Mathematic Monday

I’ve been thinking about math lately. A lot. Runners tend to get caught up in the math of it all. average pace, mile splits, weekly distance. Marathon runners  often experience acute exacerbations of math-mania.  Since the average marathon training plan lasts 4-6 months, we have a lot of time to for mathobsession. We can even use prediction tables to predict our marathon finishing time based on shorter races. Or the infamous time-machine table that will tell you how fast you could have run a specific distance if you had run it during your prime running years. 

When you really think about it, running and math are a natural combo. After all, as runners, we are measured by how fast we reach the finish line. Running is a fairly all or nothing venture—you cross the line before your competitor or you don’t. You meet your time goal or you don’t. So no big surprise that we tend to get a little numbers crazy. 

As I reflect on some of the reasons I was attracted to running, I have to admit, one of the big reasons is the safety I feel with objective numbers. My fascination with all things scientific and predictable goes way back to high school, where I  was a member of the Math Club AND the Brain Bowl. So no big surprise that running was my solution of choice to my newly discovered disease of Adult Onset Athleticism.  As a proud aunt of a competitive dancer turned competitive cheerleader, I have witnessed first hand how the more subjective sports operate.  How many times have I seen Bre or her team deliver a flawless routine, with few technical errors, only to be voted down by a judge on an elusive, ill-defined “style” category? Too bad for your team, coach, you picked a song that happened to be playing when the judge found out her husband was doing some playing of his own. That judge wasn’t seeing execution of style, she was planning another execution of sorts. 

My own experience with less math-obsessed sports was short lived, but very powerful. Last year, I was trying to transform my body. As a result of my work with Precision Nutrition, JP Fitness, and a lot of support from some good friends, I became leaner and more fit than ever. One of my assignments during my time with Precision Nutrition was to meet a new fit friend. I had been enjoying Chelle’s spin class at my local gym for a number of months prior to the assignment. I didn’t know Chelle really well, other than to know that she was around my same age, and therefore, picked great spinning music. I knew that she participated in adventure races. What I didn’t know until my assignment, was that Chelle had also dropped more than 80 pounds and was successfully maintaining that loss. We were both at a place in our weight loss and fitness where we were searching for that elusive “what comes next.” We had numerous conversations about how to take our physiques and our fitness to the next level. Our gym is owned by an IFBB pro judge and his wife, an IFBB pro fitness competitor. They hold monthly seminars for figure competitors, and women from all over the country covet those spots to work with our gym owners. Chelle and I posed the question, “what if we do the figure competitor program just to see how far we could push ourselves, physically and aesthetically?” Neither of us really wanted to be on stage exactly, but we sort of had our own Barbizon moment-“Be a Figure Competitor. Or Just Look Like One.”

So Chelle and I took the PN assignment one step closer. We each agreed to independently evaluate the figure competitor lifestyle, compare notes, and decide the next course of action. For my part, I talked to several women in my age range who were actively competing. I asked them every conceivable question about training, eating, hair, makeup, stilettos. I even took a private pilates session from an ex-pro-bodybuilder who puts on a local show every year. I left no stone unturned. Chelle did the same. 

I have to admit, I was intrigued. I particularly admired how these women felt so present and confident in their physical bodies. Even though they were working out, they took extra care in choosing flattering athletic clothing. I realized that I had allowed this part of myself to become dormant during the years that I spent in an obese body. As I looked down at my baggy drape of a t-shirt and standard, old-school phys-ed issue gym shorts, I realized that as I was gaining weight, I started treating myself poorly. I refused to spend money on stylish clothes, workout or otherwise, because I was convinced that I didn’t deserve them until I reached some ideal weight or size on a chart. I decided right then and there to start treating myself as if I were a figure competitor already. Even though I was still well above the level of body fat that would be stage-appropriate, I decided to start acting as if I were already there. I found cute workout attire that flattered the body I was in at that time. Funny thing, I actually started behaving differently. I remember the first time I saw a line of demarcation in my delts—I was wearing one of my new, body-conscious figure-girl tanks. I was doing those YTWL things on a bench, and I saw my arms in motion. At first, I didn’t even realize that the reflection was mine. You can’t get light bulb moments like this in a baggy t-shirt.

