Medieval Hernia Surgery courtesy of Medscape.

You may not know this, but I’ve been injured for a while. It’s been a trying twenty-two months (so far). As one Twitteronian put it, “Man, that’s the longest groin pull in history.” I took this as a compliment. To those who have endured my interminably personal posts, comments, tweets and updates, I thank you from the bottom of my, well, you know.

Alas, my nether-regional monomania has alienated at least one woman. A long-lost friend resurfaced on Facebook to write, “Why are all your status updates about your groin? I know we haven’t talked since 1988, but I have to tell you point blank, I’ve had enough!”

Such are the vagaries of human perspective. I feel as if I’ve shown remarkable restraint on the subject. I’ll spare you the specific details of my reply. Suffice it to say, groin jokes tend to write themselves.

Obviously, I haven’t yet recovered. I run a bit, but nothing like I used to. Recently, I was sent into a near apoplectic tizzy at the prospect of an honest-to-goodness diagnosis (a sign of how far I’ve lowered my expectations). Apparently, I suffer from something called Athletic Pubalgia. Think of this as a sports hernia equipped with a Romulan Cloaking Device. For some time, I have described pain, and sophisticated medical instruments have revealed no cause.

Only through careful process of elimination and diligent reflection have my medical team (yes, team) come to the conclusion that I have the dreaded, nebulous AP. It seems surgery is the only solution. This doesn’t bother me, but can a man truly embrace a procedure called Pelvic Floor Repair?

This sounds suspiciously like home improvement. “The lateral support in these joists are shot. You need a full pelvic floor repair. Yup.”

Next thing you know, you’re constantly at Lowe’s, spending more money than Lady Gaga spends on translucent acrylic undergarments. Nothing goes as expected. Midway through the repair job, an improbable, ancient sarcophagus is found in the subfloor, necessitating a visit by the Smithsonian Institution’s artifact recovery team. The extraction causes so much damage that the contractor tells you, with no hint of empathy, that the wiring and plumbing for the entire house must now be replaced. You’ve become the manic-depressive speculator in an exceedingly disturbing, highly personal episode of Flip This House.

Yes, it’s fair to say I’m nervous about groin surgery.

But I’ll do nearly anything to solve this problem. Fellow runners understand this implicitly. Assuming my insurance company agrees that the solution to two years of chronic pain is something they might consider covering, I’ll give it a go; even if it means being strapped upside down to a medieval operating rack.

I just want to run again.

- Dean
@zerotoboston

Winston Smith, gangly father of three, staggered across the finish line, his breath coming in wisps of labored wheezing. Streaked with grotesque rivulets of dried salt, he struck an image of one who had endured terrible hardship and emerged decidedly worse for the wear. Smith had just miraculously survived the 2009 New York City Marathon.

He was one of the lucky ones.

Death by Marathon
The marathon is a relentless killer, extinguishing the lives of spirited weekend warriors at an ever-alarming rate. Runners expect to achieve glory. Instead, legions meet their sudden demise on the course.

The numbers are sobering. With the savage appetite of a celestial black hole, the marathon devours nearly eight millionths of all participants, a figure containing plenty of zeros. Specifically, .000008 of all marathoners die during this grisly race.

Such exceptionally high numbers give mathematicians pause. According to one concerned set theorist, “It doesn’t take Pythagoras to see that average deaths have reached the 6th significant figure to the right of the decimal. I’m no alarmist, but I calculate the chances of death during the marathon as dangerously far above zero, infinitesimally speaking.”

As shocking as these numbers are, they merely reflect races held in the United States. Worldwide fatalities are surely much higher. Details are sketchy. We literally have no idea how many marathoners have joined the choir invisible under Moldova’s Vladimir Voronin or Sri Lanka’s Mahinda Rajapaksa. We may never know.

One thing is certain, ever more naïve, casual athletes attempt the marathon each year. In 2008, an estimated 425,000 runners (in the U.S. alone) made the fateful decision to entrust their lives to the cold embrace of statistics. In 2009, 465,000 people tempted the grim reaper. If these stunning numbers continue to spiral, the marathon may become one of the deadliest activities known to man, rivaling only encounters with a cow, falling down, and daring to exist during the month of January for sheer morbid lethality.

