My 2013 CrossFit Games

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“How do you balance medical school and CrossFit?” This is the one question to which it seems everyone wants to know the answer. I usually just smile or laugh and remark with a similar expression of perplexity, “I don’t know either – I’m still trying to figure it out!” I could talk about time management tips and strategies for maximizing efficiency, but those who are close to me know that I am far from mastering any of these skills. The truth of the matter is that in my experience, more importantly than time management, achieving balance begins with defining reasonable goals.

Last year, I entered medical school at the Cleveland Clinic Lerner College of Medicine with a goal of also competing in the 2012 CrossFit Games. With a good understanding of the first-year curriculum, I knew that it would be possible to dedicate the necessary time to training while still fulfilling my medical school requirements. Knowing that the path toward these two tasks I was simultaneously attempting to surmount would be physically, mentally, and emotionally draining, it was also important for me to spend time reflecting on why I wanted to pursue each one. As the year progressed, this reflection would prove invaluable as I reminded myself of these reasons with each moment of doubt, frustration, or exhaustion along the way, empowering me to steadily press forward.  The incredible support of family and close friends in and out of the gym also kept me focused and reminded me of what is truly most important in life.

Based purely on my own limited experience, here is my best advice for achieving balance:

  1. Identify your goals and what motivates you, deep down, to achieve them. Why do you want to compete in the CrossFit Games? Or pursue a particular degree, or job? Will this reason be enough to sustain you when the path toward this goal becomes dark and windy?
  2. Decide how much time you have to dedicate to each goal. No matter who you are, there are only 24 hours in a day. My engineering degree is more than a year old now, but I can still do this math: the more goals you have, the less time you have to spend on each one. Family, friends, jobs, etc are all important – prioritize and make sure you spend time on the things that matter most to you.
  3. Work like crazy with the time you have dedicated to each goal to reach and surpass it. Give 100% effort to whatever you are doing in each moment of time.*
  4. Have reasonable expectations.  If you only dedicate 3 hours per week to training, no matter how hard you work during those 3 hours it might be unreasonable to expect to stand on top of the podium at next year’s CrossFit Games (but hey, who’s to say?).
  5. Avoid the temptation to compare yourself to others who have completely different lives and sets of goals. If you are dedicating 3 hours per week of training it would be hard to compare yourself to another athlete in the CrossFit Games Open or Regionals who has the luxury of putting in 15 hours.  Stand firm in your original motivations and the goals you set for yourself and celebrate each of your personal accomplishments.
  6. Take time to reflect. As you work steadily toward your goals, it is important to periodically stop and notice your progress. Notice whether your goals or motivations have changed, and re-direct as necessary.

     *Note: This in itself is a lofty goal and one that I struggle most with!

Now comes the hard part: it is time to take my own advice. As I look toward the upcoming year, I again must define my goals and ask myself why I am choosing to pursue each one. This second year of medical school is a critical one in my program, with increased classroom commitments and a significant demand to prepare for the first medical board exam in June. As I pursue my goal of becoming the best physician I can be, this year stands out as one that will lay the groundwork for caring for patients in the future. Recognizing the importance of this goal and the time commitment  necessary to pursue it, I know that this year it must be prioritized above others, including competing in the 2013 CrossFit Games. As much as it pains me to consider not competing in the sport I love, that has become a part of who I am and who I aspire to become, I know that in this particular year, I have another goal that has to take precedence. I have considered every possibility (believe me, every possibility), and I have decided that rather than giving half an effort to medical school and half an effort to the CrossFit Games this year, I must shift my focus to dedicating a full effort to school and the board exam.

