Human Limits

Last Fall I reviewed some of the risk factors, including inactivity, for Alzheimer’s disease and cognitive decline with aging.   In this short post I want turn the discussion around and highlight a couple of things related to cognitive or even school performance and physical activity in kids.  My interest in this topic was stimulated by a news report of a study in Denmark showing that kids who walk or ride their bikes to school concentrate better.  This stimulated me to look a little more about what research tells us about physical activity and school performance.

Study 1:  Walk and read better.

A single 20 minute session of brisk treadmill walking improves academic performance in pre-adolescent children especially reading comprehension.   Here is a figure from that study.  The filled bars are the scores after walking and the open bars are the control scores.

The authors concluded that:

“Collectively, these findings indicate that single, acute bouts of moderately-intense aerobic exercise (i.e. walking) may improve the cognitive control of attention in preadolescent children, and further support the use of moderate acute exercise as a contributing factor for increasing attention and academic performance. These data suggest that single bouts of exercise affect specific underlying processes that support cognitive health and may be necessary for effective functioning across the lifespan.”

Study 2:  A review of physical activity and academic achievement.

This paper is a review of ideas about the so-called academic achievement gap in school performance by some ethnic and socioeconomic groups.   Based on the data surveyed the following conclusions emerged:

“Physical inactivity is highly and disproportionately prevalent among school-aged urban minority youth, has a negative impact on academic achievement through its effects on cognition, and effective practices are available for schools to address this problem. Increasing students’ physical activity and physical fitness can best be achieved through a comprehensive approach that includes physical education, wise use of recess and after-school times, co-curricular physical activity opportunities, and bicycling or walking to and from school.”

Study 3:  Exercise helps kids with ADHD focus. 

This study used a walking protocol similar to study one highlighted above in 20 children (8-10 years old) with ADHD and found:

“Following a single 20-minute bout of exercise, both children with ADHD and healthy control children exhibited greater response accuracy and stimulus-related processing, with the children with ADHD also exhibiting selective enhancements in regulatory processes, compared with after a similar duration of seated reading. In addition, greater performance in the areas of reading and arithmetic were observed following exercise in both groups. These findings indicate that single bouts of moderately intense aerobic exercise may have positive implications for aspects of neurocognitive function and inhibitory control in children with ADHD.”

Summary:  Physical activity is emerging as a key modulator of academic performance and learning among children of all sorts.   It also appears to be a gift that will keep giving.  In a study from Scotland, 11 year old children studied in 1933 and also studied again 68 years later at age 79 showed that physical fitness early in life was associated with successful cognitive aging.   The policy implications of the findings highlighted above for things like physical education in school, recess and public policies aimed at getting kids moving are pretty striking.   If we want a smarter world we need a fitter world.

It has been a few weeks since I posted on larger societal issues like longevity or the U.S. Federal Budget.  However, a recent column by David Brooks in the New York Times on “Big Data” caught my eye.   The idea is that in the electronic world there is all sorts of data out there that can be analyzed and that many of the ways we think and many of the assumptions we make don’t hold up when analyzed.   As early as the 1980s people started to evaluate the idea of the “hot hand” in basketball and found the widely accepted idea that people go on hot streaks is not accurate.  Brooks goes on to highlight a number of areas where the data from various sources is being used to challenge long held ideas or conventional wisdom.

One problem with the current infatuation with “data” is that we don’t always know much about the quality of the data.   This has been acknowledged by IBM, a company that has made a major push into the business of what is generically known as analytics:

“The volume of data produced today isn’t just increasing—it’s getting faster, taking more forms and is increasingly uncertain in nature. Uncertainty arises from such sources as social media, imprecise data from sensors and imperfect object recognition in video streams. IBM experts believe that by 2015, 80 percent of the world’s data will be uncertain.”

We see this all of the time in medical research where information gleaned from clinical records has to be scrubbed before it can be used in a meaningful way to address a scientific question.   It is also possible to be “led astray” using observational or easily available data.   There are a number of high profile examples of medical practices based on observational data did not hold up or were reversed when they were tested in a more rigorous fashion using a more controlled approach.   One of the best examples is post-menopausal hormone replacement therapy.   However, this remains controversial and full of nuances, so the more we know sometimes the more we don’t know.