Fortunately, most runners fall prey to debilitating injuries that prevent them from running the marathon in the first place.

Smith’s Feat Warrants Investigation
The extraordinary Winston Smith somehow avoided injuries, survived training and astonishingly escaped the 2009 New York City Marathon with his life. Were other runners as mysteriously fortunate? How many died in their quest to scratch an item off of the definitive bourgeoisie bucket list?

Available records indicate that, inexplicably, of the 43,741 people who ran the five-borough death trap, precisely none died.

This improbable wellspring of life can only be attributed to gross error, statistical oddity or, more ominously, sinister cover-up. For the sake of all involved, the startling lack of fatality in New York must be investigated immediately.

Given the overwhelming odds against living through the marathon, how could Smith have possibly lived to tell his tale? Does he even exist? What did race officials know, and when did they know it?

The public demand answers.

- Dean

A WORD ON THE NUMBERS
Running USA provides and excellent look at marathon participation statistics.

The most often quoted study for marathon fatalities (Redelmeier and Greenwald – BMJ 2007) concluded that on average, .8 marathoners per 100,000 die during the race. This is apparently the most recent, detailed and oft-quoted study related to marathon mortality. It forms the basis for the figures in this post.

Some feel that 1 of every 50,000 participants die during the marathon. Even if this lower figure is entirely correct, just .00002 of all runners die during the marathon. This is a very low number.

However, neither figure is so low that it escapes the eyes of sensationalists.

SPECIAL THANKS
Thanks to The Bigger Design for the lovely Pie Chart, and to Mr. Davidson for mathematical fact-checking.

Indirectly relevant photo by QuietDelusions courtesy of Flickr.

A burst of speed at the end of a marathon is exceedingly rare, but it happened to me once. Usually, one can’t summon late race heroics from weary muscles. But there I was at the Myrtle Beach Marathon feeling relatively fresh at mile 24. As I passed fading runners, I began to sense an excellent finish. You’ll just have to trust me. This sort of thing doesn’t happen very often.

Positively ebullient, I passed the 26-mile marker, primed for excessive celebration. That’s when I saw her. As I rounded the final corner, twenty yards ahead, mercilessly taunting me by her very presence, was a white haired old woman in Asics and a singlet.

She was going to beat me.

Defiance rose from deep within the arcane recesses of my masculinity. Flush with what I assure you were entirely natural performance enhancing intoxicants, I surged forward, determined to finish before this usurping senior citizen. I remember literally screaming to myself, “No way grandma!”

But then, my practical sense emerged from the biochemical fog. Was I really racing an older woman? To be sure, she was fit and quite capable. A 3:30 marathon is nothing to sneeze at. But let’s face it, she could collect social security and something had to be done about that.

As we jostled for position, I heard two distinct sounds rising from the crowd. Wild cheering overflowed for the white haired woman. Malevolent boos and derisive insults were hurled at me. No amount of hormones could save me now.

Consider the unmanageable difficulty of my situation.

Anyone who would pass an old woman in sight of a marathon finish is, by definition, a jackass. There’s just no way around this. However, anyone beaten by an old woman in an endurance race must be hopelessly feeble. This horrible realization makes one want to pass old women in the first place. To pass or not to pass; both options are wholly untenable. Worse, the consequence of one choice makes the other choice totally necessary, so there’s simply no way to win. It’s Heller’s Catch-22 for runners.

I had only a split second to make my choice. Like any red-blooded, hyper-competitive marathoner within sight of the immortal finish line, I bolted. Grandma ate my testosterone-laced dust.

In Chariot’s of Fire, Eric Liddell ran and felt God’s pleasure. That must have been nice. As I dashed forward, I could feel the mordant stares and quiet disgust of outraged spectators. As I crossed the finish line, the enormity of my blunder became clear. I had blatantly, unashamedly run down kindly Carole Findley, 66 of Raleigh, North Carolina. I felt like the devil incarnate.

Carole of course, finished to thunderous applause despite struggling through the final hundred yards (I suspect she may have been playing to the crowd, but I can’t prove this.) In the finisher’s chute, I sheepishly received my ill-gotten medal. I finished the marathon with rare strength and couldn’t enjoy it, even slightly. Avoiding eye contact with the masses, I skulked away.