So I went back to Chelle, excited at the prospect. So far, my experience with the figure girls was a home run! I was so excited about reconnecting to my inner glamour girl, and I was all but ready to sign up for the camp. But Chelle challenged me. She had also done her homework.We both agreed that the training  sounded fantastic! What self-respecting jock wouldn’t become delighted at the prospect of  working with one of the most respected fitness IFBB pros in the country? Chelle’s main issue was the nutrition. When we compared notes, we realized that all of the competitors that we talked to were indulging in nutrition plans that were not exactly compatible with optimal health. The clincher for Chelle was how she was going to explain her nutrition plan to her ten year old daughter.  I realized that I was indulging in some selective hearing when I was talking to those women. I heard all about the clothes, the makeup, the style, the bikinis, the shoes, the training. But I had conveniently blocked out the restrictive dieting part. And the time I saw one of them face down in a large bag of Lay’s the day after her competition. The more I investigated, the harder time I had finding a mentor that did not engage in dieting behaviors that restricted entire categories of foods for extended periods of time. Chelle was right. Did I want to role model restrictive dieting for my niece? When I really assessed the nutrition plans with my scientist’s eye, I saw large gaps in essential nutrients. Depriving my 45 year old  joints of essential nutrition did not feel any more respectful than re-loading those same joints with the 80 pounds of fat I had lost. When I considered how success is measured in the world of figure competition, I realized that I didn’t want to put in all of the tough effort into training for a sport, only to have the competition be solely based on what someone else thinks is attractive on a woman’s body. 

Needless to say, I decided to channel my math madness into splits on the  track instead of grams of carbohydrate or the size of my waist.  But my time with the figure girls was not wasted. I returned to the track in cute, figure flattering workout gear. I carried myself with the attitude of the figure competitor. I de-frumped my wardrobe. I even bought a pair of stilettos! 

But I didn’t need those stilettos to compete this past weekend. On Saturday, I ran 11 fast miles with my pace group, in a royal blue and black running skirt designed for long distance racing with matching royal blue fuel belt, and royal blue lace locks in my running shoes. When I clicked off the GPS as we returned to the start of our route, my team-mates were only concerned about our overall pace, and not at all worried that I was looking a little soft so close to my competition the next day.  On Sunday, I raced a sprint triathlon in a lime green tattoo print racing suit with matching skirt and snap in race number for the bike and the run. As I sprinted toward the finish, the race clock didn’t automatically add 2 minutes because my abs weren’t visible. 

I realize that there are healthy figure competitors and unhealthy figure competitors, just as there are healthy runners and unhealthy runners. But at the end of the day, my presence at the Boston Marathon in April 2010 is not dependent on somebody’s subjective assessment of my fitness. My ability to line up at that start line in Hopkinton and run 26.2 miles to Boston is all about the math. So if you happen to catch the Boston Marathon on television, look for me. I’ll be the runner with the royal blue running skirt and the thousand watt smile. If the camera happens to zoom in, you might even see me suck in my abs and throw my shoulders back. But you won’t see stilettos until the after party.  

The Sum of Her Parts

Dissection of the human body belongs in the anatomy lab, not in fitness forums. Well, maybe it exists in the basements of deranged serial killers too, but that is a separate topic for another day. Before you click out of here, let me explain. One of my favorite fitness gurus, Leigh Peele, recently posted an article on her website about women’s perceptions of other women’s bodies. She polled 2000 women and asked them about their perceptions of the word “bulky” as it applies to women’s bodies. The majority of women defined these physiques as bulky:

And the majority of women, 71%, in fact, said that they would rather be “too thin” instead of “too muscular”.

Naturally, this article was up for discussion on a fitness forum that I frequent. Most of the women were celebrating our “bulkiness”—to paraphrase an old disco hit, “we work hard for the muscle!” One woman posted about her own journey as an aspiring bodybuilder, and how she sometimes felt ostracized because of her “amazon” physique. In response, another poster clarified that, in her mind, too bulky or “amazon” was exemplified by this physique:

The aspiring bodybuilder was quick to praise this physique, and wrote about her wish to be that big someday. All good so far, right? Bodies come in different shapes and sizes, and Leigh’s original article brought home the point that we all have different ideas about “ideal”. Ideal for one woman might be the thin, cover girl look. Ideal for another woman might be voluptuous ruebenesque. Yet another might covet the physique of a bodybuilder. Beauty is in the eye of the beholder, yada yada. Until you traverse into serial killer territory-that’s when I feel compelled to write about it and subject you to my aimless ramblings. The aspiring bodybuilder went on to qualify her admiration of the woman pictured above, by stating that her waist was a little thick. HUH? The woman in the picture has a single digit body fat percentage. Sure, her hips are narrow, and she is ultra lean. And to have, visible, cut abs like that, you actually have to hypertrophy them! So if this woman were to buy into the whole idea of chopping her physique into little tiny parts, what are her options to fix her “thick” waist? Atrophy her obliques? Surgically implant hips so her waist appears smaller? Build even bigger shoulders and chest so her waist appears smaller? Dissection belongs in the cadaver lab. 

To be fair, most of us are guilty of dissection. How many times in my own life have I focused on my midsection? Before I understood how to lift properly to build my best body, I would try to diet myself into some idealized shape I had in my mind. Focusing on my parts never helped me achieve my goals—it always resulted in chronic dissatisfaction. I love wearing my 5 inch platform Miu Miu wedges, because in them, I am 5’ 11 ½”, the height that should have been my birthright. But alas, try as I might, without the wedges, I am 5’ 6 ½”, and no amount of dieting or weightlifting will make me 5’ 11 ½”.

 I think it is time for us to stop with the dissection obsession and focus on building our very best, healthiest bodies. And guess what? Our healthiest bodies are going to come in a variety of shapes and sizes—let’s celebrate the diversity! Some women will naturally be leaner than others. For some women to get superlean, they would have to starve, do steroids or both. Is that healthy? Other women might be very fit and free from disease, yet they are living in bodies that some would consider plump. Is this healthy?  Healthy is a continuum—somewhere along the continuum, people can venture into the “unhealthy” side. Take the woman bodybuilder in the photo above as an example. At some point, she made the decision to cross over into anabolic steroid territory. Not healthy. What about the woman in the first photo? Healthy right? Well, what if she were maintaining that degree of leanness by engaging in dangerous diet pill abuse plus bingeing and purging? Not healthy. 

In the end, we are more than the sum of our parts. We are whole, human beings who deserve to be seen with a wide-angle lens. Again, let’s look at our woman bodybuilder. Even though she might be making unhealthy decisions with her body, does that negate who she is in the rest of her life? What if she is a firefighter/paramedic? When she is first on the accident scene, and delivers the lifesaving chest compressions to the dying stranger, does that patient care that some random person at her last bodybuilding show thought she had a thick waist? Uhhh. No. What if she were a fifth grade teacher? When one of her former students with a learning disability walks the stage with her peers at graduation, does that student remember her teacher’s body, or does she remember her kindness, compassion, and refusal to give up on her like others had before? Chances are, that student is walking that stage with confidence, celebrating a lifetime of hard work. One could only hope that her teacher is there in the audience, proudly celebrating her student, and also celebrating her own newly discovered understanding of what it means to be confident on the stage.

I am not suggesting that we forego our pursuits of our healthiest selves. Living in healthy bodies gives us the energy to accomplish everything we are meant to accomplish in our lifetimes. Our healthy bodies allow us to power through life with purpose and intention. But I AM suggesting that we put down our scalpels and leave the dissection to the medical students and the serial killers. Step away from the scalpel, step toward the camera with the wide-angle lens, start seeing your body for the miracle that it is, and start living your best life. 

At the end of my life, I want to be known for so much more than my thick waist or my seven minute mile. So in case anyone on the forum ever feels the urge to give me some unsolicited physique critique, just know that you won’t be heard. This body’s got her wide-angled lens-on, a well-known shield that protects against those who would dissect me into component parts. Every click of the shutter is one step closer to health and wellness. Every whole, wide-angle picture is another piece of kryptonite that dulls the scalpel of those who would attempt to shatter a healthy body image. Dissection has a place and a time, but you won’t be seeing any more scalpels in my wellness toolbox. 

The Power of Peers

I have a lot of respect for fitness professionals, I really do. Several have been instrumental in my decade-long trek from obese to fit. Today, however, I am celebrating the power of peers.