The other issue here is that all the data in the world is no substitute for judgement.   I have used the example of Robert McNamara in the past and his “data driven” approach to “managing” the war in Vietnam.  I would urge everyone interested in the limits of number crunching and metrics to watch the Fog of War.  As the clip below points out, if your fundamental assumptions are wrong all of the data in the world will not help you get it right.

The final and perhaps more optimistic point I want to make is that sometimes an off the wall anti-metric approach is so disruptive that it wins and is incredibly successful.   The ideas about a hot hand in basketball aside, for those of you interested in really thinking differently the ESPN 30 for 30 “Guru of Go” on Paul Westhead and Loyola Marymount’s ultra-fast style of basketball is instructive.   Westhead was a traditional coach focused on defense, ball-control, getting a good shot and minimizing turnovers until he realized there was a faster and more chaotic (yet organized) way to play.

Summary:  The current obsession with metrics, data driven approaches, analytics and big data need to be taken with more than one grain of salt.   Sometimes it is the stuff you can’t measure that really counts.  All of us who value freedom and democracy are lucky that Winston Churchill was not concerned with the “metrics” of World War II when Britain stood alone and all seemed lost in 1940.   As the psychiatrist/historian Anthony Storr pointed out:

“In 1940 Churchill became the hero that he had always dreamed of being.… In that dark time, what England needed was not a shrewd, equable, balanced leader. She needed a prophet, a heroic visionary, a man who could dream dreams of victory when all seemed lost. Winston Churchill was such a man.”

If history is any lesson, then perhaps the important questions for the future are less about data and more about judgement.

Recent policy changes in the U.S. military will allow women to serve in so-called combat units.   There is some skepticism about this related in part to the idea that women may not be able to do all of the physically demanding things required to qualify for assignment to these units.   This is especially true for the most physically demanding jobs in things like the Special Forces.

What are the standards?

Standards vary by service but here is a link to the basic fitness standards for the U.S. Marines.  I am using the Marines for the purpose of this discussion because they have been very open in discussing the “Women in Combat” issue and because the Marines place extra emphasis on fitness by all members of the Corps.   Here is what it takes to get a perfect 300 on the fitness test for a Marine in the 17-26 year old age group (the standards are age adjusted) and also the minimum standards.

To earn a perfect PFT score of 300 points, a male must do 20 pull-ups, 100 crunches in less than two minutes, and complete the three mile run in 18 minutes or less. A female perfect score is 70 seconds on the flexed arm hang, 100 crunches, and a 21 minute three mile run. The minimum a male Marine must complete are 3 pull-ups, 60 crunches, and a 28 minute (9:20 pace) 3-mile run. The minimum a female Marine must complete are 15 seconds on a flexed arm hang, 44 crunches and a 31 minute (10:20 pace) 3-mile run.

The Running Standards vs Marathon Times

How do the minimum running standards above compare to something like the average pace for the marathon?   Here is some summary data from about 520,000 marathon finishes recorded 2011.

Remember these times represent all comers and when you compare them to the 3 mile pace standards for young Marines listed above it is pretty clear that all sorts of people could in fact meet the Marine Corps minimum standards for the three mile run.   Based on years of watching people improve as they train, my rough guess is that many males in their 20s could break 21 minutes for three miles and many females in their 20s could break 24 minutes.

The data below is a further breakdown of the marathon data and about 30% of men break 4 hours (9:10 pace) and almost 20% of women do.   There are all sorts of caveats about this data including people could have run multiple races and some of the times include delays while runners farther in the back pack got to the starting line.   The data is not also broken down by age.   However, I would say this data clearly proves that many women could meet the running standards for combat units.

Strength

There is nothing like the data above for strength differences in men and women as assessed by things like pull-ups and push-ups.   We don’t see thousands or people participating in massive group events and competitions to see “who can do how many” all over the world like we do for running and the marathon.   However, a few rigorous training studies suggest that young women can improve remarkably and that many could meet current standards with training:

“Strength training improved physical performances of women over 6 months and adaptations in strength, power, and endurance were specific to the subtle differences (e.g., exercise choice and speeds of exercise movement) in the resistance training programs (strength/power vs strength/hypertrophy). Upper- and total-body resistance training resulted in similar improvements in occupational task performances, especially in tasks that involved upper-body musculature. Finally, gender differences in physical performance measures were reduced after resistance training in women, which underscores the importance of such training for physically demanding occupations.”

