s circles of friends, sounded grim. She could feel almost nothing from the neck down.

The news improved, slightly, in the first few days. Her spine hadn’t been damaged, and surgery had eased pressure on it. Some feeling had returned, but doctors warned that they might not know for months how quickly or how far she could climb back.

Sandy started climbing – with strength, stamina and spirit that amazed the therapists who dealt with such cases all the time. She graduated quickly from the ICU, to her own hospital room, to the rehab wing.

I visited her there on the sixth day after the accident, taking along my handicapped daughter Leslie as a stand-in for Sandy’s students (who hadn’t yet been able to see her). Her room was empty.

A nurse told us, “She’s in the dining room having her first meal there.” We found her sitting at a table in a wheelchair, her back and neck so stiffly braced that she couldn’t turn to see us.

Other than the brace, the only visible sign of an injury was a scraped cheek. She looked tired and red-eyed, but her smile was sincere and serene.

We’d been warned not to wear Sandy out, to stay no more than 15 minutes. Lifting the fork to her mouth appeared to be more tiring than talking with us, so we overstayed the limit.

“My fingers still tingle,” she said. “It’s as if they fell asleep and are just starting to wake up.” She added that some feeling had also returned to her legs, but little ability to move them on demand.

That day she’d been placed on the parallel bars and told to take as many steps as she could manage. “I made six,” she said. “It was the happiest day of my life.”

Sandy knew then that she hadn’t lost everything. At first Sandy measured her progress in steps, then in feet, then in laps around the hallways. Little more than a month after the accident she moved back home, in time for Thanksgiving.

TWO MONTHS post-crash I greeted her at a year-end holiday party. She walked in unassisted by a person or a cane, and wore only a soft neck brace for support.

She still couldn’t drive, but reported walking to the bus stop alone and riding to therapy sessions. These were her training now, but she was advancing toward more familiar ground.

“I just received the best news,” said Sandy as that year ended. “My doctor told me I could soon start taking my first running steps.”

Life had dealt her a big detour. Now she was working her away slowly around this obstacle. Maybe she wouldn’t get as far as Boston, but she was going in the right direction again.

Photo: Sandy Itzokowitz climbed back well from her serious bike accident.

[Many books of mine, old and recent, are now available in two different formats: in print and as ebooks from Amazon.com. The titles: Going Far, Home Runs, Joe’s Team, Learning to Walk, Long Run Solution, Long Slow Distance, Miles to Go, Pacesetters, Run Right Now, Run Right Now Training Log, See How We Run, and Starting Lines, plus Rich Englehart’s book about me, Slow Joe.]

Slow Going

(To mark twin 50^th anniversaries in 2017, as a fulltime running journalist and as a marathoner, I am posting a piece for each of those years. This one comes from 2006.)

RUNNING GREW as it became more democratic. More runners were bigger, more were older, far more were female. The average race pace slowed as the field grew the most from midpack on back.

Just as road races opened up to every type of runner, the Internet and its websites democratized writing. Anyone can write anything in today’s chat rooms and blogs, and on Facebook and Twitter.

Some runner-writers spew unedited criticism and sarcasm, usually from behind a curtain of anonymity. They attack other runners, often friends of mine, by name.

One online article grabbed my attention in 2006 and wouldn’t let go. It attacked no one personally but took on a whole class of runners who are friends of mine. This piece kept eating at me, and the only way to make it stop was to answer it.

It appeared in widely read Slate.com. Its title told most of what you need to know about writer’s theme: “Running with Slowpokes – How Sluggish Newbies Ruined the Marathon.” It was signed by Gabriel Sherman, credited there as “a staff writer for Conde Naste Portfolio.”

Sherman described himself as “an avid runner with six marathons under my New Balance trainers.” As you’d expect from his article’s attitude, he was younger (at 27) and faster (2:56 PR) than most of today’s marathoners.

The provocative title perhaps wasn’t his but an editor’s. The views that followed were surely his own.

Sherman made just finishing a marathon, at any pace, sound as easy as “joining a gym and then putzing around on the stationary bike. We feel good about creating the appearance of accomplishment, yet aren’t willing to sacrifice for true gains.”

He ended with, “It’s clear now that anyone can finish a marathon. Maybe it’s time to raise our standards and see who can run one.”