 As a lifelong scary science girl, I started my fitness journey by learning everything I could about exercise and nutrition. I could detail for you the metabolic nuances of high intensity interval training versus long slow distance. I could discuss the merits of slow twitch, fast twitch, and the ever versatile undifferentiated muscle fibers. I could draw the chemical structures of simple sugars. I could detail for you the biochemical complexities of the various amino acids and how they combined to form the very building blocks of our bodies. But I was doing all of this in an obese body. Why couldn’t I take all of this head knowledge and put it into action? I was making it too complicated. And truth be told, deep down, I didn’t believe it was possible for me.

At just the right time in my life, I met Peggy. I was working out at a local gym doing one on one personal training. At 228 pounds and 5 foot 7, this trainer had me doing one set to failure of super slow reps on machines, eating 1100-1300 calories a day, and taking body building supplements, like creatine, HMB, and other popular late nineties, gym-rat-intensive concoctions. I do remember feeling really rockin’ strong when I would leg press twice my body weight for reps, but now I realize that  I was doing everything back-asswards. No wonder I would inevitably “cheat” on my diet. I could have lost body fat on twice as many calories! 

During one of my trips to the gym, I saw a pamphlet about training to walk a marathon while raising money for the leukemia society. My niece’s best friend had just celebrated her one year anniversary of being free of leukemia, and I thought this would be a great way to join the celebration.  My trainer was dubious. He told me that I should not attempt to do a marathon until I lost weight. He said my risk of injury was too high. What I heard at the time was  “you are too fat to do a marathon,” and the gauntlet was down. Game on. I’ll show you. This moment was the beginning of my fat acceptance phase. I decided if I had to live my life in an obese body, it might as well be a fit, obese body, and what better way to prove my fitness but to walk 26.2 miles while raising money for a great cause?

So far so good. Peggy was one of the volunteer coaches. When I first met her, I immediately classified her as one of those genetically gifted runner girls—she was in her mid forties then, with long, thick black hair that she would wear in a braid, gorgeous olive skin, and amazingly beautiful legs. At the time, I was struggling to maintain 20 minute miles on our walks, and it was barely even an effort for her. 

Peggy wasn’t a fitness professional. She worked in an electronics factory putting together components. And she was one hell of a runner, often winning her age group. As I got to know her,  she told me her story—five years prior, she had been obese, had a health crisis, and decided to take up running. I didn’t believe her. So she brought in pictures. I recognized her by that long, beautiful, thick braid, but otherwise, I wouldn’t have believed it was the same person. In that moment, I believed that change was possible. I could feel myself switch from scary science chick, overthinking, overanalyzing, overeverything to humble student. I wanted to know how Peggy did it. I wanted to be as lean as Peggy. 

Fortunately, marathon training is inherently time intensive. Over many miles, Peggy became my mentor. I learned how she prioritized cooking, I learned how she fit exercise into her busy schedule. When we would go out to eat, I would watch how she seemed to effortlessly modulate her intake, and how she would leave food on her plate. 

One day, we were on a training walk in my old neighborhood, and she said to me, “Wendy, why don’t we just run from here to that lamp post?” Said lamp post was maybe 200 yards ahead. She might as well have said, “Wendy, why don’t we jump off this cliff without a parachute and hope there is a big trampoline at the bottom to catch us?” I didn’t trust her. I didn’t believe that I could be a runner. Running was for thin people. Someday, when I lost enough weight, I would be a runner like Peggy. But for right now, my thighs were so large that I would get chafing just from walking. My feet were so stressed by the distance walking that I had custom orthotics made. Despite  the negative head-chatter, something in me decided to trust her anyway and go for it. Those first steps, that brief fraction of a second that both of my feet were in the air at the same time--- the movement that differentiates running from walking --- was transformative, intoxicating, and literally breathtaking. I was running, but I might as well have been flying. I had jumped off the cliff, I was airborne, and I experienced a sensation so liberating. I  finally believed that I had the power to transform myself into a fit, healthy, lean person. I was hooked. 

 Peggy carefully nurtured me to the finish line of that first marathon. She believed in me before I was capable of believing in myself. Peggy didn’t judge my external body and make assumptions about me based on my physical appearance like I had made assumptions about her based on her physical appearance. Out on the roads, we were just two athletes, training hard, swapping life stories and making memories. 

