Exhaustion

My thoughts right now are on being tired. I mean really tired. So tired that exhaustion becomes your alternate universe. In that moment it is where you live, all consuming, a wormhole tunnel with no light at the end, in fact, no end.  I remember such a feeling once in my professional life. In general surgery residency, feeling tired was the normal state of affairs. I use to fantasize about being able to sleep as much as I wanted, and it WAS a fantasy because it never happened. My daytime sleepiness was such that I even went to Stanford University’s sleep laboratory to be checked for narcolepsy. For two days I was asked to try to fall asleep several times a day while my brain waves were monitored with electrodes stuck all over my head. I looked like a true bionic man.  .        The verdict? I needed to get more sleep!

Once, as a 4th year resident on the neurosurgery rotation in San Francisco’s main trauma hospital I was continuously awake, working up patients, going to the operating room, rounding on patients in neuro intensive care unit for 36 hours. At the end of the day, I went home, a one hour drive from San Francisco to my apartment in Oakland, CA. No sooner did my head hit the pillow than the phone rang. I was informed by the chief neurosurgery resident that the other junior resident was sick and I had to come back in immediately to cover his shift. I drove back in a fog and worked another 24+ hours. By the end of that time I was beyond tired. I was so tired that my sleepiness, ironically, went away. The chief resident had been up operating almost continuously too (this was in the day before the 80 hour work week restriction for residents). At one time, in the early morning hours, we were sitting together in the intensive care unit giggling like two silly teenage girls over just about anything. .     I had never been so tired in my life……..until now.

 This week, I did an intense strength session at the National Training Center on Tuesday. It was one of those where, at the end of each session, I was literally gasping, my breath coming in loud whoops as I tried to suck in enough air to get caught up. Each session ended in failure, or near failure, of the muscle groups involved. I wasn’t sure I had the strength to get to my car and drive home. The next day, I did an interval session on the treadmill. It involved six 400 yard segments at a near sprint, with 30 seconds recovery running between each. Again, at the end I was tapped out. Then, Thursday called for a 2 ½ hour run. I made the first half but around mile 11, I was suddenly hit with exhaustion of such intensity that I could not run another step. There is a reason it’s called “hitting the wall”. Total exhaustion is, indeed, a wall. I started walking, trying to keep up a good pace. Usually, I can recover fairly quickly, but this time every time I tried to resume a slow jog, I only lasted a minute or two. I basically walked the rest of the way home. My breathing did normalize for 45 minutes after I got there.

This was a reality check of what it feels like to be beyond tired, beyond exhausted, even. I am expecting to feel this way in about 4 weeks. I only hope that I will be mentally prepared for that, and that I will have banked enough time earlier in the day that, if I have to, I can walk “home” to the finish.  Time is my concern now because I have resolved that, come what may, I will not quit moving forward. In fact that will be my “mantra”: keep moving, don’t stop moving. It’s only 17 hours of effort. I have said much the same at times in my professional career. Some days just never seem to end. To get through them, you have to tell yourself, "this won't last forever; there will be an end to this day". Somehow, it gets you through. I think a big part of life is learning to get through the hard times, knowing there will be an opportunity for rest later.  .      

It’s easy to stop moving when. to move, is uncomfortable. Many of the patients I see every day have basically done that; stopped moving for most of their lives, which are little more than a steady progression from sedentary place to another. Exercising is not easy. If it was, everyone would do it. If there is one overarching problem with our society today, it is that it is too sedentary. This leads to a host of ills: metabolic syndrome, obesity, muscle mass loss, etc. These, in turn, lead to a plethora of illness that are sinking our economy in a sea of red ink to pay for their care. “I’ve fallen and I can’t get up” is more than a humorous catch phrase. It describes a large proportion of older adults.

 After this tri is over, I don’t plan to train like this again, but I do plan to keep moving………..