Since then, I’ve cultivated a healthy grasp of competitive etiquette. I wish I had shown greater maturity at Myrtle, particularly in light of one painfully salient fact: Carole ran the half rather than the full marathon that day. Had I known this at the time, her 3:30 would have seemed a tad less threateningly impressive and the whole day might have gone differently. As it stood, I beat down an older woman who ran 16-minute miles (probably a personal best) in an entirely different race. And I had to kick into high gear to pass her. Even my act of strength revealed weakness.

So Carole, I apologize for my callow buffoonery. I’d like to make it up to you someday; perhaps we can meet for dinner at the Piccadilly Cafeteria and enjoy Bingo afterward… my treat.

- Dean

APPENDIX: OFFICIAL RESULTS

2007 Myrtle Beach Half Marathon
Carole Findley – Age 66 (Really, not old at all)
3:30:08

2007 Myrtle Beach Marathon
Dean Schuster – Age 36
3:28:52 (PR at the time)

Sylvia Collins – Age 65
3:31:21 (Whew, I’m glad I beat the amazing Sylvia.)

Photo by annette62 courtesy of Flickr.

I run with some hilarious characters.

There’s this one chap, well read and possessed of a keen wit, who regularly and zealously rouses the locals for the weekend trail-running binge. He’s become a sort of town crier. Every Friday, he announces the training run, reports on our latest trail ultra results, and offers a succinct weather report. We’ve come to expect and enjoy it.

With the advent of summer in South Carolina, his job has become much tougher. You try convincing people to run eighteen to twenty miles in the oppressive June heat. In the South, one feels the robust heat index and heady dew point at dawn. It can break the willpower of the most determined runners.

Undaunted, our intrepid motivator has offered up a clarion call to our group and to runners everywhere. Today, he sent out a singularly amazing note. If this doesn’t get you out of bed in the morning, I don’t know what will…

Brothers & Sisters,

This week I’d like to talk about sin. Not gluttony; not sins of the flesh like coveting your neighbor’s wife; not using your mouth to blaspheme instead of raising a joyful noise. No brothers & sisters, I am here to save you from the sin of sloth.

Papists called it “Acedia,” and they numbered it among the Seven Deadly Sins—the worst of the lot. You may know them as the Cardinal Sins. Maybe your grandpappy called them the Mortal Sins. Regardless brethren, I’m here to remind you that idleness and listlessness are the handmaidens of the Devil—the tools of Beelzebub himself.

So I’ll tell you what we’re going to do. First we’re going to congregate. Then we’re going to motivate. We’re going to ambulate. And I can guarantee we will perspirate. We are going to cast that demon Sloth right out of our temple! Are you with me brothers and sisters? Hallelujah!

Yes, mighty temptations face us. We are tempted to stay in bed. We are tempted to put things off until tomorrow. Some say the forest is too big, the trail too long, the weather too unbearable. But it is not so. The forest is not too big when you run with your friends. The trail is never too long when others are there to encourage you. The weather is not too unbearable when you meet it with the joy of the Holy Ghost!

No burden will be placed on you that you cannot overcome. I can testify before each of you, the first step out of bed is the hardest step you will take. If you take that leap of faith, you’ll find yourself helping carry the burden of others and discover the load you carry yourself lighter because of it.

Look to the Good Book for guidance; the book of Hebrews in the New Testament:

“Let us run with endurance the race that is set before us.” [Hebrews 12:1] “For you have need of endurance, so that when you have done the will of God, you may receive what has promised.” [Hebrews 10:36]

Can I get an Amen?

Sunrise service will be held at the outdoor tabernacle of Harbison Forest at 5:40 a.m. The forecast calls for heat: 74 degrees and 84% humidity at dawn. Hot? Yes, my friends that is hot— but not as hot as the eternal fires of damnation.

- Deacon Rick (The Other White Meat)

I expect to see everyone in church this weekend, full of the sorrow that leads to repentance.

- Dean

Photo by TravISU courtesy of Flickr.

If you’ve run a road marathon, you’ve probably heard an encouraging word from a volunteer or spectator. These folk mean well. Full of enthusiasm and wholeheartedly devoted to your cause, they shout, “You’re almost there!” and “It’s right around the corner!” If you’re seriously lucky, they’ll boldly proclaim, “You look great!”

