Ironman Wisconsin

Dear Dr. Young,

The good news is I have heart disease . . .

These are the actual first words of an email message I sent to my primary care physician a couple of weeks ago. I had just undergone an angiogram to determine the source of an abnormality seen in my EKG reading during a prior exercise stress test and learned that my calcium score was 363, which, according to the University of Maryland Medical Center website, means, “You have heart disease and plaque may be blocking an artery.” Now, it so happens that I have no blockages. That’s likely because the same thing that caused the plaque buildups in my coronary arteries—decades of punishing my body with hardcore endurance training and racing—also blessed me with arteries the size of sewer pipes that can (at least for now) accommodate all that calcium. This silver lining is one reason I was in a mood to joke about my diagnosis.

But there’s a second reason, which is that I believe in the importance of joking about everything, including one’s own potential death by heart attack. If you know your Bible, you may be familiar a proverb that begins, “A merry heart does good like a medicine.” The phrase “merry heart” is sometimes also translated from the Hebrew as “laughter,” and it’s scientifically accurate. A study published in Psychosomatic Medicine in 2016 reported that, within a population of 53,556 elderly people tracked over a 15-year period, women who recorded high scores for the cognitive component of sense of humor in a standardized questionnaire were significantly less likely to die from cardiovascular disease or infections, while men with similar scores were also less likely to die from infection.

Laughter has an instantaneous healthful effect on mood and physiological stress levels. But mirth is more than just a salutary state. As a psychological trait, a sense of humor is an effective way of coping with challenges. The 18th century German poet Novalis wrote, “After losing a war, one should write only comedies.” My response to this advice is, “Why wait until the war is lost?” Laughing amidst a losing battle will take some of the sting out of defeat and may even improve your chances of turning things around and winning.

In my latest book, The Comeback Quotient, I describe how humor helped me cope with serving a drafting penalty during Ironman Santa Rosa 2019 after having dealt poorly with the same situation at Ironman Wisconsin 17 years earlier:

In 2002, while serving my penalty, I argued with the referee who had flagged me for drafting until she threatened to disqualify me if I didn’t shut up. This time I cracked jokes with the two officials stationed at the penalty tent (“Dang, these are longer than church minutes!”), not only because I didn’t want to be disqualified but also because I knew they had an unpleasant job (thanks to athletes like the one I was 17 years ago), and I wanted to be a bright spot in what was surely otherwise a largely trying day for them. And also because I knew I would feel better and probably even finish the ride stronger if I kept my sense of humor. Before my five minutes were up, I peed myself, unaware that doing so was a violation of the rules punishable with a DQ. I got off with a warning, however, and I can’t help but think the officials’ leniency was a karmic reward for my having treated them like human beings.

See how that works? The lightheartedness that I carried into this triathlon, signaled by my quip in the penalty tent, enhanced my enjoyment of the overall race experience and very likely also aided my performance. And there are a million other situations where having a sense of humor can benefit an athlete in similar ways. Just recently an athlete I coach, we’ll call her Cindy, found herself struggling to perform hill sprints in tough winter conditions while wearing ice shoes. In the past, Cindy might have allowed her frustration to get the best of her, ruining the workout, but this time she didn’t.

“It was comical trying to pick up speed,” she reported to me afterward. “I think I worked harder for those six sprints than any I’ve done before. As difficult as it was, I know I got the intended benefit and oddly really enjoyed the challenge of doing something almost impossible. I laughed out loud during every recovery.”

In addition to supplying a terrific example of how maintaining a sense of humor can benefit an endurance athlete, Cindy is also living proof that a risible mindset can be cultivated over time. You don’t have to be Rodney Dangerfield to laugh at your own losing battles.

But wait: If discovering I have severe plaque buildup in my coronary arteries was the good news that I reported to my PCP, what was the bad news? It was, simply, that the new diagnosis offered no explanation for my chronic fatigue, brain fog, orthostatic intolerance, and other symptoms (of post-acute COVID-19 syndrome, I’m about certain) that caused me to seek medical care in the first place. So, in a sense, I went to the doctor with one ailment and came away with two. Which, now that I think about it, is itself kind of funny.

The weekend before last I did a 10-mile run. Under normal circumstances, such a workout is no big deal, but I am coming back from an injury and this one did not go terribly well. Having done a succession of eight-mile runs every other day over the preceding week, I was hoping to feel comfortable, both fitness-wise and pain-wise, going a little faster over a slightly longer distance in this particular session.

