Everything will be alright once I start running

75km in 3 days over breathtaking trails in Sweden. I signed up for it without a second thought. What a way to kickstart my 6-week of time off from work! To prepare for it, I ran a total of 3 x 10km trails in MacRitchie reservoir (one time even when I was post-call!).

I packed light for my trip as usual, bringing just 1 running vest, running shorts, dri-fit t-shirt (in case it got cold), arm warmers, gloves, full length compression tights and my Vibram Fivefingers shoes. I will discover how grossly inadequate my packing list was in the days to come...

Friday: Stage 1 (24km)
Everyone was decked in their hydration vests and had windbreakers stashed away. There I was in my 2-Iayers, arm warmers, compressor tights and shorts. I felt sorely under-dressed for the cold and what lay ahead.

The run started off well with my Vibram gripping onto every surface with ease. I felt like a mountain goat skipping across the terrain. Trail running works your mind in a way conventional city running does not. One has to at all times plan one's footing, watch for danger and continuously reassess one's plan of advance. Furthermore, trail running utilises more muscle groups compared to city running and this somehow makes it less tiring (maybe it is just the exposure to nature that excites and invigorates me).

At the finish of stage 1, my feet were so sore that walking was almost unbearable. It was then that I realised I did not have enough mileage on my Vibrams prior to this event; my feet were unprepared for the punishment that was metted out. In order to survive stage 2, I decided against the old adage of not wearing a pair of untested shoes on race day - I borrowed a pair of Icebug Acceleritas 7.

Saturday: Stage 2 (29km)
Sleep does wonders. I woke the next day with renewed vigour and less sore legs. The first 10km was amazing, my legs were firing and the shoes provided excellent grip on various surfaces which made running carefree. Things went downhill after that though. However perfect those shoes were, the fact was that I had never broken them in before; my feet ended up broken by them instead. At the 24km mark, I was in so much pain that I decided to walk the last 5km bearing in mind that there was another day of running in stage 3 the next day.

Sunday: Stage 3 (22km)
I woke to a rude shock that ALL my running paraphernalia was soaked from the rain overnight. I left them out to air, using the same attire for all 3 days (I know, I can be digusting). It was 3hrs to the start, there was still time. I wrung my clothing and started to look for tips online for quick drying. To my surprise, there were many lifehacks available! Placing my semi-dry clothing into a dry towel, i wrapped it up and stepped on it to remove excess moisture. I then left them out to air dry.

By the time it was to get dressed, my clothes were damp but almost fully dried. It is an experience to wear damp clothing and socks on a cold day prior to a race. I was at my lowest in terms of morale. My foot was taped up a various pressure points to prevent blistering in a shoe that I was not used to. It was the worst possible way to start a race.

Once we started running though, all my concerns went out the window. Which brings me to my point: everything will be alright once I start running.

1. The cold sorted itself out once I ran and generated heat.

2. My tired legs went into motion after 4-5km once my muscles warmed up.

3. Blisters and pain somehow disappeared when I ran possibly secondary to the release of endorphins or the scenery that was around me.

I played back the last 3 days of running as I was dragging myself to the finish line. Life parallels trail running: you never know what to expect, and have to adapt to the situation and terrain as needed. Furthermore, there are times when you are too tired to go on, but somehow find it deep within yourself to eke out just that little more, placing one foot before another. Repeatedly. You will get there as long as you keep moving. I find this deeply sobering when extrapolated to life.

I will get there as long as I keep at it and persevere. Until then, keep running as everything will be alright once I start running.

6-monthly reflection 2

This week long annual leave came at a rather apt time. This was my first break in 2019 (not counting the 5 days taken for the exit MCQs). Among the many things jostling for my attention, one stood out the most - my journey in becoming a surgeon.

As to when exactly did I begin to become numb to my work I cannot remember, but I would place the period sometime after my KTPH posting. It was only recently that I realised I do not recognise this person I have become. I was just going through the motion of work, the flame was gone; I was just an outer shell, not unlike a machine.

WHO has now defined burnout in its latest edition of the ICD-11 as “a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed.” The syndrome was characterised by:

1.       Feelings of energy depletion or exhaustion

2.       Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job

3.       Reduced professional efficacy

I came across the above while reading some articles about depersonalisation. Reading it felt like I was reading about myself, every word rang true and it was scary. I have always been a very private person, choosing to sort things out on my own rather than seek help. Understandably, I do not believe in counselling - that process was for people who are weak. I cannot be more wrong.

This time away from work, albeit short, has kickstarted in me a process. I have sought help from a Christian counsellor, met up with a lifecoach and very roughly made plans for the next 6-months of 2019. I believe when you are at your lowest point, the only way is up. I have to alter my trajectory if I wish to continue on my journey to become a surgeon.  

“Do you still want to become a surgeon?”

I recently read Atul Gawande’s Complications, the chapter ‘when good doctors go bad’ stood out especially to me. I am sure that if I do not do something about my situation, I might end up harming patients like Dr Hank Goodman. I appreciate that there is a system in place to address this behaviour before it spirals out of control or before someone gets harmed.

The answer to the question above is: “YES”, and I will and must bring about change that is sustainable which will see me through the rest of my career. I am looking forward with fear of the unknown but filled with hope that something good will come out of this. That I am sure of, in the end, it will be OK.