Find Your Grit

It’s easy to pick up a magazine with articles about health and fitness, how to improve a running time, or how to increase muscle size, all of which are positive. There are barriers for every sport known, but how do you overcome the obstacles?

Does it take a support system, or can an individual tackle the situation alone? In keeping with sharing information and motivation and overcoming barriers, this column is about the barrier of anorexia nervosa, an eating disorder characterized by weight loss; difficulties maintaining an appropriate body weight for height, age, and stature; and, in many individuals, distorted body image. People with anorexia generally restrict the number of calories and the types of food they eat.

The recent accomplishment of Vikki McKane-Dent is the ninth-place finish, in 4:21:44 at the USATF 50K (31.07 miles) Road Championship in Lloyd Harbor, NY on March 3, 2019. Two weeks prior, McKane-Dent ran in the Washington’s Birthday Marathon and placed third with a time of 3:23:27.

Let me first introduce the term “grit,” which is from a book written by Angela Duckworth called GRIT: The Power of Passion and Perseverance. In her terms, “Grit is about having what some researchers call an ‘ultimate concern’—a goal you care about so much that it organizes and gives meaning to almost everything you do.”

Keep the term “grit” in mind as you read.

The prior column was about Adam Popp, and do you think he displayed grit?

Think about your exercise program or sport of choice and how committed you are to it. It’s personal, and you can’t work out for the benefit of others. If you go out and set a personal best in a 10K, it does nothing for me.

If I want the benefit, then I need to run the 10K.

Let’s take a walk back to where Vikki was as a teenager: “I didn’t start running until I was 17, and by then I’d been anorexic for nine years. But I was pretty good at it—1600 in 5:01, 3200 in 10:52. In a rare moment of clarity I thought, ‘what would happen if I could eat?’

Vikki continues: “I never ran in college and weighed 69 pounds at age 20 (I was 5’8”). Working with a coach, I withdrew from college and was hospitalized for nearly a year, doubling my weight, growing two inches taller. But my bones couldn’t handle running, so I took up cycling. I didn’t run again for nearly 10 years. I can run more now than I could as a teenager. I am incredibly thankful to Benji and Amie Durden for getting me through my toughest times.”

There was internal motivation to achieve a predetermined goal: “I had an extremely difficult time when hospitalized for anorexia, as I was told I could ‘never run again’, and not a single practitioner believed me when I said that running was the impetus to my desire to overcome the eating disorder. Honestly, I don’t think the desire to be a walking skeleton will ever go away. I had over 20 years with no issues whatsoever, but then was hit hard a little over a year ago, when out of the blue I stopped eating again. Running has again brought me back.”

Vikki adds, “I am thankful for every day that I can run. When I was a teenager, I thought my knees were ‘shot’ (per several orthopods). Because I could not initially run after my recovery, I became a cyclist, and was a two time All-American. I briefly raced professionally, beating Jeanne Longo the weekend before she won the Atlanta Olympic road race. But in that same race, I hit 79 MPH on a canyon downhill and narrowly missed a head-on collision with a pick-up truck. After that, I lost my nerve to race bikes. (However, my husband and I just bought a titanium tandem racing bike, so we plan to race tandem together —very excited! And heck, if we crash, ‘…we will all go down together’ – Goodnight Saigon, Billy Joel).”

There are always obstacles to overcome, she said. “I have mitral valve prolapse and tricuspid regurgitation—and though I am supposed to see a cardiologist annually and was told back in 1998 that I’d need to have valve repair, I figure that if I can still run comfortably, I am not changing anything. I’m a medical doctor myself—first in family medicine, then in anatomic and clinical pathology with a fellowship in transfusion medicine. My heart rate does tend to run high. When Benji Durden was my coach, we tried the heart rate monitor thing, but gave up when I could not get my heart rate under 150 even at 12-minute pace. Yet my resting rate ranges from 40-55. Physicians don’t know everything, and it is most important to remember that the doctor works for you. If he or she is abusive to you (I had an obese patient I sent to an orthopedic surgeon once, who told her, ‘You are too fat to exercise. Go home and eat fruit,’ which is abuse and reportable to the state medical board), or does not address your concerns, or cannot fully answer your questions, or worst, does not admit to not knowing something (the most dangerous doctor is he who thinks he knows it all), then find another doctor and report your adverse experience to your insurance company.”