That having been said, my bet is that with intensive training, plenty of women would be able to meet current body weight specific tests of strength.  Whether the distribution would be similar to that for running is not clear, but the point is plenty of women could qualify.

Special Forces

The table above also provides some insight into what happens if the standards are really tough as they are for the Special Forces in various services.   If you set physical standards that less than 1% of men can meet then perhaps only 0.1% of women will be able to meet them.   Until you get to the fastest of the fast or the strongest of the strong do you see things that “no woman” can do.   The figure below makes that point for the marathon (42,000m) and 1,500m times.

This is an Old Issue!

In the 1970s my teacher Jack Wilmore was asked to evaluate whether women could ever be fit enough to serve in the California Highway Patrol.  Many of the arguments about physical strength and fitness as they relate to women in combat echo the arguments made about police and firefighter work in the 1970s and 80s.    In a classic study Dr. Wilmore made a number of observations including the fact that many police officers were in poor physical condition once they finished training.  He also advocated task specific fitness tests, and noted that:

“….there were overlaps between the range of values for each task for males and females, indicating some women were performing better than some men.  The authors feel strongly that a screening test battery must be nondiscriminatory both on the basis of age and sex.”

Summary

The data from exercise physiology and sports performance studies clearly indicate that with training there will be many women who can pass the rigorous physical fitness tests required for assignment to many combat units and combat related jobs in the U.S. military.  The only exception to this conclusion might be seen in the Special Forces with physical fitness standards similar to those seen in truly elite athletes.   I will leave the political, philosophical, and religious discussions about women in combat to others.  However, from a physiological perspective there is no reason to bar women from combat, and there is no reason to believe many women will not qualify and excel.

In a post last September colleagues from the University of Kansas highlighted a free exercise program in Lawrence, Kansas known as “Red Dog’s Dog Days”.   I have been studying exercise in the lab since I was 19 years old, and that got me thinking that it was time to get out of the Ivory Tower and try something similar in Rochester, Minnesota during 2013.     My wife Teri was enthusiastic and so was Wes Emmert, an experienced strength and conditioning expert.  Wes has forgotten more types of calisthenics, body weight strength exercises, and agility drills than most of us have ever heard of.    He also knows how to stop people mid position during push-ups for a 5 second hold to make things more “enjoyable”!

The initial plan was to pilot the program on Saturday mornings with friends this winter and then open things up to the community in April.   However, the local paper reported on one of our earliest sessions and things have accelerated from there.   We now have a Facebook page and during the first month more than 50 different people have participated in our Saturday morning workout –10:30 at Soldiers Field track, EVERYONE IS WELCOME!  The youngest participant has been less than 10 and the oldest around 70.  Most people seem pretty fit to start with but it is also clear we have some beginners and folks perhaps looking to lose a little weight or get back in shape.  The goal is to make the program welcoming to people of all ages and fitness levels and provide everyone a workout they can calibrate to meet their own goals.

All of this has happened outdoors which makes it even more impressive considering how cold and windy it is in January in Minnesota.   Here is a sample of what we did a couple of weeks ago:

•  Stationary Warm-up  (neck circles, jumping jacks, etc)
• Moving Warm-up (over/under hurdles, knee to chest walk)
• Push ups for 60 seconds – lunge to first pole and jog back
• Mountain climbers for 60 seconds – high knees to second pole and walk back
• Squats for 60 seconds – butt kicks to third pole and walk back
• Planks for 60 seconds – skip to fourth pole and walk back
• Sit ups for 60 seconds – run to fifth pole and walk back
• Split squats for 60 seconds – jog to fourth and walk back
• Abs of choice for 60 seconds – side shuffle to third pole and walk back
• Back extensions for 60 seconds –  grapevine to second pole and walk back
• Burpees for 60 seconds – walk to first pole and back
• Cool down – (yoga)
• Optional 2 mile run

So, what have I learned so far?   I have learned that burpees (squat thrusts), planks, lunges, and mountain climbers are much harder than I remember them being in about 1975.   I have been sore for a couple of days after doing them on Saturdays and am now incorporating these movements into my training during the week.  I have also learned that it is pretty easy to stick with what you know and what you are good at.  Endurance sports have always come easy to me and my approach has typically been when in doubt go for a run, get on the bike or hit the pool.   The data shows that as we get older staying strong is really important and my struggles with these simple body weight maneuvers has been an eye opener.  Our ability to literally get up off the floor as we age is a pretty good predictor of healthy aging and even longevity.  Doing challenging old-school calisthenics would seem like an easy way to address this issue.  I am also thinking about starting to jump rope again (remember high school basketball practice?) to improve my footwork and general coordination.

