Human Limits

Exploring performance and health with Michael J. Joyner, M.D.

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Archive for April, 2013

Mistakes, Adaptability and Success

Most of us spend a lot of time avoiding mistakes.   However, there is a long line of thinking from multiple fields that suggests too much concern about mistakes inhibits risk taking.  Along these lines, perhaps the time we spend “looking over our shoulder” avoiding mistakes might be better spent taking risks and learning from our mistakes.   Let me give you a few examples.

 

The Team That Makes the Most Mistakes Usually…….?

The conventional answer to this statement/question is usually “loses”, but the great basketball coach Piggy Lambert felt that the team that makes the most mistakes usually wins!  Lambert was also the coach of John Wooden and the point is that he did not want his players to be tentative and he wanted them to take reasonable risks.  There are mistakes of action and inaction and all things being equal perhaps mistakes of action are better.

 

Make the Most of Mistakes!

Viagra was initially tried as a drug to treat high blood pressure and chest pain.   The results were marginal.  However, many patients with high blood pressure and chest pain also have erectile dysfunction and improved erectile function was a lucky side effect of the failed blood pressure and chest pain studies.   More importantly, the fundamental discovery that led to Viagra (made by Robert Furchgott and colleagues) was also a “mistake”, or as Furchgott put it an “accident”.   Furchgott’s mistake or accident also led to a Nobel Prize.  In fact the history of medical innovation based on mistakes, accidents and serendipity is at least as impressive as the results associated with carefully planned goal directed research and development.

 

Mistakes and Progress

A lot of “scientifically proven” ideas are later overturned after being hyped or sold as definitive.   So, perhaps the goal in science is to have a way to make better use of our mistakes.  Here is a link to a recent article on the philosophy of science and the central role of mistakes in what might be termed progress.  The article also addresses the difficulty in communicating these ideas to the general public, and here is a key excerpt:

 

As the physicist John Wheeler said, “Our whole problem is to make mistakes as fast possible.”  Indeed, Karl Popper built an illuminating philosophy of science on the idea that science progresses precisely by trying as hard as it can to falsify its hypotheses.”

 

I would add to these ideas that the fundamental point of science is to generate questions based on the current state of knowledge and ignorance.   I read a terrific quote on this recently in the obituary of Francois Jacob, a pioneering molecular biologist who died recently.  Jacob had wanted to be a surgeon, but injuries to his hands in World War II made him redirect his interests towards research.

 

“What mattered more than the answers were the questions and how they were formulated.  For in the best of cases, the answer led to more questions. It was a system for concocting expectation, a machine for making the future. For me, this world of questions and the provisional, this chase after an answer that was always put off to the next day, all that was euphoric. I lived in the future.”

 

Adaptability is the Key

My friend and colleague Hiroshi Nose recently sent me a very insightful e-mail that included the idea that the essence of life is ambiguity and plasticity in response to environmental change.    In other words how do we adapt to the world we live in? This includes the ability to learn from our mistakes.   Hiroshi’s observation leads to a larger lesson and an observation by the historian Bernard Lewis on the way things happen in the United States.  Lewis is in his 90s and a Professor at Princeton but is originally from England where he served in World War II.  Here is his fundamental observation:

 

“I still remember my first two impressions of Americans, derived from my wartime comrades. One was that they were unteachable. When America entered the war, we in Britain had been at war for more than two years. We had made many mistakes, and had learned something from them. We tried to pass these lessons on to our new allies and save them from paying again the price that we had paid in blood and toil. But they wouldn’t listen—their ways were not our ways, and they would do things their way, not ours. And so they went ahead and made mistakes—some repeating ours, some new and original. What was really new and original—and this is my second lasting impression—was the speed with which they recognized these mistakes, and devised and applied the means to correct them. This was beyond anything in our experience.

In looking at the world today, and at our present predicament, I vividly recall that first impression, and anxiously await the second.”

 

Optimism and Mistakes

One of the reasons I think I am an optimist has to do with making the most of my many mistakes in all aspects of my life.   I think the observations by Bernard Lewis give us cause for optimism as a culture provided we keep learning, doing and fixing things.   The baseball catcher and sometimes Zen philosopher Yogi Berra once described a loss this way:

 

“We made too many wrong mistakes”

 

So make good mistakes, learn from them and make them count.  Stagnation and frustration await those who spend too much time mired in their mistakes vs. adapting because of them.

