Hello.

What do you call the person who graduates last from med school?

Finished with a time of 2:14. Again, goals of 1) Don’t die 2) Finish 3) Don’t walk were achieved. This was a miserable, miserable, beautiful run. 10/10 will never, ever, ever do again.

I had heard this was a hilly run. We went out there in February to see how bad it was before I committed to it. It turns out that driving the course in an Outback is far easier than actually running the course. I should also mention that I’m specifically forbidden to do hills. My primary cardiologist says if I’m going to run, don’t do hills. I actually agree with her on this, but it’s kind of hard to avoid in the Pacific Northwest.

We took our dog, Sir Remus Valentine of the Lone Star and stayed at a B&B the night before. It was a small crowd, maybe 300 people. The race starts at South Beach, heads west for a little bit, then meanders back to Friday Harbor. The race immediately starts with a slight uphill slope.

Before even the second mile, there’s a 150 foot elevation gain. It then drops 150 feet over another two miles, rises 150 feet again, then repeat the cycle. Throughout the course, you’re either hugging the coast or running by vast farmlands. If you can get past the misery, it is an incredibly scenic run. At the mile 9 water station, the volunteers cheered. I cried out, “I’ve made terrible life choices, and I regret everything.”

After that station, there is a long downward slope followed by another freakin’ sharp hill. In the last races, I pick up the pace in the last mile and empty the tank. However, in this race, I was just trying 1) not to die, and 2) not walk.

Part of my pre-race ritual is that I get a doppio right before the start. On the way to a cafe that morning, Gene Loves Jezebel’s Motion of Love was on Sirius. It psyched me up, so I programmed it into my phone. I started the song as I crossed the starting line. I was so focused on surviving the first two miles of uphill, I never changed it – for the remainder of the run. Two and a quarter hours of Motion of Love on repeat.

I imagined seeing my dog at the finish line excited to greet me. Nope, he was too busy sniffing around the beach. I grabbed a couple of free bananas and found the result station to check my time. Guess what? Third in my age group! Third out of five, but still, I get a special medal for it! What *do* you call the person who graduates last from med school? You call them “doctor.”

I’m going to take a couple of weeks off. First week to rest, a business trip to Chicago after that, then back on keto. I’ve decided to basically follow Hal Higdon’s Marathon training program. Let’s just see how it goes. I expect to have to stretch things out longer as my body adjusts to performance under fat adaption, but why not. Let’s see if I can actually get to marathon distances.

These are the part of my story that are relevant. I’ve tried to limit the emotional drama.

I was a pretty casual runner from about 2003 to 2013. I did maybe 12 miles a week, a couple of 5ks, and a 10k. I flirted with the idea of one day running at least a half marathon, but never seriously trained. In 2013, I got pneumonia and was hospitalized for four days. After a few weeks, I felt pretty close to normal and got back on a treadmill.

I couldn’t run for more than a minute. Thinking it was just because I hadn’t really recovered, I took a few days off then tried again. The next time, it was a little bit better, but not much. 63 seconds.

After a slew of cardiologist visits, I was diagnosed with viral cardiomyopathy. Basically, a virus came in, fucked up my heart, then left. My heart was operating at 30% of normal, and I was told it was going to be like this from now on. I was told explicitly not to run anymore – I was at an elevated risk for sudden cardiac arrest. Based on family history, I was pretty darn sure this was going to happen, and I only had a couple of more years to live.

In late 2014, against doctor’s orders, I started running again, and it felt great. My rationale was that if I was going to drop dead, dropping dead doing something I thoroughly enjoyed was an acceptable was to go out. My first run was 2.25 miles, and I pushed it to almost 10 miles a week. Knowing I wasn’t going to squash this bug, I got an implanted heart defibrillator to shock me back in case I did keel over unexpectedly.

Shortly after that, my wife discovered the ketogenic diet, and we went on it together. I had crept up to about 190 pounds post-diagnosis. Keto dropped me down to 157 after eight months. At that point, I decided it was now or never to check at least a half marathon off the list. I was leaner and cardio-wise, felt great. However, conventional wisdom said that long distance running doesn’t go with a carbohydrate-free diet, and from keto’s perspective, you shouldn’t do cardio. Therefore, I decided to go off keto and focus on the running.

On January 21, 2018, I achieved one of my goals, finishing the 3M Half Marathon in Austin, Texas with a time of 2:07. My goal was to 1) Not die 2) Finish 3) Not walk. All three were achieved.

Later that year, as I trained for 3M again, I discovered Orca Running, a local race promotion company. They put on multiple races per year ranging from 5Ks to full marathons. If you run any three of their races, no matter what the distance, you get a swanky special medal of an orca tail. I needed that medal. Therefore, I’m doing four half marathons in 2019.

I finished 3M this past January with a time o 2:04, better than last year and feeling like I can run at least an extra five miles. I did the Tunnel to Viaduct 8K in February with a pace of 9:04, but that was a mess. I’m not doing fun runs again. I’m in the final stretch of training for San Juan Island Half Marathon in a couple of weeks.

I’ve decided to go back on keto after this race. San Juan will be fine, but I’ve been dodging a bullet with crappy eating. I’m not sure what my weight is. It’s definitely closer to 157 than 190, but it’s not ideal for running. My ankle has been giving me problems, and I’ve been going to a physical therapist. I’m sure the extra ten pounds do not help with joint issues.

So, heart issues + keto + long distance running. Because I’m going against what my cardiologists, keto evangelists, and running experts say, I feel like it would be helpful to document these efforts.

TL;DR – If you want to do something, do it sooner rather than later. You never know when the ability will be taken from you.