Doctoring, cycling, blogging and the “plan”…

Spring in the Ohio valley has brought hours upon hours of gloomy rain.  We are indoors, and reflection is on the docket.  Seven months have passed since the blog journey began.

Why do I have a blog, or some may call it a cocoon.

I ask myself this question a lot.  The EP lab and the office are busy. Riding bikes is fun, and to compete requires a few hours a week dedicated to training.  This weekend, parenting took the form of congruent triangles and geometric proofs. (Thanks, Sal) This past week there were 2 four-hour track meets in which Will ran for about eight minutes each.  Life.

Yet, the blog draws me in. Medical practice seems to exude tellable stories. Clinical vignettes, human stories, educational discoveries and the silliness resulting from non-clinicalians inserting themselves into the delivery of care.  Doctoring seems an infinite source of words.

Additionally, there is much irony in the union of an electrophysiologist, who implants internal shock boxes solely designed to arithmetically increase longevity, with a palliative care physician whose intellectual level of advancement allows the acceptance and inevitability of death.  In accepting the realism of death, the skillfully administered relief of human suffering at the end of a person’s life provides a steady stream of inspiration.

As if this wasn’t enough material for a blog, there is the metaphor–the religion–of the bike. The bike even illustrates the “plan” for success.

The “plan?”

In preparing for an important bike race–or just honing peak fitness–the “plan” is called into action. Some components of said plan are worthy of words.  But not too many, as the plan is by definition simple, and therefore does not require droning on ad infinitum.

The plan works for most everything: take the bike and doctoring as just two (of many) examples.

Baseline requirements of the plan include a certain level of genetic favorability:  An offensive lineman is just not going to make it as a bike racer.  Like certain talented individuals, say an artist or a mason, may not be well suited for doctoring.  It’s OK.

Years are required to hone the skill:  A well known phenomenon in cycling is the cumulative strength gained over years.  Some call this muscle memory.  It’s akin to medical school, residency and years of practice where experience makes a doctor wiser,.  That is of course until the old doctor, like the aged cyclist, reach a time where life (realism) mandates a new chapter.

Peaking for a race requires a gradual build-up of training. The formula calls for gradually increasing the duration of rides, varying the intensity and working hard on weaknesses   This is what good doctors do.  They have periods in which the intensity of work rises and new procedures (treatments) are learned.

Inexorably linked to cyclical increases in intensity are periods of rest.  Rest allows the body, in the case of the cyclist, and the mind, in the case of the doctor, to rejuvenate and come back stronger.  For peak performance, the notion of rest is the most critical.  Cyclists know the sensations of getting on the bike after a period of rest–often forced by injury or some other means. Your legs generate tension that seems magically endless.  That same sensation can be felt in doctoring. Take for example my experience last year, after two shoulder reconstructions and three months in a sling.  I was rendered completely unable to hold a catheter or pacemaker lead. However, when I returned to the EP lab (which was still there), the sensations of doctoring were similar to the rested cyclist.

Sadly though, despite experiencing the amazing sensations that adequate rest brings, many cyclists and doctors persist with the more is better philosophy.  More miles, more intensity and more racing is addictive to many cyclists.  Doctors are not immune to this addiction either.  Many doctors drink the elixir of more procedures, or more patients to see.  Like the flat tired legs that excessive training brings to the legs of a cyclist, so comes the erosion of the joys of doctoring too much.

So why do I blog?

I am still not sure, but it could be as simple as positive sensations.

JMM