It took me many more years before I was able to fully understand the things Peggy tried to teach me. I am just now putting some of those things into practice. I don’t see Peggy anymore at the races, and I often wonder what happened to her—maybe she moved, maybe she has moved on to another sport? I want her to know that the seeds that she planted in me a decade ago, are finally bearing fruit. After many years of trial and error, too much sunlight, not enough, too much fertilizer, not enough, I think I finally have negotiated a balance—just enough running, just enough strength training, just enough nutritious food, just enough rest—all working together to form the athlete I am today. The athlete that Peggy was able to see a decade ago. 

This, my friends, is the power of peers. Peers who have walked before. Peers who can look at you and see your potential. Peers who can hold the vision of your very best life, and believe in your future before you are able to believe it yourself. Pretty soon, you are not only believing in your visions, you are creating them, manifesting them, achieving them. And each time you share the gift with others, each time you hold someone else’s dream for them before they are strong enough to hold it for themselves, your own resolve to reach your own goals becomes hypertrophied like a muscle. Together we can achieve our dreams, peer-to-peer, athlete-to-athlete, step-by-weightless, effortless step. Together we fly. Thanks Peggy, you have permanently altered the course of my life, and I celebrate you today.

Intuitive Eating-The Ultimate Power Tool


I am a big fan of intuition. As a practicing psychiatrist, I couldn’t do my job without a healthy dose of intuition. My neuroscientist friends call this “right brain” activity- the part of the brain that houses creative thinking, subjective thought, big-picture thinking. The opposite side, or “left brain” activity is where your more rational, logical, linear thought patterns live. Using this simplified version of neuroanatomy 101, if you came to see me as a patient, my left brain would be doing all of those logical, left brain, traditional physician behaviors, like taking your history, doing a mental status examination, determining your diagnosis, and then presenting you with options for medications, therapy, and other treatments. But at the same time, my right brain would be looking at your non-verbal language as you tell your story, your posture, your subtle changes in emotion. And sometimes I will know to ask you a question that absolutely is the key question to ask you, and it might completely change the treatment plan in a different direction. Sometimes I just “know” things. I am intuitive. My intuition is part of what makes me a good doctor. However, I would NEVER rely on my intuition as sole method of treating my patients. I rely on my entire toolbox of tools to help my patients heal. You might say that I teach my patients to acquire and assemble their own toolbox full of tools to handle whatever problems they might have.

My own journey from extreme obesity to a healthy weight required me to assemble my own toolbox of tools. And yes, I had my team of professionals helping me along the way—a therapist, a dietician, more than a few coaches and trainers, fit friends who walked the journey before me, and sports medicine doctors, just to name a few. Throughout my decade-long journey from obesity to health, I learned to use a variety of tools. Some of them are clearly left brain activities, like tracking my intake, output, and measurements, taking monthly pictures and assessing the change, weighing my food in grams, measuring my heart rate data, and calculating my running paces. Others are definitely right brain activities-connecting emotions to certain foods, or using my intuition to help me decide why I had an insatiable craving for chocolate when my stress levels were high.

I have come to believe that intuitive eating is a learned skill. Like any skill, some people just get it easily, naturally and without hassle. Other people (like me) have to work hard to acquire that skill. In fact, intuitive eating has been such a difficult skill for me to master, that I have considered it a “power tool” for me. Let me explain.

When I was learning how to scull, I wanted to start out in the long, skinny boats—I would watch the experienced rowers, and would marvel at how beautiful they looked in those tiny little narrow boats. From a distance, they looked like giant silver, black and red needles, slicing their way through the Halifax River at sunrise. They made it look so easy and effortless, and I wanted to be just like them. But I didn’t want to spend the necessary time building the skills. I just wanted to launch off the dock and effortlessly row myself into the sunrise-all balanced and poised, strong and confident, maybe even intuitive.
I clearly remember the first time I ever sat in a shell. Lucky for me, it wasn’t one of the long, skinny needles, it was a big, clunky, wide yellow beginner boat. Had I been in one of the needles, I surely would have launched myself right into the drink instead of off the dock into the sunrise. Before I even took my very first stroke, I realized how difficult it was even to stay stationary in the water. It took many lessons of intense left brain study to learn the coordination required to balance the boat, move the oars in the right direction, move my body in a way that powered the oars--legs-back-arms-arms-back-legs. And while doing that, you are feathering the oars down-up-down-up. Kind of like rubbing your stomach and patting your head at the same time. For a bit, I had to constantly repeat the sequences in my left brain. Legs-back-arms-down-up. The coach had to correct me. A lot. Soon the creative right brain was able to take over. My mind and body began to intuitively learn the rhythm. Instead of focusing on the left brain chatter, I started feeling the power of my stroke as I propelled myself down the mighty Halifax, negotiating my way through the tight pillars of the Seabreeze bridge, maintaining my position as I navigated the boat wakes from the larger yachts.