The USMLE Step 1 – My 2013 CrossFit Games

It is important to set our goals high and to push ourselves beyond what we think we are capable of so that we may ultimately reach our full potential.  I believe it is also important to remember that we are human – and that some goals are just too important to sacrifice. I would never want to look back on this year and my career and wonder whether I could have done better had I not been distracted by training for the CrossFit Games. This year my goal is to crush the USMLE Step 1 exam, and in order to reach my full potential in this endeavor I know it requires me to sacrifice training for the 2013 CrossFit Games. But don’t you worry – I’ve still got my eye on the top of the podium in 2014, and training for that particular goal starts today.  😉


Thank You

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Well, this post is certainly long overdue – the whirlwind of starting back at school has kept me busy these past 2 weeks! Much more reflection on my experience training for and competing at the 2012 Reebok CrossFit Games is to come, but I must start by expressing my gratitude for all of the people who have supported and enabled me to follow my dream this year. What you don’t see during that single week in July are all of the moments during the other 51 weeks of the year that make that performance possible. This year, more than ever, I have learned that although it is important to be strong and determined oneself, it is equally important to know when to lean on others. I have been fortunate enough to have leaned on more than a few people this year, and I cannot even begin to describe how thankful I am for their support:

My training partner a.k.a lifesaver, Sarah

My training partner – without her sweating by my side, every single day, I simply don’t know how I could have kept going!

My family – for always encouraging me to do what I love, and loving me no matter what I do

My amazing boyfriend – I think he deserved to be standing up on that podium more than me for what I put him through this year!

The men of my life- Dad, Boyfriend, and Coach

My coach, Doug Chapman – who is much more than a coach, and who brought me from here to the podium in three years. Embarrassing as it is for me, I think this video illustrates that he had his work cut out for him 😉

HyperFit USA Crew in LA

My HyperFit USA family  – for everything over the past 3 years, you guys really are like family

My new CrossFit pals in Cleveland – thank you for welcoming me into your community and for your support and friendship

Training buddies!

My training buddies Shana, Christy, Nicole, and many more – through MANY moments of shared suffering, you girls keep me going!

My school – thank you to faculty, friends, and fellow students who have supported me and allowed me to chase my dream this year

Reebok – for continually striving for improvement while staying true to what CrossFit is all about

Every staff member, volunteer, judge, etc who made the Games possible – Thank you for your passion and dedication to what you do, and for allowing us athletes to have the time of our lives out there

The CrossFit community – for your enthusiasm and energy. To every single person who sent me a message or cheered me on- your support means the world to me!

Reebok, Rx Jump Ropes, and PurePharma – thank you for your support and for your innovation and mission to make people better

And to the man who started it all, thank you for changing all of our lives forever and for enabling us to make the world a better place each and every day!

Coach Greg Glassman

CrossFit for Hope

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As I look toward this weekend, my excitement is building for CrossFit for Hope. In my first post I wrote about the connections we make through CrossFit that allow us to  elevate not only each other but the community as a whole. With so much attention focused on the CrossFit Games this time of year, CrossFit for Hope provides a timely reminder of what the Sport of Fitness is really all about- – coming together to make one another and the world around us better.

We have a truly amazing and unique community that continues to grow by the day. There were 0ver 60,000 participants in the Open this year – pretty remarkable! Now it is time to harness the power of this community to support  a great cause. The beneficiary of CrossFit for Hope,  St. Jude Children’s Research Hospital, epitomizes what I aspire to be a part of as a developing physician researcher – providing the very best patient care and constantly striving to expand the boundaries of medicine.  We have a chance this weekend to support St. Jude’s mission of finding cures to cancer and childhood diseases through treatment and research. Just think – if every participant in the Open were able to raise just $30, we would surpass our goal of $1.7M.

This is what it’s all about, people. Sign up, do the workout, at the very least make whatever donation you are able to your box or someone you know.  I look forward to fighting through the Hope workout and supporting this cause on Saturday with all of you!