This didn’t seem like too much to ask. Having averaged about 8:15 per mile in my last eight-miler, I was hoping to knock that down to 8:00. But as it turned out, my groin let me know in no uncertain terms that going any faster than 8:20 per mile would be dangerous. And while it certainly was not a strain to maintain this pace, I felt as though I were running quite a bit faster. I kept glancing at my watch, convinced I was speeding up, only to find that I wasn’t.

In the face of my thwarted expectations I became frustrated and began to contemplate cutting the run short. Accustomed to completing 10-mile runs in 75 minutes or less, I almost couldn’t bear the thought of needing a full 10 minutes more to slog through this one. My mood turned dark, my self-talk negative. But then something happened. One moment my consciousness was wholly absorbed in these dark emotions and negative thoughts. The next moment I was mentally removed from them, observing them from a separate level of consciousness. This new perspective allowed me to judge them for what they were—unhelpful—and intentionally choose alternative emotions and self-talk.

I chose, specifically, to be grateful that at least I was able to run, however slowly, whereas just a few weeks ago I was unable to run a step without significant pain. I told myself to embrace the necessity of going slow for now, reminded myself that today’s restraint would be rewarded tomorrow (or eventually). Like a pedestrian dodging raindrops to who discovers the futility of staying dry and begins dancing through puddles, I suddenly went from being irritated the large numbers on my watch display to being amused by them. The second half of the run was infinitely more enjoyable than the first.

Metacognition and Endurance Training

This little anecdote is an example of metacognition, or thinking about one’s own emotions or thoughts. This (almost) uniquely human capacity plays an important role in endurance training and competition. Some athletes are more skillful users of metacognition than others, and those who use it well are able to control their thoughts and emotions in ways that enable them to make better decisions and perform at a higher level.

As athletes, we tend to regard our thoughts and emotions as effects of how the body is feeling and performing. If you feel lousy and are off pace at the midpoint of a 10K road race, for example, you are likely to experience negative thoughts and emotions as a result of your bodily situation. But research has shown that the causal loop goes both ways—that thoughts and emotions also affect perceptions and performance. A 1988 study by Damon Burton at the University of Idaho identified a strong negative impact of anxiety on performance in swimmers. And a 2013 study by Samuele Marcora at the University of Kent found that two weeks of training in positive self-talk increased performance in a time-to-exhaustion test by 17 percent.

What makes metacognition so powerful is that it allows us to choose our thoughts and emotions to some degree. Without it, your mind is totally at the mercy of your body. Only by taking a mental step back from the present contents of your mind can you clearly see what’s going on and actively choose more helpful thoughts and emotions.

Like any mental ability, metacognition comes more easily to some than it does to others. But anyone can develop it through practice. That’s what mindfulness meditation is all about. There are other ways, though. Indeed, it’s enough just to start every workout and competition with the intention of “catching” negative thoughts and emotions and choosing more helpful alternatives. Initially, you may find yourself brooding on a negative thought or feeling for a while before you snap awake and take a mental step back from it, and even then you may struggle to find a helpful alternative (for you cannot simply lie to yourself, saying, for example, “My foot doesn’t hurt” when in reality your foot doeshurt), but with practice you’ll get better and better at this process.

Another personal example of metacognition at work—and one where there was a lot more at stake than in the previous example—is something that I experienced during Ironman Wisconsin back in 2002. My lowest moment of that race was the first few strides of the marathon. I’ll never forget the fear and dismay I felt when I discovered that, with 26.2 miles of running ahead of me, my legs were as battered and depleted as they had been when I finishedmy last standalone marathon, perhaps more so, as the damage resulting from a severe calf muscle cramp suffered two minutesinto the swim had, during the bike leg, morphed into a pins-and-needles sort of pain affecting almost the entire front leg. I thought, ‘How the hell can I possibly do this?’

But in the next moment I took a mental step back and reminded myself that I was hardly the first athlete in this position, and that I had prepared for this race in more or less the same way thousands of others had done before me, athletes who had grinded through the discomfort I was feeling now and finished strong. And that is precisely what I proceeded to do, even pulling off the relatively uncommon feat of even-splitting the marathon, the mantra Trust your training looping through my head the whole way.

That’s metacognition for you!

Here is an interesting scientific paper on the role of metacognition in endurance performance.

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