 

How I Lost 10 Pounds

Today we are taking a break from data driven topics and things in the news.  Over the last 4-5 months I have lost about 10 pounds or perhaps a bit more (5kg).   I am tall, about 6’5” (1.95m) and weighed perhaps 206-210 pounds (93-95kg) before I started to lose weight.    With just a few exceptions I have exercised daily for the last 38-40 years.   I am now about 196-198 pounds (88-90 kgs).  How did this happen?  Here are the reasons I can come up with:

 

  • I continued to exercise 30-60 minutes per day during the week and a bit more on weekend days.   Except on vacation, almost all of this was indoors cycling on a trainer, running on the treadmill, or swimming.  It has been a very, very long winter in Minnesota.

 

 

  • I added circuit training with body weight exercises like burpees to go with the weight training, ab work and push-ups I had been doing for a long time.

 

  • The first three factors are not much different than what I have done for years except for the circuit training.   The other big thing has been that my wife and I made a conscious decision to get the chips, ice cream, cookies, and (most) of the soda out of the house.   I also encouraged people to stop bringing “treats” to the lab.  When I have been hungry during the day I have tried to “reach for an apple” or protein bar.

 

What is interesting is that after a few  months of avoiding junk food I don’t miss the chips, and when I occasionally have more than a few I feel really full and sort of uncomfortable.  The ice is finally off the street and I am riding my bike to work again and the days are longer.  It will be interesting to see what happens over the summer when my physical activity picks up.   Will my weight go down a bit more?  In terms of diet my recent observations suggest that limiting the availability of junk food can have a big effect on body weight.

 

Terrorism vs Learned Helplessness

The events in Boston have me thinking more about “learned helplessness” and how we do or don’t respond to difficult and sometimes tragic events.   I want to give you two examples from the world of sports about how to respond.  In contrast to the bullying techniques used by some coaches and authority figures, the legendary football coaches Eddie Robinson and Jake Gaither took another approach.  These men coached at segregated colleges in the U.S. South and developed an incredible number of outstanding players who were also outstanding people.   At some level they experienced a sort of daily slow-motion terrorism as a result of institutionalized racism with an implicit threat of violence against those who spoke out.  Here is what Robinson said reflecting late in life.

 

“When I first started coaching, my state dictated to me where I had to go, when I played and who I played. I hold no grudges and I don’t have a chip on my shoulder. You can’t unring a bell. I played as long as I could play, whenever I could play and as hard as I could play. How else can you judge me, except for what I accomplish?”

 

The clip below is from Frank Shorter last week.  Shorter won the 1972 Olympic Marathon a few days after the terrorist attack on the Olympics and he was at Boston when the bombs went off.  The horror he describes is palpable, but the important part of his reflections come later in the interview when he discusses how he was able to focus amid the chaos in Munich.

 

click here for video

 

Do What You Can

Robinson, Gaither, and Shorter remind us all that life is ultimately about how we respond in situations that we don’t control and that the best choice is to be proactive.

 

Boston Bombing & Individual Power

The Boston Marathon Bombing is horrific and whoever is responsible took a shot at everything that is great about living in the modern world especially inclusiveness and the celebration of individual effort.   In terms of the tragedy and what it means for individuals, Boston, and the rest of the world I have nothing to add to what has already been written or said in many forums.  However, acts of terrorism highlight just how powerful, for better or worse, we have all become.   My point here is that individuals and small groups of people now have ready access to technology and can do things that used to be the purview of large organizations or governments.   That “power” can be used to good things or bad things.   Let me give you four examples:

 

1.     Car Parts Baby Incubator

Incubators for babies are lifesaving.   When high tech incubators (and other medical equipment) designed for the developed world are donated to hospitals in less developed parts of the world they fail and the infrastructure to repair and maintain them is not available.  However, low cost baby incubators can be made from “Toyota parts” that are available everywhere.   This is an example of how “good enough” technology can be used to innovate in creative ways.

 

2.     Bombs From Ag Supplies & Cell Phones

The bombs in Boston were made using cheap and easy to obtain parts.  Similarly, the truck bomb used in the 1995 Oklahoma City attack was constructed using readily available materials including fertilizer that cost perhaps $5,000 dollars in total.  The 2004 Madrid subway attacks were remotely triggered using cell phones.