The other thing I have re-learned is that working out with a group is fun and so is using a bull horn and a coach’s whistle.   If the program grows, we may have to invest in an air horn!

I got an e-mail a couple of weeks ago from a reader about when to start training again after a marathon.   That is a pretty broad based question and the answer depends on all sorts of things including the training background and goals of the athlete, the course he or she just ran, and just how sore and tired the runner was after the race.   Here are a few things to think about.

Delayed Muscle Soreness

After a period of exercise, especially trying something new, people frequently experience so-called delayed muscle soreness  that usually peaks about 48-72 hours after the bout of exercise.   This can also happen after something like a marathon and downhill running is a notorious way to generate delayed muscle soreness.  The idea is that microdamage to muscle and inflammation lead to the soreness and pain.   Going down stairs is particularly uncomfortable but going downstairs backwards typically is much easier.   What is interesting is that things like stretching and cold water immersion post-exercise don’t seem to help that much.  Drugs like ibuprofen can help with the soreness but may not improve muscle function either.   The best way to avoid delayed muscle soreness is to start a new program slowly.  One key for running races with a lot of downhill is to actually do some training going downhill.

Training After a Marathon

The rule of thumb is that it takes about 1 day per mile to recover from a race.   So 6 days for a 10k and 20 plus days for a marathon.   I am not sure where these rules of thumb came from and again they would depend on how trained the runner is and a lot of the individual factors mentioned at the start of this post.   However, there is some research on what happens when people do run in the days right after a marathon and whether it speeds recovery.   In a classic study from the 1980s, scientists at Ball State University studied 10 young male runners who ran a marathon on average in less than 3 hours.   Half of the runners ran for 30-45 minutes per day the next week, and half rested.   The authors concluded that:

“Seven days rest postmarathon did not allow complete recovery of maximum peak torque (MPT) nor did exercise facilitate recovery of work capacity. To prevent impairment of the normal course of recovery postmarathon, exercise intensity and duration must be judiciously selected.”

Active Rest

So what to do?  After something like a marathon give yourself at least a week or two to recover.  One idea is to use something called active rest.   This might include things like cycling, swimming, or deep water running for a few days at 50% effort for about 30 minutes until the delayed muscle soreness has passed.   Then slowly add a bit of running.  Daily training is a part of the routine for most people who do marathons so there is no need to get out of your routine.  However, there is nothing magical about “running the next day”, so give it some time and substitute other activities.  One of the nice things about both biking and swimming is that they seem to generate much less of the soreness associated with running.

I have gotten a lot of e-mails and chatted with a number of friends about the future of sports doping post Lance and Oprah.   Here is a sample of what has come up.

The Future of Doping?  A couple of people sent me a link to a New York Times piece on doping in the 21^st century.    Among other things this piece talks about so-called gene doping and other high tech approaches to doping.  I am a bit skeptical in the short run because literally billions of dollars have been spent on gene therapy for medical conditions like cystic fibrosis with limited success.   So when gene therapy becomes a reality in clinical medicine we can maybe revisit the possibility of gene-doping in sports.

The 1% Solution?  Most people, including journalists, fail to understand that a 1% edge in something like a 10,000m running race means the doper wins by 100m, a huge margin.   This also means that there is no need to use industrial strength doping.  Thus doses of things like EPO and steroids can be given at levels beneath the threshold of detection with any imaginable drug testing technology.    A number of people, and I am one of them, are shocked that anyone fails a drug test given how beatable they are.   The low rates of positive tests at things like the Olympics can be seen as proof that testing is working or proof that testing is beatable.  Perhaps it is some of both.

Brand Protection vs. Drug Testing?  Some argue that all the sports federations, leagues, sponsors and TV networks want is the appearance of clean play and that depending on the situation they intentionally or unintentionally turn a blind eye toward doping.   The idea is that if they really cracked down, all sorts of people would have to be suspended, and the “product” would be second rate.  The best example used to support this reasoning is the widespread suspicion that management tolerated or even tacitly encouraged steroid use in Major League Baseball in the late 1990s after the 1994-95 baseball strike.   Was doping part of a pact of ignorance designed to generate home run records and get fans back in the stands?