By this he apparently meant running a faster marathon. He implied that slowpokes are slow because they don’t try hard enough.

So they must try to overcome the genes that didn’t grant them a fast-runner-like body? Try to shed decades of age? Try to ignore a history of injury or illness? Try to have fewer kids and an easier job?

I’ve spent my running and writing lives fighting against the views expressed in “Slowpokes.” I side with folksinger Woody Guthrie, who wrote:

“I hate a song that makes you think you’re born to lose, no good to nobody, no good for nothin’ because you’re either too young or too old, too fat or too thin, or to ugly, or too this or that. I’m out to sing songs that’ll make you take pride in yourself.”

I hate a story that makes you think you’re too slow. I’m out to write stories that will make you take pride in yourself.

GABRIEL SHERMAN suggested that slowness is shameful. He didn’t define “slowpokes,” so who are they?

How many of us slowpokes does Sherman knows personally and did he talk to about their histories, motives and training? Not many, I’d guess.

I know these people from coaching them, as well as now being one of them. We aren’t a nameless, faceless blob of unfit laziness. To say we aren’t trying is wrong.

For the sake of discussion here, let’s draw the “slow” line at a five-hour marathon. That’s twice as long as the average winning time for U.S. races (a little more for men, less for women, but close enough as a talking point).

I know exactly how it feels to finish just over five hours. I know too that about a quarter of the runners on my marathon teams take at least that long, and they aren’t slacking in training or putzing on race day.

Let me introduce some friends of mine whose marathons usually take five hours or more. There’s Bob Dolphin, who in his 70s ran about two dozen marathons a year and soon would reach the 400^th of his life. There’s Cathy Troisi, well into her third round of running marathons in all the states.

There’s the late Paul Reese, whose marathon PR was 2:39 but who took more than twice as long in his last one – at age 85. And there’s the late Fred Lebow, who finally ran his own New York City Marathon, while weakened by terminal illness, in the high fives.

From my training groups I could tell about Max and Gregg, Emily and Katie. They all started in the fives but graduated into the next lower hour.

Paula and Susan, mothers of 10 young children between them, ran 5½ hours together. Andy and Matt took much longer to finish, while carrying lineman-like weight. Joyce and Al ran-walked their first marathon at ages 66 and 67.

I looked these teammates in the eyes every Sunday for four months and told they should feel proud what they’d done. I dare anyone to tell them to their face that they’ve ruined the event.

Yet that’s exactly what the title of the Slate.com article told these people en masse. I would send them the opposite message: How Slowpokes Made the Marathon.

We make possible the 400-plus U.S. marathons each year. We’re the critical mass that lets the young, skinny and fast call themselves “elite.”

Walt Stack, a tough old San Franciscan who was slow before he had much company at that pace, gave the best answer to the anti-slowpokes: “Be nice to us turkeys. We’re the ones who make you look good.”

MARATHONGUIDE.COM shows no marathon results for Gabriel Sherman from 2007 and later. Cathy Troisi and Bob Dolphin completed dozens more marathons in those years. Better to run a slow one than none, I say.

Photo: Cathy Troisi’s marathon count keeps growing, even as she’s slowing.

[Many books of mine, old and recent, are now available in two different formats: in print and as ebooks from Amazon.com. The titles: Going Far, Home Runs, Joe’s Team, Learning to Walk, Long Run Solution, Long Slow Distance, Miles to Go, Pacesetters, Run Right Now, Run Right Now Training Log, See How We Run, and Starting Lines, plus Rich Englehart’s book about me, Slow Joe.]

Whatever Works

(To mark twin 50^th anniversaries in 2017, as a fulltime running journalist and as a marathoner, I am posting a piece for each of those years. This one comes from 2005.)

IT’S INSTRUCTIVE what you can hear while running when you aren’t too busy talking and don’t have recorded music or news talk plugged into your ears. Here’s what I heard one morning in early 2005:

Two runners came up from behind. One did most of the talking, his volume growing as the gap between us shrunk.

The first words I caught were “... new marathon training program.” Then “... only run long every other week.” And louder, “They only go over 20 miles once, peaking at 21.”

They passed me with a small wave from one and a nod from the other. They didn’t know me, or that I’d overheard them.