These are all lies.

You’re not almost there. The finish line is not right around the corner, and you look far, far from great.

Don’t get me wrong. I appreciate lusty support. But what if marathon fans couldn’t use standard catchphrases? What if they were restricted to the raw, brutal truth? If so, somewhere around mile 22, unsuspecting runners would find themselves absolutely blitzed by excessive honesty. Imagine the wide-ranging, rather bizarre cheers:

NAUSEATING
“You can keep that vomit down for another mile, I know it!”

CRUEL
“You have no chance of catching the senior citizen in front of you.”

OBLIGATORY
“You’re the only runner in sight. I offer half-hearted, token applause.”

REPULSIVE
“Your bloody nipple shirt offends us, sir.”

INSULTING
“Hey look, it’s Abe Vigoda!”

INSENSITIVE
“Can you hurry things up a bit? The police need to pick up these traffic cones.”

INCREDULOUS
How are you still upright?

BLUNT
“All this effort for a cheesy, cotton T-shirt?”

PERCEPTIVE
“You appear to be running dangerously low on hope.”

NERDISH
“The Salt Vampire from the original Star Trek has nothing on you!”

EXISTENTIAL
“You know, I really just don’t see the point.”

SELF SERVING
“Hey sweatipotimus! Five dollars says you get a class-A dehydration cramp before the next aid station.”

CONDESCENDING
“From the comfort of my curbside lawn chair, it’s exceedingly easy for me to tell you to run faster.”

ALARMED
“We need an ambulance at mile 22, STAT!”

BLEAK
“The winner finished like, two hours ago.”

Now then Intrepid runner, wouldn’t you prefer lies? Who wants the truth when you’ve got four or five oppressive miles to go?

At least fans care enough to show support. Goodness knows they’ve probably got more constructive things to do. Most just don’t know any better. If they truly understood the unending, quasi-hallucinogenic misery of the last few miles of the marathon, they’d add subtle nuance to their spin doctoring. They’d avoid exaggeration altogether.

But, I don’t want that.

Fans, you keep right on telling me I look great. I know it’s a lie. You know it’s a lie. It will be our little secret, the proverbial elephant on the course. We’ll be as comfortable together as politicians and voters.

Beyond turning a deaf ear to alluring half truths, I have a practical solution. Fans, position yourselves after the 25-mile mark. Then you’ll be free to say whatever you please about distance. At that point, even the most morose, pessimistic runners will concede they’re “almost done.” Fans aren’t censored. Runners are too buoyant to care. Everyone wins.

Better yet, cheer during the final .2-mile stretch run. There, you’ll have carte blanche to say damn near anything to me. Nothing can offend when I can see the finish line. Call me Abe Vigoda. Insult my beatific grandmother. Heck, announce to the crowd that I heartily enjoy kicking puppies. Knock yourselves out.

But before this remember, I look fabulous.

- Dean

Kentucky Derby Marathon and Mini-Marathon runners needed nourishment for the miles that lay ahead.

When making lemonade from lemons, consider context. Never make lemonade for your diabetic aunt or for people with citrus allergies. You may inadvertently harm them. Similarly, if you’re an injured athlete who wants to run “just for kicks,” don’t race a half marathon in a polyester suit jacket.

Not one to heed my own advice, that’s exactly what I did. I ran the Kentucky Derby half marathon dressed as the inimitable Colonel Sanders. The man has achieved legendary status in Louisville. The plentiful lamppost banners and colossally gigantic downtown mural convinced me. He’s a big deal in this neck of the woods. I just don’t know how he handled the heat in that suit.

Polyester doesn’t breathe in the best of circumstances, least of all in sizzling conditions. By 6 a.m. on race day, temperatures reached the upper 70s, perfect for sipping iced tea on your veranda, but punishing for a long distance race. I certainly didn’t have to wait long to feel the effects of the heat. Perspiration began in earnest on the bus ride to the starting line. During the race, I needed to stop occasionally to avoid getting dizzy (let alone extra crispy). Thankfully, I opted for shorts instead of trousers.

The wig didn’t help. Besides oven-roasting my head, it made me look more like Mark Twain or Albert Einstein than Sanders. The shocking eyebrows completed the Muppet-esque caricature.