“At the root, this isn’t about the elite athlete. What this does is promote the programming. I’ll take a person losing 100 pounds over the Games any day.” – Greg Glassman on the CrossFit Games

“Our specialty is not specializing”

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Having recently turned in my first-year summative portfolio (what we do at the Cleveland Clinic Lerner College of Medicine [CCLCM] in lieu of exams and grades), I can’t help but reflect on how this unique system of evaluation has changed my outlook and afforded me tremendous growth during this first year of medical school. “No exams and no grades?,” people often remark when I explain our curriculum, “Sounds like a pretty sweet deal!” While the true ways in which this system is “pretty sweet” may not be so apparent on the surface, they are many-fold and offer insight into what may be a much more fulfilling approach to life (once the initial discomfort is accepted, of course).

From a very young age, I, like many others, have been conditioned to strive for perfection. Whether in school trying to please teachers and earn perfect grades or at gymnastics practice performing movements over and over again so that my routines might score just a tenth of a point closer to a “perfect 10,” I always focused on the most minute details to be sure that I gave my best effort in every endeavor. I thought that as long as I studied hard enough or practiced long enough, “perfection” would be within my grasp. While this approach did me well in the sheltered environment of my primary school years, once set loose into the real world and exposed to the vastness of knowledge and possibility, I quickly realized I had neither the time nor the energy to embark upon such a comprehensive quest for perfection in each avenue I wanted to explore. Because in college grades provided the single most visible measure of my abilities, I began to channel my perfectionist tendencies toward my transcript. Trying to hang on to the possibility of perfection by dedicating myself to this single endeavor with such an important outcome, I would often find myself settling for a less-than-perfect effort in other areas such as extra-curricular activities or spending time with friends and family. As each semester passed and the amount of information to learn and assignments to complete continued to grow exponentially, I also found myself losing touch with the pleasure of learning for the sake of learning and sometimes even sacrificing my own true understanding of material in pursuit of perfect grades. However, these grades provided a false sense of satisfaction – though I walked away from many an exam feeling confused and defeated, upon receiving a grade I considered satisfactory I never again considered returning to my books to clear up my previous qualms – I was too busy studying for the next exam to earn the next grade. Perhaps these grades, in addition to disproportionally shifting my efforts toward only one aspect of my life, masked many of my weaknesses and hindered me from making further improvements.

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What’s in a grade, anyway?

Enter medical school: no grades, no exams, and the analogy “drinking water from a fire hose” could not be more true. The amount of information to learn, shadowing and volunteer experiences to be had, and research projects to conjure up seemed endless from day one. Students who have been conditioned to strive for perfection their entire lives are suddenly overwhelmed with the impossibility of learning it all, and gone is the opportunity to feel even a slight sense of validation for our efforts by earning an “A” on an exam. However do these type-A’s cope with such a situation? From my experience, the answer lies in gaining comfort with recognizing and unmasking our weaknesses and in acceptance that balance across many domains trumps perfection in just one – a.k.a, the portfolio system.

Instead of the traditional system of exams and grades, the CCLCM implements a portfolio system in which students evaluate their own progress in 9 separate competencies: research, medical knowledge, communication, professionalism, clinical skills, clinical reasoning, personal development, health care systems, and reflective practice. Incorporating feedback provided by faculty and peers throughout the year, we assess our progress toward achieving the standards in each of these competencies and devise realistic strategies for making improvements.

In the above description, you will notice that medical knowledge provides only ONE of the 9 competencies in which we are assessed. The portfolio system recognizes the equal importance of each of these areas in the development of physician researchers and does not allow us as students to neglect any one in exchange for deeper pursuit of another. Sound familiar? CrossFit also recognizes that in order to achieve optimum physical competence, one’s ability must be distributed evenly among “10 General Physical Skills” – cardiovascular endurance, stamina, strength, flexibility, power, speed, coordination, agility, balance, and accuracy. We concede that as CrossFitters we may not achieve the level of stamina displayed by an Olympic triathlete or the strength of a world-class powerlifter, but we are willing to make those sacrifices in order to maintain balanced physical abilities. In much the same way, as physician-researchers-in-training, we recognize that we may not have the degree of knowledge in any given subject area as a Ph.D. researcher or the understanding of health care systems of health policy makers, but we are willing to sacrifice striving for such a degree of perfection in any one of these areas in order to be competent in the many areas that allow us to successfully care for patients and improve the field of medicine. For individuals conditioned to strive for perfection, this is not an easy task at first – it requires us to step back and evaluate our goals.