How Many Tours Would Lance Have Won Without Doping?  The short answer is who knows.   The Tour de France is a long and brutal three week race that lasts about 90 hours with margins of victory of only a few minutes.   Additionally, perhaps only 5 to 10 of these hours are typically decisive.   So to win, the champion must be lucky and not crash, have a team to protect him on the long boring stages, and then do well in the time trials and on a limited number of the steepest climbs.  Time trialing and steep climbing are especially sensitive to something called VO₂ max and this is where EPO use or blood doping would make the biggest physiological difference.   So Lance appears to have had the best doped team, best able to protect him and his doping strategy was optimized for the critical stages.   However, based on what others have said he also trained like a maniac and left nothing to chance.   So again, who knows……. he might have won several but I doubt seven in a row.

The Level Playing Field?  Everyone was doping therefore it is “dope or be marginalized”, that is more or less one of the arguments Lance made to Oprah.   Just like the average person and journalist do not understand what 1% is worth, most don’t understand what it is to be immersed in a micro-culture where the only things that matter are the last race or workout or the next race or workout.   So the temptation to dope is immense.  The 1968 Boston Marathon champ Amby Burfoot has recently commented on this and wondered whether he would have doped back in the day.   I applaud Amby for being so honest.

What Next For Lance?  I see three paths:

1. He gets caught in a downward spiral of lawsuits and legal proceedings over the next few years and his downfall is complete and might include prison time.
2. He drifts into irrelevancy and perhaps ends up on a reality TV show for faded celebrities down the road.
3. He names his enablers, has a protracted apology tour, settles the lawsuits and is back in business one way or another.

If I were betting, I would bet on number three.  Never underestimate someone as driven as Lance Armstrong.

In several recent posts I have tried to provide some information about life expectancy and measures of public health that might inform the current debate on raising the eligibility age for Medicare and perhaps Social Security.  These posts focused on some basic facts about longevity trends over the last 50 plus years. I also highlighted differences in life expectancy for men and women and also the influence of race and socioeconomic on life expectancy.  Finally, I made the point that behavioral and other risk factors that operate throughout life need to be addressed if we want to narrow the effects of sex, race, and money on life expectancy.  In this data heavy post I want to focus on the future of longevity and ask what this might look like going forward.  One idea is that life expectancy is going to continue to rise, and the other idea is that as a result of the obesity epidemic and other factors it is going to flatten out.

What the US Social Security Administration says

The next four figures are from the U.S. Social Security Administration (SSA) and might be described as the “official” estimates from 2005 for what might happen to life expectancy in the future.   Here is a description of the first figure from the SSA report.

“The figure shows life expectancy at age 0, by sex and calendar year, based on period life tables. Rapid gains in life expectancy at age 0 occurred from 1900 through the mid 1950’s for both males and females. From the mid 1950’s through the early 1970’s, male life expectancy at age 0 remained level, while female life expectancy at age 0 increased moderately. During the 1970’s faster improvement resumed for both males and females. Life expectancy for males and females in the 1980’s improved only slightly with males improving more than females. In the 1990’s, life expectancy has remained fairly constant for females, increasing only slightly for males.”

The second figure is also from the same SSA report and shows trends and projections in life expectancy at age 65.

The third figure from the SSA report I want to show is about the age of the oldest of the old…….people who truly are one out of 100,000.   For those interested in the topic of extreme aging here is a link to a list of the oldest lived people in history.

The final figure is comparative survival curves from 1900 to 2100.  Here is a description of this figure from the SSA report.

“This figure presents the population survival curves based on period life tables for selected calendar years. Great strides were made in the twentieth century toward eliminating the hazards to survival which existed at the young ages in the early 1900’s. Very little additional improvement to survival rates is possible at these young ages. Survival rates at the older ages are projected to continue to improve steadily. Projected gains in the probability of surviving to age 90 during the next 50 years are about the same as experienced during the past 50 years. For age 100, projected gains are much greater than for the past. Figure 5 shows population survival curves based on period life tables for, from left to right, 1900, 1950, 2000 and projected years 2050 and 2100.