Not content to simply look the part, I carried a bucket of the Colonel’s secret formula, original recipe fried chicken with me at all times. I convinced as many runners as possible to enjoy the deep fried goodness. I carried the bucket for the entire race, but I did not partake. As a personal rule, I never consume corn syrup solids and saturated fat during rigorous exercise.

I also spoke in an aristocratic Southern accent. From the pre-dawn bus ride to the post race stretching routine, I embodied the Colonel. All older women were “young ladies,” fried chicken was the currency of champions, and gentlemanly Southern manners ruled the day.

I didn’t race well, finishing with my slowest half-marathon ever (2:03:45). But it hardly seemed to matter. As the iconic Colonel, I enjoyed unceasing, vigorous crowd support, posed shamelessly for umpteen photos along the course, high-fived countless kids and had a lovely chat with Louisville’s courier-journal at the finish.

For the record, I gave away all of the chicken by mile two, mostly to runners. This includes the thigh and leg I gave to the Elvis troupe.

I had a wonderful time. Just what the doctor ordered.

- Dean

(Thanks to “Rick – The Other White Meat” for the costume inspiration.)

I’ve tried everything shy of ritual sacrifice to solve this vexing groin problem. Now it has come to this: I’m reading medical journals. Normal folk waste their evenings with Facebook, YouTube and detective dramas. I read “The Groin Triangle: A Patho-Anatomical Approach to the Diagnosis of Chronic Groin Pain in Athletes.” Exciting stuff.

Written by professionals for professionals, medical journal articles like this are hopelessly dense. They’re full of esoteric terms like “anthropometric,” “trochanteric” and “tuberosity.” It took me less than three seconds to find these words after I randomly selected a typical three-sentence paragraph.

Technical jargon can be forgiven. But these articles habitually break the most sacred laws of sentence structure. I’m reading English, but it feels like German. I keep wondering when the verb will rear its fearful head. Such is the dilemma for the common man. How can one gain knowledge when it requires both an advanced degree and an interpreter?

Consider the abstract (introduction) for the article I’m currently reading:

RIDICULOUSLY COMPLICATED ABSTRACT
(skimming recommended)
Chronic groin pain is a common presentation in sports medicine. It is most often a problem in those sports that involve kicking and twisting movements while running. The morbidity of groin pain should not be underestimated, ranking behind only fracture and anterior cruciate ligament reconstruction in terms of time out of training and play. Due to the insidious onset and course of pathology in the groin region it commonly presents with well-established pathology. Without a clear clinical/pathological diagnosis, the subsequent management of chronic groin pain is difficult. The combination of complex anatomy, variability of presentation and the non-specific nature of the signs and symptoms make the diagnostic process problematical. This paper proposes a novel educational model based on patho-anatomical concepts. Anatomical reference points were selected to form a triangle, which provides the discriminative power to restrict the differential diagnosis and form the basis of ensuing investigation. This paper forms part of a series addressing the three-dimensional nature of proximal lower limb pathology. The 3G approach (groin, gluteal and greater trochanter triangles) acknowledges this, permitting the clinician to move throughout the region, considering pathologies appropriately.

Remember, the abstract is the simplest part of an article. Call me crazy, but I’m still trying to find the verb in sentence four. Reading becomes more laborious in the body of the article. Unless you’re a trained grammarian, you’ll exhaust your patience quickly.

If you just want to learn about your groin injury? Never fear. I’ve rewritten the article’s introduction:

MY REWRITE
Groin pain is common and worse than you think. Injure your groin and you won’t run, play or compete for months. Forget about a straightforward diagnosis. The human groin is a class-A mystery with anatomy more complex than the plotline of LOST. Groin pain can be maddeningly difficult to pin down. It comes and goes and moves annoyingly from place to place. We triple-dog dare you to clearly describe your vague symptoms.

Your doctor is probably flummoxed, which doesn’t bode well for you. If she can’t figure out precisely what’s wrong, you’ll be up the proverbial creek. Inconclusive tests await. Kiss that deductible savings good bye.

But don’t despair! We have a way to solve this problem. It involves drawing an imaginary Triangle™. Really, that’s all you need to know. We’re pretty sure this will help but promise nothing.

I’ve submitted this rewrite to the authors. I’ve yet to hear back from them.

Longing to run again,
- Dean