I had become a rower. By the time I was ready to graduate to the needle boats, my stroke felt natural, normal, effortless and intuitive. I clearly remember when one of my fellow rowing classmates and I were out for an early morning row. It was one of those perfect water days-flat and calm, no wind, and only the occasional small fishing boat. I took the opportunity to work out hard-I effortlessly launched my silver needle toward the sliver of rising sun, and powered my way down the Halifax. I had a glorious row, the rising sun, the fishing birds, the faint smell of the ocean in the distance. I noticed that my classmate stayed far behind me, but I could tell he was fine. As I returned to the dock, I felt worn out and spent from the hard effort. My classmate’s first words to me upon his return were “wow, I tried hard to stay with you, but you were just moving, you are a really strong athlete.” Coming from an ex-college rugby player, his words meant a lot to me. I had become an intuitive rower. Power and strength are important, but at the end of the day, technique rules. And my intuitive flow on the water didn’t just happen the first time I put myself in a shell. It happened after much left brain angst. Before I was capable of handling the silver needle power tool, I had to learn with the safe yellow basic model.

And so it has been with intuitive eating. I can’t tell you how many times I tried on intuitive eating for size throughout my journey, and landed myself firmly in the drink. Except the drink in this case wasn’t the mighty Halifax, it was the mighty weight gain. Sometimes only 5 pounds. Sometimes 25 pounds. As I look back on those times, I see a pattern. I was trying to use the power tool before I learned how to use the basic beginner model. For me, intuitive eating is an advanced concept, an advanced skill. Early in my journey, it was just too easy to convince myself that I intuitively needed more chocolate or peanut butter.

I have recently completed a two month experiment again with intuitive eating. I am thrilled to report that I maintained my weight without any tracking, weighing or measuring. All of those left brain skills seem to be flowing seamlessly over to my right brain, and I appear to be navigating the river of maintenance with ease. I am officially capable of using the power tool. But here’s the catch- life doesn’t always have smooth, glassy water to row. Even though I was capable of piloting that silver needle, there were days when the rough ocean tides spilled over into the Halifax, causing some challenging swells. On those days, I retreated to the safety of my big, wide, yellow boat-the perfect tool for the job.

I would like to think that I can live most of my days as an intuitive eater. It just feels right. It certainly takes less time. But I would be foolish to totally abandon all of the tools that brought me to the place I am in today. I am not ashamed to go back to my beginner skills anytime I need them. They are always there for me in my toolbox.

In my work with others who are undergoing major body transformations, I notice that some people are scared to ever try feeding themselves differently. They stay locked in the skills that brought them success. They believe that they could never become an intuitive eater. Sometimes I notice the opposite problem, people who are absolutely convinced that intuitive eating is the only way recover from a lifetime of restrictive dieting, and that any attempt to weigh, measure or track is somehow a personal failure.

The most successful weight managers I know move effortlessly across these techniques depending on life’s numerous variables. Have you noticed that you are afraid to leave the safety of your carefully calculated plan? Or perhaps you are someone, like me, who longed to be an intuitive eater, but who didn’t have the patience to learn some of those boring, tedious left brain steps prior to firing up the power tool. Wherever you are in your journey, consider building your own toolbox. Chances are, when the rough waters of life come lapping up the side of your boat, you will have the right tool for the job.

I just have to share this story with my friends. I am so blessed to be a faculty member of FSU College of Medicine. I could not be prouder of our 8 graduating seniors here at the Daytona Campus. This is an email that I just sent to my Dean regarding one of my students:

I would like to nominate Mai Vo for the Regional Campus Dean’s Award. Mai’s dedication to patient care was obvious to me as she began her rotation in Psychiatry as a third year student. She quickly became an integral part of the treatment team, and contributed in a very significant way to the clinical care of psychiatric patients. Her attending noted specifically her keen interest in learning, as well as her attention to the details of her patients’ medical illnesses. Very early on in her rotation, Mai was exceptional at treating the whole patient. As I observed her with patients, I was similarly impressed by her ability to manage all aspects of patient care. Even though she was rotating on Psychiatry, she was always looking out for the non-psychiatric needs of her patients, often suggesting consultations that proved critical to clinical outcomes. At the time, I had absolutely no idea that I would be observing these same outstanding clinical skills from the vantage point of spouse of a patient instead of Clerkship Director.

