A DOCTOR’S LIFE by Jordan D. Metzl, M.D.

Kona Ironman: The Ultimate Challenge He’d run 25 and four Ironman since his internship. Then, in October, Jordan Metzl, M.D., went to for the big daddy of them all—the Ford Ironman World Championship

S A SPORTS MEDICINE PHYSICIAN at Hospital for Special Surgery in New York City, I care for thousands of athletes every year. Runners, gymnasts, dancers, foot- ball players and others of all ages come through the door, eager to have their injuries treated and hoping for a quick return to their pursuits. In my spare time, I am one of them. On October 15, 2005, my brother JamieA and I competed in the Ford Ironman World Championship in Kona, Hawaii. Triathlon—a sport trio of swimming, triathlons since my internship in Boston. In biking and running performed in succes- fact, triathlons and exercise are what keep sion—is sweeping the nation. There were me going personally, and they help me take roughly 1,800 sanctioned triathlons in 2005 better care of my patients. By experiencing in the U. S., approximately double the num- the same training that many of them go ber held 10 years ago, according to USA through, I can truly understand the aches Triathlon. Nationwide, more than 250,000 and pains that come with the territory. And triathletes competed in races in the U.S. in daily exercise gives me the energy and vital- 2005, compared with 90,000 in 1995. ity to keep up with my busy schedule. Buoyed by the realization that there’s less When I was growing up in Kansas City, wear and tear on the body in triathlon Missouri, our household was always active. training than in running alone, mainly My father, Kurt, a pediatrician, still rides his because triathlon training builds core bike every day. My mother, Marilyn, a psy-

C strength and muscular ability, triathletes of chologist, is an avid ballroom dancer. My T W / all ages (even kids) race in every state. oldest brother, Jonathan, a psychiatrist, is a N PHOTO FINISH O S

S Jordan Metzl, M.D., Physicians and other medical professionals basketball junkie. Jamie, an attorney and N E

V and his brother are frequent participants as well. Ph.D. (and the only one of us who escaped S -

E Jamie celebrate their K “Are you nuts?” people often ask me med school), and Josh, a fourth-year med- K

A stamina. Right: B

: when they find out that I’ve run 25 ical student, are both Ironman triathletes. T Dr. Metzl at work. F E