 

3.     Designer Doping

Novel steroids for sports doping have been developed essentially in “underground” labs.   In the past making new drugs would take the research lab facilities of a big hospital, university, or a drug company.  There is also a web-based secondary market for lab equip, and a rogue innovator can easily develop a lab “in the basement” with an impressive array of low cost equipment.   On the positive side, this secondary market also facilitates legitimate innovation in small companies.

 

4.     Computer Capacity & Cyber-Attacks

Most people have far more computer capacity on their desktop or laptop than they need for routine tasks like e-mail and word processing.   This excess capacity can linked and used to solve problems or it can be harnessed surreptitiously to do mischievous and destructive things like generating denial of service attacks directed at various organizations or governments.   There is a lot of talk about sophisticated cyber warfare, but the vast majority of cyber-attacks are denial of service attacks that merely overwhelm the target’s IT system.

 

Summary

We are surrounded by cheap and reliable technology that can be mixed and matched to do wonderful things like make simple, effective and easy to fix incubators for babies.  Forget the developed world; cell phones are transforming economies and political systems in the developing world.   Cheap lab equipment and computing power is leading to all sorts of invention and innovation.  However, this same cheap and reliable technology can also be used for great evil as the Boston bombings show.  Unlike big organizations or governments what end users do with all of this technology as it diffuses is very difficult “control”.

 

 

 

The Real Masters and Aging Well

Last week I happened to see the ceremonial opening tee shot at the Masters golf tournament that featured Arnold Palmer, Jack Nicklaus, and Gary Player who are all great champions.  Palmer is 83, Nicklaus is 73, and Player 77.   What struck me as I watched was how well Player hit the ball at age 77.   The video clip below is from earlier in the year and shows Player hitting off the tee.   Here is a link to a slow motion video from a year ago.

 

click here for video

 

I am not a huge golf fan, but the flexibility, range of motion, rhythm and power of Player at age 77 is remarkable.  Player is also one of the first high profile athletes to really incorporate fitness training into his routine and he has kept at it as he ages and continues to participate and compete.   His program includes a lot of core strength exercises and he has some excellent tips about things like remembering to take the stairs.  Here are his “10 rules” on being an athlete, you can argue about some of the specifics, but on the whole he has it right.   His program and his rules might also be described as state of the art thoughts from someone who is aging well — extremely well.   He also makes a key point about staying engaged in life with his rule number 10:

 

“When I’m on vacation, I try to play golf with younger people, the fitter the better. I think you tend to take on the characteristics of the individuals you spend the most time with. Doing activities with young, healthy people has had a way of making me rise to their level. The best traits of young people–their optimism, curiosity, alertness and energy–are contagious and will definitely make you feel younger. “

 

Never Too Late!

Seeing Player hit the ball so well and reading about his fitness program reminded me that it is never too late to improve.   The clip below is of 95 year old Paul Lurie swimming with Terry Laughlin.  Lurie, like Player, shows outstanding flexibility and rhythm along with terrific overall technique.   I find the fact that Lurie is taking lessons and improving in his 90s as inspirational.

click here for video

 

Something Special?

It is tempting to argue that Player and Lurie are “something special”; however what they do is pretty typical of “healthy agers”.   And while the population as a whole gets fatter and less fit there is going to be a subset of people like Player and Lurie who both age and thrive.  I also think Player’s comments about doing things with younger people are right on the mark and a key part of the “staying engaged in life” element of successful or active aging.  Some have argued that aging has become overly medicalized and that as the world gets older we need a new paradigm focused on the many positive aspects of aging and how to promote them.  Player and Lurie are good examples of what a new aging paradigm might look like.

 

NCAA Human Limits Bracket Winner!

Congratulations to Tony Gage who took first place with a total of 116 in the Human Limits NCAA pool!

The top finishers include:

1.  Tony Gage – 116

2. Jennifer Meyer –  114

3. Wes Emmert – 111

4.  Anders McCarthy – 110

5.  Laura Stoltenberg – 105

Walk Across Kansas

Today we have guest post from Dr. Sandy Billinger from the University of Kansas.   She has a remarkable story and will be walking across Kansas in May and June of this year to celebrate all sorts of things including the key role that physical activity can play in resiliance.