Last month, my husband was hospitalized with massive bilateral pulmonary emboli. I happened to run into Mai in the doctor’s lounge, where she was having lunch with her Cardiology attending. As we discussed Ed’s situation, her attending offered to see my husband. So off we went to my husband’s hospital bed, and Mai proceeded to take his history. Just as she was ready to place her stethoscope on my husbands back, she immediately took notice of a mole. She completed her cardiovascular and lung exams, but then proceeded to compare that mole to the others. She was clearly concerned about the mole, and advised a dermatology consult. Her attending naturally was focused on his specialty, and we participated in an interesting discussion of Ed’s stable cardiovascular status. But I was mostly interested in Mai’s assessment. Part of me felt like a proud mama duck as I watched one of my students venture out and make her own clinical recommendations and design her own treatment plan for her patient. At the same time, here was someone whose clinical judgment I respect, who was telling me that she suspected cancer in MY HUSBAND. Naturally, I was terrified and scheduled the dermatology appointment within days of his discharge.

The dermatology nurse practitioner gave us the straight talk—she was ruling out malignant melanoma. And sure enough, the following Thursday, I got that call that no wife ever wants to get—my husband telling me that he has malignant melanoma. Two awful words that mean so many things to a Psychiatrist who has walked the end stages of this disease with too many patients over the years. But the next two words that my husband said provided immediate relief to the growing anxiety in the pit of my stomach—IN SITU. Malignant melanoma in situ. 99% curable. Another bullet dodged. And with that relief, came an overwhelming sense of gratitude and a new appreciation for Mai’s ability to look at the whole patient. Sure, Mai was rotating on Cardiology. And she did an amazing job of answering her attendings questions regarding the finer points of my husbands illness. But it didn’t mean that she shut off all of the learning she did in her dermatology rotation. She saw a problem and she went after it. She literally saved my husband’s life. When I called her with the news and thanked her for saving his life, she said that this was the first time anyone had ever told her that she had saved someone’s life. I told her this would be the first of many.

here are some after pictures!!! these were shot about a month ago.

Crash Time, Again


You know how that saying goes, “third time’s a charm?” I am hoping that saying applies to me regarding crashes. Crash number one, Wendy versus bench. Result-improved fitness. Crash number two, Wendy versus dirt road. Result-improved respect for my body and what it has allowed me to do so far. Crash number three? Well, let’s just say that all of you who cautioned me against trying to maintain a calorie deficit while training hard were correct.

Like I have said before, something profound happened to my relationship with food when I put up such a fast baseline 5k time on no fitness back in mid December. For the first time ever, I believed, truly believed that I had the potential to be a good runner. From that point forward, my willingness to ease up on portions of “recreational” food and drink seemed almost effortless. I actually lost a small amount of weight through the holiday season, which has never happened. For the first 6 weeks of 2009, I totally motored along, setting personal bests every workout, and steadily losing around a pound a week of scale weight. Enter crash number three. I wish I could blame it on PMS, because it happened during that week. But the data indicates that I had no issue navigating PMS the other two times that happened since mid December. Nope, this was a metabolic crash, pure and simple. This crash was my body’s way of telling me “enough is enough”.

It started innocently enough-mild crankiness, loss of focus at work and home, fatigue. I knew something was up when a friend decided to have an impulsive super bowl party. We had been scheming for months to set up two mutual friends on a blind “date”, but in a group setting. My friend ended up going, I didn’t have the energy to get myself off the couch.

My appetite was really strong during this time, and I was craving stuff I typically don’t care about, like the processed 100 calorie packs that are for sale down at the pink lady shop in my building. Me? The food snob? Wanting Hostess Twinkie 100 calorie packs? Ummm something is gravely wrong with this picture.