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The CCLCM portfolio system and CrossFit – recognizing that balance across many areas may be better than perfection in just one

Could I be better at Olympic lifting? Yes, probably, if I spent all of my time practicing Olympic lifting. But what is my goal? My goal is to achieve optimum physical competence, therefore I cannot afford to spend all of my time practicing Olympic lifting while neglecting development of other areas such as endurance and stamina.

Could I achieve greater breadth and depth of medical knowledge? Absolutely, if I spent all of my time pouring over my textbooks and memorizing every word. But what is my goal? My goal is to become an excellent physician researcher, so my medical knowledge will be useless if I have not also developed skills such as communicating with patients and clinical reasoning.

Additionally, you will notice in the description of the portfolio system that gone are the days where our shortcomings can be hidden behind the outcome of a stellar grade. In this system the façade is removed and we are all forced to address our weaknesses. We are required, even rewarded, for identifying the areas in which we need to make improvements and then acting on them. This notion is one that society frequently shies away from. Constantly pressuring individuals to exude an air of perfection, society persuades us that the perfect outfit or a stellar college transcript, house, or career can provide a façade for the imperfections and insecurities that we all have. While they may allow us to proceed through life smiling on the outside, outward expressions of perfection may actually prevent us from recognizing our flaws and capitalizing on real opportunities for growth. In a similar way to the CCLCM portfolio system, CrossFit also acts to eliminate façades of perfection, giving individuals the opportunity to be vulnerable, to explore their weaknesses, and to learn from them in order to become better athletes all-around. The beauty of CrossFit is that it cannot be bested by our fancy façades – no matter who you are, how much money you make, or what kind of clothes you are wearing, CrossFit will force you to come face-to-face with your imperfections. In so doing, CrossFit allows us to conquer these weaknesses that we otherwise might have shrugged off, avoided, or kept hidden to ourselves. By calling our bluff – exposing weaknesses in the gym and showing us that it is possible to make improvements, CrossFit empowers us to extend this behavior to other aspects of our life. And though we may feel vulnerable at first, identifying, rather than ignoring, our shortcomings and taking steps to overcome them paves the way for an exponentially more fulfilling life.

My first year at the CCLCM has reinforced the concepts that CrossFit teaches me every day. The portfolio system reminds me that “perfection” in life is defined by our own personal goals, and sometimes balance across  many competencies IS the perfection we strive for. As our goals shift, so does this “perfect” target, such that we are in constant pursuit of betterment. Additionally, I am assured that though incredibly uncomfortable, true growth is possible only by stepping out from behind our façades of perfection to grapple with our weaknesses. In doing so, we gain strength in our shared struggles and the impetus to work toward the goal of becoming better human beings.

“Our strength grows out of our weaknesses” ~ Ralph Waldo Emerson

Endo Block and the Obesity Epidemic

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We’ve spent the last two  weeks of medical school in our Endocrinology Block.  Returning from a much-needed and  very restful break for the holidays, I was excited to be learning about a new system and expected the coming days  to be filled with discussion of those elusive glands and hormones I’d heard of, but never really knew exactly what  purpose they served.  While we did spend plenty of time learning about things like T3 and T4, Chromaffin cells,  and the difference between the anterior and posterior pituitary, to my surprise (and perhaps also to my  fascination) a significant portion of the past two weeks revolved around obesity.