L marathons and four Ironman-distance Among us, we have run more than 50 >>>

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marathons and 10 Ironman triathlons. fates that might befall me: Dehydration, Through this six-hour phase, I Healing, helping others and exercise were hyperthermia, hyponatremia and cramping concentrated on hydration and the rules of our family. are common. As a physician, I tend to rec- nutrition. Once conditioned by There are varying distances in this sport. ognize these issues early, and that’s helpful, practice, the body can endure such Sprint triathlons, the most attainable, but like other triathletes, I still experience an environment only if electrolyte involve a half-mile swim, a 15-mile bike them. In a typical Ironman distance race, levels are kept in the normal range ride and a 5-kilometer run. Distances go up around 30% of the athletes will visit the and hydration status is carefully from there: Olympic-level events require a medical tent, many requiring IV rehydra- Over the monitored. Each athlete has a for- one-mile swim, a 26-mile bike ride and a tion. Most finishers take 13 to 15 hours to mula for making this work, and 10-kilometer run. Half-Ironman-distance complete an Ironman race. five months CHEERING thankfully, my nutrition plan was races involve a 1.2-mile swim, a 56-mile Nothing could have prepared me for the leading up SECTION successful. Six hours later, I was off bike ride and a 13.1-mile run (half spectacle in Hawaii. When Jamie and I More than the bike and back in the transition to the race, 20,000 ). Then there’s the big daddy of arrived in Kona, four days before the race, area to change into running clothes. I dropped spectators lined them all—the Ironman race. the town was already buzzing, the energy the route of the It’s difficult to describe the feel- overwhelming. Competitors from 50 coun- eight race, right up to ing you experience when it dawns T FIRST GLANCE, the distance of the tries speaking many different languages‘‘pounds and the finish line. on you that you still have to run a is ridiculous. were all there for a common goal: to tackle converted 26.2-mile marathon—after a 2.4- A Among the world’s toughest sport- the Super Bowl of triathlon, the monster fat to HE ATHLETES at Kona are all champi- mile swim and a 112-mile bike ride. Yet, ing events, this race involves a 2.4-mile swim Ford Ironman World Championship. ons. Although they complete the probably because it seems pointless to stop followed by a 112-mile bike ride and capped As the day of the race crept closer, we muscle. I T course at different speeds, everyone after having come so far, you somehow find by a full marathon, 26.2 miles of running. unpacked and adjusted our bikes, practiced started to covers the same distance and faces the same the strength. As I set out from the transition Each year there are 50 Ironman races world- swimming in the ocean and tried to accli- look the difficulties with wind, heat and fatigue. The area, I knew that if I could just keep going, wide, and the world championship is held mate to the heat of the Big Island. Suddenly part.” athletes ranged in age from a 19-year-old I would make it. annually in October in Hawaii. it was race morning. When the alarm college sophomore to an 80-year-old grand- The hours and miles of the run rolled The race in Hawaii is generally reserved sounded at 5 a.m., Jamie and I were already Competitors father. There were people running for caus- onward, and I found myself willing my body for the best of the best. The top two or three awake, thinking about the race that would from 50 es, people with physical disabilities, even one forward.“Move, move, keep the legs going,” finishers in the sanctioned half- and full- start in two hours. Seeing almost 2,000 of countries man diagnosed with ALS who wants to keep I thought, trying to squeeze every ounce of Ironman-distance events—men and women the fittest people from all over the world speaking doing the Ironman as long as he is able. energy from within. Even when there is no of various age groups between 18 and 80— assembled in one place was simply incredi- Then it was time. My heart was pound- more left, one finds something in reserve. usually get an invitation to participate. Not ble. As the competitors lined up for body many ing as all the athletes swam out to the start At mile 16 of the marathon, I passed surprisingly, the competition is fierce at marking, a tradition in triathlon whereby different line. Looking back at the shore, I saw a Jamie. We’d seen each other several times these Hawaii qualifier races. There are also your race number is inked on the skin with languages crowd of fans. Ahead, 1.2 miles of orange throughout the day. Unlike any race we had lottery spots for 200 people, so everyday indelible marker, the fitness and dedication ‘‘ pylons stretched out to sea.“The Star-Span- done before, however, this time I was in the were all mortals get a shot at being one of the more of each athlete were clear. gled Banner” was played, and then came the lead, two miles ahead of him. He was run- than 1,800 participants. there for a boom of the cannon. The race had begun. ning toward me at a place where the route When I found out that I was going to be EARLY CALL common Imagine almost 2,000 people swimming looped back on itself. “Jamie, please be among them, I started the most intense At 7 a.m., more goal— to a common point. It can be rough going, careful,” I told him. I had never beaten preparation of my life: nine workouts a than 1,800 arms and legs everywhere, and the experi- Jamie in a race, and even with his desire to swimmers tackling the week, early in the morning and late in the headed for the ence is not for the faint of heart. As I swam win, I knew he wouldn’t catch me. I didn’t evening. Weight training, swimming, run- start line. Superbowl along, I found myself thinking of the many want him to suffer any physical harm by ning and biking were all part of the regi- of triathlon.” hours we’d all spent practicing in the pool pushing beyond his limit. men. My social life was put on the back and of the profound dedication that hope- As I closed in on mile 25, I heard the burner, and so was my love of hamburgers. fully would be rewarded at the race’s finish. roar of the crowd at the finish line. My legs Over the five months leading up to the race, After swimming for more than an hour, lost their heaviness; my body glided for- I dropped eight pounds and converted fat the end of the first leg was near. Suddenly I ward. As I crossed the line at 11 hours, 59 to muscle. I started to look the part. was out of the ocean and rushing toward minutes, 59 seconds, I knew that I had Finally, it was October. Despite my rac- Jordan D. Metzl, the transition area to change from swim- found the strength that makes the Ironman C C T

T M.D., is a sports W W / ing experience, I was nervous. In the world / medicine physician at ming to biking gear. In Kona, the 112-mile the ultimate challenge of body and spirit. N N O O S of triathlons, Kona is legendary for its diffi- S Hospital for Special bike ride is mostly along the Queen Ka’ahu- When Jamie came across the line 30 S S N N Surgery in New York E culty: The heat and wind have destroyed E manu Highway. Cut through lava fields, it is minutes later, I was just as excited. Com- V V S S -

- City and the medical E E K many athletes. On the flight to Hawaii, I K columnist for one of the hottest roads in the world, with pleting the Ironman with your brother is K K A A ●D B found myself thinking of all the possible B Triathlete Magazine. temperatures routinely topping 130 degrees. the best vacation I can imagine. >>>

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