The gap between us grew again. The last words I heard were, “... not enough training.”

Says who? Themselves, from their marathon experiences? Another writer whose schedules they’ve read?

They weren’t reading my writing. And their experience didn’t match mine.

They were talking down a training program being adopted for the first time locally. That was my schedule, written for the marathon team that I was coaching.

The runners whose critique I overheard were right in their description. But they were wrong, I have to think, in their conclusion.

Yes, the long runs would come every other weekend, going up by two-mile steps from 11. (A pre-training program built to 10 miles, testing if runners could or wanted to continue.)

Yes, the distance would peak at 21 miles, the only training run above 20. And yes, these runs would be long enough for most runners.

A rebuttal to these doubters would come in June 2005. That’s when my first marathon team would reach its graduation day at Newport, Oregon.

WRITING TRAINING schedules in books is the easy part. They go to an unseen audience, to take or leave, and then I walk away. As a writer I rarely hear who took or left this advice.

Acting as a coach for months of Sundays, getting to know the runners as individuals, is harder than writing a schedule – and immensely more satisfying. Also more nerve-wracking.

A coaching truism: Credit all goes to that athlete when everything goes right. Blame goes to the coach when something bad happens. I promised myself, when the direct coaching began in January 2005, to give the credit and take the blame.

My first and biggest responsibility was more medical than technical: to keep these runners healthy enough to get where they wanted to go.

Few of our 16 runners eased through the training trouble-free. I listened to all the physical complaints, from head (colds) to foot (plantar fascia). I-T band pain became the injury of the season.

All 16 survived their scares and reached Newport intact on marathon weekend. But their troubles, real or imagined, weren’t over yet.

By race eve pre-marathon neuroses had kicked in, with almost everyone now suffering from some race-threatening malady. Worry exaggerates the severity, and their worries multiplied by 16 for me.

Runners who had come together as strangers were now friends – family, almost. On race weekend a larger support team of spouses, parents, children, grandkids, partners and friends joined us at our own pasta dinner. 

The largest number came with Paula Montague. She is the mother of three daughters, “and my 16-year-old sister is like a fourth.” Those four, and Paula’s own mother, were in Newport.

A few weeks after the marathon, Paula would undergo a medical procedure (she wouldn’t call it “surgery”) to correct a non-life-threatening heart irregularity. Her concerns were more immediate: knee pains that had all but stopped her since our longest training run.

As I mother-henned the team on the course, the last to pass my spot at three miles was Paula. I asked about her knees.

She grimaced, shook her head and asked for the tube of Biofreeze that she’d left with me. We next met up at 11 miles. This time she smiled, shouted, “I’m better now!” and stopped for a hug of mutual relief.

Our next runner ahead of Paula at that point, Michelle Martin, appeared fearless. She’d started boldly, given her condition.

In April, Michelle announced that she was pregnant. I might have urged her to postpone the marathon for a year if she hadn’t already rejected that idea.

“My doctor gave me permission to keep running,” she said, “if I keep my heart rate below 140.” I was never clear if she mentioned “marathon” to the doctor, but I know that her monitored pulse seldom dropped as low as the recommended high.

Passing my spot at 11 miles, Michelle was running a minute per mile ahead of her pace goal, seeming worry-free. But the marathon wasn’t yet halfway finished. A lot could happen in the second half, of a marathon as with a pregnancy, some of it unpleasant to anticipate or to experience.

Michelle Martin expressed momentary disappointment at missing her time goal of five hours, then quickly remembered that she wasn’t yet halfway through her bigger “race.” In November she would deliver a healthy girl.

Our final finisher, Paula Montague, sobbed with the greatest joy and relief that her knees had allowed this. Her heart procedure two weeks later would bring even more success, and relief.

Photo: Most of the original marathon team returned for the second one in 2005. This one, for Portland, doubled in size.

[Many books of mine, old and recent, are now available in two different formats: in print and as ebooks from Amazon.com. The titles: Going Far, Home Runs, Joe’s Team, Learning to Walk, Long Run Solution, Long Slow Distance, Miles to Go, Pacesetters, Run Right Now, Run Right Now Training Log, See How We Run, and Starting Lines, plus Rich Englehart’s book about me, Slow Joe.]