Monday, April 30, 2018

Dirty Fury Stage Race: 2018

You may recall the Dirty Fury Stage Race from my 2017 recap, notable for 3 straight days of gravel craziness culminating in me missing a bag drop and my brain deciding I was dying from hyponatremia, hypoglycemia, and just Texas being Texas all at once, which all worked out swimmingly in the end, particularly after I went home and ate a whole jar of salsa.

The landscape was quite different for Dirty Fury 2018 thanks to a cold wet spring, yet wonderful in its own way. That’s the beauty of returning year after year to the same gravel grinders. A pavement 5k is going to look the same no matter what the preceding year has wrought. Perhaps you get rained on one year or you wear a different color pair of socks, but it’s largely going to be the same. There’s comfort in consistency and predictability. And while you hope the essence of your favorite gravel grinder stays consistent, the gravel itself does not necessarily do that.

Life also changes. In 2017 I was relatively bright-eyed when I showed up Friday morning, had 3 days worth of food and camping gear in my car, and could’ve done my work from the Jacksboro Community Center if I had to for several days. Ah, the luxury of flexible time.

In 2018 I shoved random items that might be useful for riding bikes and sleeping outside in my car at 5am on Friday, worked 13 hours, stopped at Trader Joe’s on my way out and bought 3 large bars of chocolate because that seemed like suitable gravel stage race sustenance, drove to Jacksboro TX, rolled out of my car and laid in the grass, mumbled some incoherent things including my intent to sleep right there, and then eventually got up and into a tent after multiple people pointed out that the thunderstorm apocalypse was coming.

Race organizer/Spinistry grand master Kevin Lee had already made the call to switch Saturday and Sunday’s courses given the weather forecast. Unlike last year’s 3 days/80-110 miles per day format, the 2018 version had moved to a planned two-day format with 110 miles on Saturday and a 42 mile race on Sunday morning/10 mile TT in the afternoon. The 42 mile course was more flood-friendly so we did that on Saturday instead. The TT was canceled. I have no top end and am currently on a drop-bar mountain bike, so I did a little dance of joy.

The 42 mile course was new this year, although I recognized the beginning and end as overlapping with Sunday’s course in 2017 (mostly because of the house that gave us Powerade after being bone-dry for 30 miles. See: missed drop bag.) There may have been other familiar parts as well, but they were rendered unfamiliar by the rain. Lots of sinking in sand, one flat tire, and a short hike-a-bike later we were back at home base, where I was repeatedly told I had mud in my hair (GASP). (I did subsequently wash the dirt out of my hair, lest the Feminine Police come to get me, however I discovered the next day that there was still dirt on my nose. Fail.)

After en masse calorie consumption, most riders retreated to their hotel/motel/home, while the four really dumb ones (present company included) went back to the race site to brave the next few cells of severe weather. We spent some quality time in the rec center gymnasium and then, after much effort and with the assistance of a sardine can filled with gasoline, were able to get a campfire going without setting ourselves on fire in the process.
2 Better weather, and coffee.

              Sunday was like a new day. Well, it was a new day…but you know what I mean. Sunny, dry, and 50 degrees. The biggest challenge would be head winds. The 110 mile course wound west through Graham, then dipped south before ending back in Jacksboro. The previous day’s rain had left some of the sandy sections soft, but the hardpack and loose rock that comprises most of the route had dried out. The geometry of a mountain bike was less than ideal in the wind, and I wished to the Gravel Gods for aero bars, but none magically materialized. A rogue water table at mile 45 and a Dairy Queen at mile 66 did, however.

              Miles 85-95 become distinctly deciduous, so much that I remembered Wild Pig Road (the road where a family of wild pigs ran in front of me last year. It has a different, much less fun name in actuality.) I waited patiently for the Pit of Despair, which was a long stretch of lacrosse ball sized loose gravel inhabiting mile 90ish last year, but it never came. I almost felt cheated, but ran into a road being actively resurfaced shortly thereafter. After dodging the road resurfacing equipment and getting a lot of strange looks from the tractor dudes, I found a rideable line in the rutted loose dirt, and was promptly chased by a dog that did not care one whit which line I wanted to ride. We all lived to tell the tale and the dog got a bonus Honey Stinger waffle out of it.

              The end of every stage of Dirty Fury follows a deceptively long cinders path around a lake before dumping you back at the rec center and campground. Like all good gravel events, it involves hopping a fence at some point, and has some short punchy climbs and surprise loose rocks, just for funsies. It’s a peaceful (and joyful, on a Salsa Cutthroat) way to end the long ride and take in the views.

Monday, April 16, 2018

Bikepacking Oklahoma & North Texas

Because...why would you ride your bike into the middle of nowhere self-supported for one day when you could load it up with your camping equipment as well and go for multiple days?

There is something about having to rely solely upon yourself and what you can carry, about being outside totally disconnected for a few days. Realizing again how little you actually need. How much the people around you matter more than anything else. Or having no one around you and finding yourself again on an empty long red road.

Here's to ever more trips.

Trip #1: Tulsa, OK -> Lake McMurtry (via Stillwater, OK)
Solo roll.