So I did what I always do when I have a question about my fueling or my training. I consult my experts! I posted a few threads here to get feedback from our very own Leigh Peele, the Fat Loss Troubleshooter. I emailed the expert running coaches at Furman University, who promptly emailed me back. They all said the same thing-don’t cut calories and run hard at the same time.

So now I was faced with a dilemma. I know that as a 5 food 6 ½ inch woman who weighs 150 pounds at 26% body fat, I am not the ideal candidate to run a fast marathon and qualify for boston. Ideal running weight for someone my height is probably around 125, which is a joke, particularly with the muscle I have built over the past few years. Even the sports dietician told me that the women she knows who do what I want to do are in the high teens for body fat percentage. The local women I know who have qualified are in the high teens. I know I don’t want to be in the high teens, mostly because I don’t want to work that hard, but also because I like the way my body looks right now! But my goal for this 5k season was to get down to the low 140’s and around 23-24%, which I felt was a good compromise. I have no doubts that I would have an easier time running if I were leaner. I have proven this to myself so far in this 5k season.

But my body was sending me clear messages to stop trying to do it all. So I stopped. I started eating at maintenance or a little above. And felt amazing. And had amazing workouts, in running, swimming and lifting. Most importantly, my mojo was back. I was focused, motivated, energetic, happy.

Clearly, I had a choice. Choice 1: Put my running dreams on hold for yet another year, and focus on really leaning out, coming as close as I can to that ideal runner girl weight. Choice 2: maintain the body that I am in now, train hard, fuel correctly, and reach for my running dreams in the body I have today.

I don’t have to tell you all my choice! The lesson I have learned in crash number three, is perhaps the most critical lesson of them all: The time for achieving my dream of becoming the best runner I can be is NOW. I could spend a lifetime chasing an ideal runner’s body composition. It took me nearly 10 years to lose 78 pounds. At this snail pace, it could take me the rest of my life to get to 19 percent body fat! At some point, aging does accelerate, and even though the Boston qualifying times do slow with age, they don’t slow THAT much. The time for me to run well is now, today, right here, in THIS body.

I have decided to eat at or near maintenance. Some days more, some days less. My body composition on race day will be my body composition. My fitness on race day will be my fitness. I am going to give everything I have this year to train hard, fuel smartly, enjoy life, be productive, stay healthy. I will show up to that starting line in the best shape of my life. And if the finish line clock says 4:00:59 or less, dream accomplished.

But you wanna know the coolest thing? If the finish line clock says something slower than 4:00:59, dream accomplished! What! How can that be! You spend an entire year training with everything you have, recording your intake in the daily plate, measuring your output with the gowearfit, doing speedwork in the 88 degree florida sun with 90 percent humidity, waking up at 4 am on a Saturday to meet your running buddies for a 20 miler, plunging your legs in an ice bath to aid recovery, passing on that yummy shiraz because you have a 15 mile tempo run the next morning.-You have made all of the sacrifices and you miss your goal? You miss it by a minute or an hour. You miss it by an inch or a mile.

Here is the other big lesson learned from crash number three. It isn’t about the outcome, it is about the process. I crossed the finish line of the Disney Marathon in 2000, weighing 208 pounds in 7 hours, 13 minutes and 52 seconds. If I cross the finish line of the Spacecoast Marathon weighing 150 pounds in 4 hours and 1 minute, one second past the time I need to qualify for Boston, I am victorious. I may have lost my Boston dream, but I have won my battle against obesity. I have proven to myself that I am capable of maintaining a lean, fit healthy body. I have beaten the odds. The odds of losing 80 pounds and maintaining that loss for a lifetime are abysmal, like less than 5 percent. but I am doing just that. I have beaten the odds. Will I beat the odds again and be a woman with 26% body fat who qualifies for Boston? Who knows. One thing I know for sure-I will be celebrating at that finish line. I will be celebrating the woman that I will become during this year of hard training and sacrifice. A woman who is more than just a number on the scale, a percentage of body fat, or a time on the race clock.

At the end of the day, we really don’t know how many heartbeats we get to have in these bodies. I want to make sure that I spend my heartbeats doing activities that I love, with people I enjoy. These day to day, moment to moment, beat to beat activities are the basic building blocks of our lives. And if all you do is focus on the outcome, become attached to the outcome, and miss the glorious process, than you are wasting your precious heartbeats.