 

 

Why would anyone want to walk across the state of Kansas?  In the western part of the State, the distance between towns is quite great and water is scarce.  Thistles and tumbleweeds roll across the road due to the constant 25-30 mile an hour winds with the occasional gust to 45-50 miles per hour. In any part of the great state of Kansas, the weather can be very unpredictable and can become severe without much warning.  Kansas is right in “tornado alley” and for the most part, Kansas residents find themselves in a tornado watch from April to September.

 

It really begs the question of why would anyone want to walk across the state of Kansas? The Walk Across Kansas is both a personal and professional endeavor that will take my son and I across the State for the second time.  It was a life-changing event that led me to travel from my hometown of Hays, Kansas, to Kansas City.

 

Almost 20 years ago (April 1993), I was driving home for lunch when a car ran a stop sign and t-boned my car.  The car hit me with enough force that my car was turned counter clockwise and was facing the opposite direction.  I was 30 weeks pregnant with my son at the time of the accident.  Not only did the impact change the path of my car but it would change my life in ways I had never imagined.   You can read about my personal story, my road to recovery and how I ended up torturing myself obtaining a dual PT/PhD degree at www.walkacrosskansas.com

 

I was always told by various physicians that I was lucky I was healthy (no comorbid conditions) and exercised before my car accident — that it helped my recovery and probably saved my life.  Exercise has always been part of my lifestyle and hope it will always be.  My son and I have been through a lot since 1993 and we are embarking on this journey together, across the State for the second time, thankful that we both survived almost 20 years ago.  We hope to inspire others to be physically active.

 

I am a huge fan of physical activity and try to support as many organizations that promote physical activity.  I serve on several American Heart Association committees, the National Physical Activity Plan for healthcare providers and a group of faculty at Rockhurst University and KU Medical Center host an Exercise Is Medicine conference in May.  Each year we obtain a proclamation that May is Exercise Is Medicine month.  May also happens to be Stroke Awareness month which is a research focus in my laboratory at KU Medical Center.  So, why not combine efforts in the month of May.

 

I have a goal for this walk and that is to educate people on the importance of physical activity (even just walking) in Kansas.  In a previous blog, Dr. Joyner highlighted the awesome and tremendous work of Red Dog’s Dog Days in Lawrence, KS and his free community exercise program that has been in existence for 30 years and serves up to 500 community residents and visitors per day….now that’s IMPACT.   There are others that inspire me to do more and be proactive such as Dr. Michael Joyner, Dr. Steve Blair, Mr. Dick Sarns, inventor and engineer and his wife, Norma, and Mr. Herb Strange, 80-year old weightlifter in Kansas who holds numerous national and world records.

 

On May 16, 2013 my son, Michael Thomas and I will begin this adventure.  We will walk 570 miles across the state of Kansas following the American DiscoveryTrail(ADT) and our goal is to complete it in 23 days, returning June 7th.  That averages to about a marathon a day of continuous walking.  We will be backpacking, carrying our gear, and trying to plan for our food and water supply.  This is a challenge since the towns are far apart in western Kansas.  Questions like, “How much food do we carry and how many days’ worth?”; “SmartWool socks or liner socks combined with wicking cotton socks”; “What do we do when an unexpected storm hits?  Will there be a ditch nearby to crawl into or do we run to the nearest farmhouse and hope someone will let us in the cellar or basement?” How do we handle loose dogs? Answer: Bear spray?”  “What happens if one of us gets injured and how much Advil can one really take safely?”  I am sure there are more things to consider but these are a few.  I am also traveling with my 19-year old son.  There is certainly a difference of opinion on how to handle these issues, with me being the more reasonable, logical, and having a fully myelinated brain.  He wants to fly-by-the-seat-of-his-pants and while I love adventure and used to be that way, not this time.  The reality of the challenges is forcing me to be more of a planner. I’d like to survive and retell the stories.