She has some additional thoughts. “Very few physicians are athletes. In medical school, things are so very competitive that we do little other than study and try to outdo everyone on tests. The result is that many doctors do not have the mindset that being active—running, hiking, climbing things, cycling, sledding, skating, walking, you name it—is the norm, and that as long as you are alive, you are ‘OK.’ I’m from Colorado, where it’s perfectly normal to run 10 miles with a cold. Here in Pennsylvania, everyone thinks I’m nuts to run no matter what. While people feel it’s perfectly acceptable to criticize my running, it would be totally inappropriate to point out to an obese individual that eating a McDonald’s super-sized meal deal is a really poor idea.”

Vikki continues, “I’m kind of disappointed with the 50K results, though happy to be 16 minutes faster than three years ago. I misjudged the calories I’d need and forgot about calories for shivering. With 15K left, I was cold. With 10K left, I was hungry. It was all I could do to hang on to finish.” 

Vikki’s views on focus. “That’s hilarious! I have ADHD. The diagnostic criteria for children include inappropriate running and climbing at school. At work, I used to get in trouble for running in the halls with trays of slides and for climbing on my desk (to fix the air vent above my desk). Focus is not one of my skill sets. Running in a way ‘takes the edge off.’ It calms my brain enough that I can relax for once. It’s difficult for me to remember that I’m supposed to be racing in marathons and longer.” 

What does she think about when she’s running? “I do a lot of math—differential equations-type things (calculating the speeds of two moving objects with respect to each other), or converting miles per hour into feet per second to figure out how many seconds it’ll take for that speeding car to hit me, or I think about difficult diagnoses for patients, or think about a research project I’d like to do.”

Vikki comments on thoughts about racing and competition. “I really dislike racing. If I feel the need to see how fast I am, like in a 5K or 10K, I can do that on my own, without paying money and getting another T-shirt or award to throw away. I enjoy the company on long runs, in races of 10+ miles. I try to run at the outer envelope of my ability and run negative splits always. I never look at age group results—I’m racing for overall, not just women. In 2017 I ran a 19:24 5K for third overall—behind the first two men. So, although I hate racing, when I do race, it’s for the overall win. Ann Trason was the first woman to outright win a national championship, over men in the 24-hour run. I run because I love it. It helps me deal with depression and PTSD. Back when I raced seriously, my coach and psychiatrist had to consult, because when we dropped my mileage after races, I used to get hospitalized. Until I worked with Jerry Mungadze, a Kenyan PhD psychologist. Since then, whenever my mileage is under 50 a week, my meds need adjusting.”

Vikki shares some thoughts to those who may be in the place where she has been. “It is a hard, long road back, and the desire to be a skeleton may never go away. This isn’t like addiction where you can avoid the substance of abuse for the rest of your life. We need to eat every day for the rest of our lives. It’s most helpful to enlist help of the trusted people in your life, to separate eating from running, and never weigh yourself. Benji and I together eventually realized that when I was ‘feeling fat’ or calling myself fat, that either I was feeling unloved and unimportant, or there was some strong emotion I was having with which I couldn’t deal or express. You need to find someone you implicitly trust and, in a way, decide to believe them, regardless of what you feel. My husband now does that for me as well as Benji and Amie Durden. I decided if any of these three told me, ‘Vikki, you are not fat’ or ‘you did not eat too much,’ I could and would believe them. This is not easy to do and it takes time to develop that kind of trust. But it has saved my life.”

The following accomplishments stands out: “[The accomplishment of which] I am most proud probably is starting the intercollegiate cycling team at the University of Colorado School of Medicine over 20 years ago. It still exists and provides an opportunity for medical, nursing, and pharmacy students to race collegiately (it’s run under the NCCA—National Collegiate Cycling Association, so one can race until one achieves a doctoral degree). Cycling is a team sport, while medical training tends to put students against one another. Grading is on a curve—top 5% of the class get “honors,” while anything under 70% is failing. There is no distinction in between. People in study groups intentionally mislead each other, in hopes of lowering others’ grades.

“My running philosophy: It doesn’t matter how slowly you go, as long as you are out there moving!”