 Although the shape of the survivorship curve has become somewhat more rectangular (less diagonal) through time, it appears that very little additional rectangularization will occur because survival rates are already so high at the young ages and are expected to continue increasing at older ages. The so-called “curve squaring” concept, though appealing to many, simply cannot be supported by the mathematics of mortality. The age at which the survivorship curve comes close to zero, through the compounding of single-year probabilities of survival, has increased greatly during the twentieth century and will continue to increase, as further strides are made against degenerative diseases. That mortality rates are found to continue to decline, at every age for which adequate data are available, demonstrates that no absolute limit to the biological life span for humans has yet been reached, and that such a limit is unlikely to exist.”

Looking past the Social Security data

As I noted in my introductory comments, there are two basic ideas about the future of longevity.  The first idea is that life expectancy is going to continue to rise and that the curves above might be underestimating life expectancy in general and the fraction of people who make it to 100 or older in specific.  If this occurs the public policy implications for the funding of and eligibility for Social Security and Medicare are problematic at best and a demographic time bomb at worst.  Here is a quote from the article by Olshansky and colleagues:

“The cumulative outlays for Medicare and Social Security could be higher by $3.2 to $8.3 trillion relative to current government forecasts……….”

There are also concerns about the techniques used to make life expectancy forecasts for the Federal Government that might lead to underestimates over time.  The second idea is that life expectancy is going to decline due to obesity and other factors.   The people who take the position that life expectancy might fall are also concerned about the techniques used to make these forecasts and that they might lead to overestimates of projected changes in life expectancy.

Caveats & Conclusions about the future life expectancy and where this will lead

• Any changes in life expectancy are likely to be unequally distributed in the population at large.  They are more likely to be seen in educated, well-connected better off people.  Even in a country like Sweden where heroic steps have been taken to reduce health care disparities and inequalities, there are still health disparities and inequalities in life expectancy.
• The genetics of who makes it to 90 or 100 are not well understood and no obvious genetic markers that predict extreme old age have been identified.  There is also some evidence that none will emerge with further research.
• My personal opinion is that trends in life expectancy will be divergent with some people trapped in a cycle of lifestyle related diseases and low social autonomy.  There will be another group of long lived super guideline followers who will be generally well-educated and better off.  These people will also be physically active, non-smokes, relatively normal weight, moderate drinkers, and engaged in life.

News reports indicate that Lance Armstrong will admit to doping when he is interviewed this week by the media impresario and TV personality Oprah Winfrey.   In a number of earlier posts I have laid out the pros and cons of the Lance doping case, his motivation to dope,  stonewall and then stop contesting doping allegations, and the idea he might be seeking a “second act.  In addition to looking for some sort of return to the limelight there is at least some speculation that Lance is worried about criminal charges if he admits to too much.

All of this makes me think about Richard Nixon, who resigned the Presidency in the wake of the Watergate scandal, and a series of interviews he did with David Frost a few years after he resigned.   Nixon and Armstrong both grew up under tough circumstances.  They were both self-made, tenacious, incredibly resilient, and devoted practitioners of hard-ball tactics.   Lance “won” the Tour de France 7 times; Nixon is the only man to be on the National ticket of a major political party and run for President or Vice President five times.   Frost was an all-around media operator and society high flyer before Oprah took these labels to a new level.

That having been said, Nixon fundamentally never saw Watergate as more than a political problem vs. a series of criminal acts.   The clip below shows this pretty clearly.  Will Oprah be able to get a similar admission out of Lance?   Nixon saw Watergate as political gamesmanship that needed to be contained.   Will Lance tell Oprah that he saw allegations and denials concerning his well-organized doping program as athletic gamesmanship that needed to be contained vs. a vast and corrupt criminal conspiracy that did all sorts of damage to all sorts of people?

click here  for video

In the next clip Nixon says:

 “I don’t go with the idea that there … that what brought me down was a coup, a conspiracy etc. I brought myself down. I gave them a sword, and they stuck it in and they twisted it with relish. And I guess if I had been in their position, I’d have done the same thing.”

click here for video

Nixon, for all his faults, understood that in the end he was a victim of his relentless and even obsessive use of hard ball tactics.  Will Lance ever understand this?  Additionally, at least until now, Lance clearly has not grasped the central lesson of Richard Nixon’s life……..that a cover up is always worse than whatever led to it.

Richard Nixon can be seen as tragic giant.  If Lance is lucky he will avoid prison, retain some of his fortune, and re-emerge as a less than first rate celebrity.