We have learned about the genetics of obesity, how hormones and neural networks control how much you eat and  how much energy you expend, and all the hormonal factors that our fat cells release contributing to insulin  resistance.   We talked about a number of endocrine diseases that lead to uncontrollable weight gain or loss, but what resonated with me most was this figure that seemed to kick-off every other seminar I participated in, highlighting America’s  “Obesity Epidemic:”

The Obesity Epidemic – http://www.cdc.gov/obesity/

With all this buzz about obesity, I was fascinated by how quickly the word “exercise” passed in and out of  conversation – as if it were some sort of fictional idea, a figment of the imagination that only worked in fairy tales  and highly-controlled research studies.  Instead, after rapidly dissuading the eager medical students’ suggestions of  “lifestyle changes,” clinicians quickly turned the focus toward pharmacology and novel molecular targets for  treating this epidemic.  Did I miss something here?  At first I was quite perplexed – if we know that exercise  affords  us countless health benefits and is likely to prevent diseases from diabetes to cancer, why are we searching so  hard for the “magic bullet” drug to treat obesity and leaving this thoroughly tested and proven antidote to the  wayside?

What strikes me the most about many of our seminar discussions with highly-esteemed clinicians is their sheer  lack of faith in the ability of any patient to adhere to an exercise regimen.  But then I stop to think – can I blame  them?  Though I’ve only been immersed in the field of medicine for half a year now, I’ve become accustomed to  the standard “diet and exercise” talk.  Patients in need of serious lifestyle change are sent off for an appointment  with the nutritionist and told to “exercise.”  Now talk about an elusive idea – if I had been living an increasingly  sedentary lifestyle for much of my adult life and was given these instructions, I would have no idea what to do  either. Heck, I had no idea what to do or how to exercise the minute I was set free from my high school sports  programs, and exercise had been part of my everyday life for years!  The plethora of weight loss and fitness advice  we are constantly bombarded with  doesn’t help one bit – with so many options, many of them contradictory, and  different people asking for your money, it’s nearly impossible not to become overwhelmed and discouraged before  finding a program that works.  So, why is it that doctors frequently leave it up to their patients to figure out?  Sure,  they might suggest Weight Watchers or purchasing a gym membership, but ultimately this choice is left up to the  patient.  Do we leave other choices of this magnitude up to our patients?  If I came in to see my physician with  strep throat, would he make a few suggestions of what medication I should take and the dosage and leave it up to  me to decide? Absolutely not!  If I needed to rehabilitate a torn ACL would my doctor point me to a few  online resources and send me on my way? Not at all!  Next thing I know I would be standing in a physical therapy  clinic receiving step-by-step instructions from a doctor who had helped countless others through ACL rehab, and I  would be returning several times a week to ensure my therapy was completed fully and properly.  So why is it that  exercise, perhaps the most important and life-saving treatment of all, is so improperly “prescribed” by our  physicians?  The problems are many-fold, and as far as I can see they stem not from the doctors themselves but rather the health care system in which these doctors work. However, at least in my mind, the complexity of these problems doesn’t preclude working toward a solution.

After these past two weeks, the disconnect between medicine and fitness has never been so apparent to me. While I always knew it existed, there is just quite nothing like experiencing first-hand the Grand-Canyon-sized gaping hole between experts in sickness and wellness, and experts in fitness.  My favorite of CrossFit’s models of fitness is by far the “Sickness-Wellness-Fitness” continuum, yet in the context of medical care, this continuum is not quite as smooth as we might hope.  Instead of individuals oscillating freely along from wellness to fitness, fitness to wellness, and occasionally (God forbid) inching over to sickness, we have a serious traffic jam on the Sickness-Wellness side of the spectrum.  People are stockpiled on the cliff we call “Wellness,” peering over the edge   and looking down at the polluted waters of “Fitness.”   That’s a scary jump to take – and who knows where you will end up once you do?  A $10-per-month gym membership?  $100 for a video that promises to give you a six pack?  What we need is something to bridge this gap – someone who can take patients by the hand and lead them toward the right side of this continuum, and it’s clear to me that CrossFit may just help us find that someone we need.

“Your doctor is a lifeguard, not a swim coach” – Coach Greg Glassman.