Kona Big Honzo DL loaded up with Oveja Negra frame bag, dry bag roll w/ Wanderlust front pack,
Nuclear Sunrise chuck bucket, and tent poles strapped to top tube.

After the first 20 miles out of the city, I took 60 miles of mostly gravel roads until hitting downtown Stillwater for some Aspen Coffee and 1907 Meat Co refuel. The last 15ish miles up to Lake McMurtry to camp. Same process in reverse the next day.

Trip #2: Denton, TX -> Muenster, TX

Party of 2.

Specialized Crux w/ Oveja Negra frame bag, Rogue Panda top tube bag, dry bag roll w/ Wanderlust front pack. 2 person tent on the bike that's not a 48cm frame. Jones bar envy.

Classic Texas white slushy gravel once out of
town...slushy because the weather forecast lied to us, which it often does. Barbecue and 4R Winery & Ranch at the end are powerful motivators. 70-some miles, 25 mile ride around Muenster, 70 back the next day.

Trip #3: Tulsa, OK -> Osage County, OK

Native Lands Tour. Sizable group. Female n = 4.

Specialized Crux w/ Oveja Negra frame bag, Rogue Panda top tube bag, dry bag roll w/ Wanderlust front pack, tent poles strapped to down tube.

70-80 miles x 2 days of the best of Northern Oklahoma prairie land.

Write-up and some sweet photos can be found on my Gravel Cyclist article here. Including a great demonstration of what to do if you happen to forget your non-bike shoes.
Never forget your rocket fuel.

Wednesday, April 11, 2018

Wellness for Physicians, & Why It Matters

As I've transitioned from primarily research & teaching back into the clinical realm, I've been looking for ways to bring my worlds together - so I'm excited to be a part of the Academic Life in Emergency Medicine's Wellness Think Tank this year.

Wellness has been getting a decent amount of attention within the healthcare field for the past few years, and for good reason. Burnout rates are high (with emergency medicine being the highest), and resident & physician depression and suicide are finally being talked about. The New York Times has published many articles on physician wellness, or our current lack thereof.

But what is wellness? It's gotten a lot of lip service lately...but what's actually been accomplished?

While it has been encouraging to see the increased attention to physician and resident wellness in recent years, there’s a lot of work to be done still – and the solution is not yet apparent. Creating educational programs for stress management and having wellness days is all well and good, but it’s essentially a bandaid – physicians aren’t burnt out because they don’t know how to take care of themselves or are lacking ice cream socials in their lives, they become unwell with the cumulative toll of daily micro-hits from the (often subconscious) emotional toll of managing difficult patients, time spent fighting with Electronic Medical Records, depletion of cognitive resources after a long shift, and looming worries of litigation.

The essential problem is that these aren’t things we can make go away (at least anytime soon and without significant nationwide systemic changes in healthcare) – so if we can’t take away the underlying source of un-wellness, we have to figure out how to help each other manage better. 

After building a research program of cognitive neuroscience centering around brain changes associated with stress, stress reduction interventions, and resilience, I began thinking about how this same line of work could benefit physicians in terms of wellness and managing symptoms of burnout. There’s a lot of potential for resilience training to be incorporated into residency education, using similar techniques (e.g. targeted mindfulness training) that the military has recently implemented. We need to start doing these things during residency, particularly for emergency medicine residents, to ensure career longevity (and this isn’t only for our well-being, it will have a direct impact on the quality of patient care we’re able to sustain over the course of our careers.)

So here's what I'm hoping to work on implementing:

First, I think a key step is to give people the information on why this should work - by going through what we've already shown about the neural and physiologic effects of mindfulness training (focus on emotional reactivity, non-judgment, and resilience aspects). From giving previous lectures to academic populations, showing science-minded people (e.g. our MDs) that you actually affect physiologic parameters by doing these things greatly increases buy-in.

The next step is to create a curriculum for resilience training exercises - similar to what exists in popular apps like Headspace & Calm, but specifically targeted to things that will help physicians the most – think non-reactivity, non-judgment, open monitoring. Ideally, we can also incorporate mental training techniques for enhancing situational awareness, which is key in a high-performance, critical care setting. Other keys: make this as easy and accessible as possible. Short and high-yield.

Finally, we want to know if it's working. An online form for evaluation, looking at effects (or lack thereof) on both perceived emotional wellness and job performance. What's the eventual dream? Being able to have a “smart” algorithm for advancing such a training program with further targeted exercises (to strengths, weaknesses, and goals) at the individual level.

Tuesday, April 10, 2018

It's been almost a year since I posted on here. Whoops.

I've been writing. Mostly ride reports and rants on women in cycling, for Gravel Cyclist (linked in Writing). Mostly I've been off being an emergency medicine doc, and trying to train, which has really just turned into trying to be outside every now and then, which is necessary to let all the things out that accumulate over hundreds of hours of that kind of work.

And sometimes that means not riding the best tactically that you might, or the fastest that you might, but riding the way you need to. Which may mean staying in a big gear up a hill so you can feel some hurt, and then sitting in a ditch and crying for a little while because you want to. And there will be those people that get that, and those that don't.

Next up...the things I've been working on when not on a bicycle.