 

As we pass through each town/city, we are inviting people to join us and walk.  We are working with our local American Heart Association to get the message out to these towns and engage stroke survivors.  As we get closer to Kansas City, we have groups or “teams” who are going to join us.  Some will walk with us on the Flint Hills trail, while others are walking parts of the last leg, which is 18 miles.  We’ve had remarkable community interest in being active.  In fact someone recently mentioned we may have to close a section of the city or route traffic to allow all of us to walk.  Our Doctor of Physical Therapy students are conducting a fundraiser (we are also raising money for stroke research at KU) and having people walk in teams.  They are also walking portions of the trail with us.  A stroke survivor who recently was in one of our studies while he was in the hospital has been “extra committed to rehab” as he wants to walk a short distance with us as we cross the finish line.  I was so impressed and in awe of his desire to improve his walking ability.  It has been amazing to hear different stories from people and their excitement for our Walk Across Kansas.  Already, I feel I’ve made a difference in Kansas City and am both nervous and excited for this physical and mental challenge.

 

So, if you find yourself wanting to do something fun or just happen to find yourself wandering along the ADT in Kansas in May or June, we would be more than happy to have you walk with us on our journey.  I am sure that we will have some interesting stories to share that will help the time pass by.   If you are not up for joining us, on the website you will find a link for our Facebook page and you can follow my training and our journey.

 

Rutgers: Failure of Process or Learned Helplessness?

The Rutgers coaching abuse scandal raises all sorts of issues about sports, higher education, money, power and perhaps most importantly how to “get the best out of people”.   Here are a few thoughts on what happened at Rutgers.

 

Student Athletes?

The term “student-athlete” is used almost reflexly in the media and by organizations like the NCAA.  The implication is clearly that the student part comes first and that sports subserve an educational function.  That having been said, would the average professor at the average university be permitted to berate their students, physically abuse them, and throw things at them?  I doubt it.   Here is a video clip of legendary coach Bob Knight throwing a chair during a Big 10 game in the 1980s.   What educational purpose was served by throwing a chair?

 

click here for video

 

Times Have Changed!

Some have argued that “kids have gotten soft” and that harsh coaching methods are a key to success.  I would argue that harsh coaching tactics can lead to “learned helplessness” and ultimately limit the ability of the (student) athlete to respond independently to challenging situations.  If sports are critical in developing the ability to act independently and make decisions under stressful circumstances why not teach those skills in a positive way.  The great basketball player Bill Walton has a number of relevant observations on this topic, and here is a link to something he wrote in 2000 about the firing of Bob Knight after decades of abusive behavior as coach at Indiana.  In no way does Walton advocate a soft approach to accountability but merely a constructive one.

 

“We all need motivation. It’s a particularly important aspect of sports because the tiniest of margins often separate the winners from the losers. Yet with Knight, we’re not talking about a constructive approach to making people perform by challenging them on their positions or on their failures in life. Knight does it to denigrate. Doesn’t Indiana know that universities are supposed to be about how you teach? Teaching is about building confidence, about making people feel better about what they do and who they are.”

 

Change a few words and ask the same questions to the folks at Rutgers.  I would also add that times have changed and that we live in a world where things can be hidden, but only for so long…….ask Lance Armstrong.   What is really nuts is that various high officials at Rutgers seemed to have been involved in mostly an effort at damage control vs. correcting a crazy situation.  How many times do we have to collectively learn the Watergate lesson that the “cover up is usually worse than the crime”?

 

Failure of Process?

The President of Rutgers, Robert Barchi, has described what happened there as a “failure of process”.   It seems to me what happened was a failure of values and judgment.   This was more than faulty systems and procedures.   It also makes me think that there is perhaps an institutional version of learned helplessness going on.  Here is a synopsis of what can happen when organizations get too hierarchical and tolerate abusive leaders.

 

“Rarely does the subject of power and abusive power come up for open discussion…….and yet it is a critical component of any organizational setting. As communication breaks down, errors compound and the situation feels increasingly out of control, organizational leaders become more controlling and authoritarian. Under these circumstances, workplace bullying is likely to increase at all levels and organizations may become vulnerable to petty tyrants. As the organization becomes more hierarchical and autocratic there is a progressive and simultaneous isolation of leaders and a “dumbing down” of staff, with an accompanying “learned helplessness” and loss of critical thinking skills. The organization and the individuals in it become highly risk-avoidant…….”

 

Summary

Anyone who feels justified in using harsh and abusive tactics to get the best out of people needs to look in the mirror and ask what they are trying to accomplish.  Organizations that confuse process with values and judgment need to take a longer look in the mirror.   Empowering people to solve their own problems can be very challenging but ultimately lead to much better and more satisfying results for all involved.