Yes, You Need More Than Just You

Last Saturday morning I woke up, facing into my seventh and eighth training sessions in four days and I struggled. As my care assistant knocked the door, let himself in and made his way up the stairs in my house, I wanted to tell him to turn around and let me sleep on.

I want to write this blog to tell you that I can only do what I do because of people and the strategies that they help me to keep in place. Good people. It made me think of all of you who are part of Run in the Dark: training, struggling with training, fundraising, volunteering and setting up pop-ups. I suspect that the good people around you are as important to you as they are to me. Whether it’s a running partner or someone to watch your kids when you’re training or a good physiotherapist. We need more than just us to get where we want to go. It’s the only way. I am sure of it.

So, when last Saturday, my care assistant knocked the door, let himself in and made his way up the stairs in my house and I wanted to tell him to turn around and to let me sleep on, (not because I am lazy or just don’t fancy it, but because it’s hard and I’m tired and eight sessions in four days is a tough schedule with work and life and all it involves), I said nothing. And this was only because I knew that in 90 minutes time Simon O’Donnell, my South Pole teammate turned rehab teammate would be waiting in the gym to help me train and Dr. Neil Fleming, the post-doctoral research fellow that we fund, would be ready to capture the data.

My care assistant, Chris came into my room, I transferred onto my shower chair and rolled into the shower. He got my clothes, I dressed and we headed to the lab. Simon, Neil, Chris and I together completed 30 minutes of standing me at a squat rack completing single knee bends, alternate knee bends, double leg straightens and squats.

Then I completed my usual hour of spinal electrical stimulation while walking in my robot.

The reason I am doing it is clear to me – I want and have a shot at treating, if not curing my and others paralysis. I am the only person in the world so far who’s fortunate enough to trial this combination of electrical stimulation, drug and walking. But even when the future benefit is clear, my present self (the tired self who wants to sleep) trumps the future self (the paralysed man who is getting some way better). Even where there can be no clearer incentive for me to commit to every training session, I need strategies and good people to guard against my present self failing. People I cannot and will not let down.

So, now, at the end of another day with an early morning in the gym tomorrow, I think about that Run In The Dark red river of light that will flow through the streets on Wednesday the 11th of November carrying me along with it (www.runinthedark.org). I think about the 25,000 people right around the world pulling on running shoes and going training and how you’ve helped me to get out of bed, to go to the lab. Over the last few years I’ve met so many people with different reasons for running: some run in the dark as first timers with the aim of finishing, some are there to win, some are there for their loved ones who are injured and so many are there to help us fast-track a cure for paralysis, to be on this most exciting of expeditions. Runners, walkers, volunteers, committees, professionals and sponsors, look after yourselves, get help and support from others to do so, and know that I couldn’t do this without you.

My Beating Heart

I spend almost every day in the gym. I wear sports kit almost all of the time and I’m forever banging on about my diet and training. But I never have to change my kit after training because I never really sweat. The reason that I never really sweat is that my paralysed muscles don’t contract, which means they never demand extra oxygen, which means my heart rate never goes up and I don’t sweat and it’s incredibly frustrating.

But on the 14th of September everything changed. About 50 minutes into my usual 60 minutes walking in my Ekso Bionics robotic legs, something quite incredible happened. For the first time since I strapped my paralysed body into my exoskeleton in 2012 and over half a million steps ago, my heart rate reached a maximum of 166 beats per minute.

Watch Mark explain adding the heart monitor into today’s training.

The beating heart

Let me explain why this is so significant. In September 2008, a couple of months before I skied to the South Pole, I did a number of physiological tests. During one of these I ran on a treadmill and achieved a maximum heart rate of 178 beats per minute. At that time I was told that my aerobic stamina training for long distance cross-country skiing in Antarctica (mostly Simon and I training on indoor ski machines or dragging tyres behind us on a beach) should be in the range of 129 – 157 beats per minute. I was to start training at the lower end of this range and move towards the upper limit where I should feel it getting progressively harder. And, it did. At 157 beats per minute the effort wasn’t sustainable for 14 hours per day for weeks on the ice.

Below is a clip of Mark at his first South Pole training session with Simon O’Donnell in 2008.

Maximum heart rates differ depending on the person, age, fitness and on whether the test is done, for example, while running or cycling. We certainly must expect that there is a difference in maximum heart rate when the person being tested has been paralysed for 5 years and is being stimulated while walking in robotic legs. But we have no one else doing what I am doing yet to compare to!

Until we do, (and we are working on that), I am satisfied with comparing my stimulated robotic-walking heart to my heart before my body was so broken. Its beating, my body sweating through my t-shirt, my mind pushing me on, being able to embody my desire to train hard – at times I almost feel like me again.

Since the 166 beat high, I’ve managed to work out how to move between 130 and 150 beats per minute as I progress through our 60 minute training sessions. On the couple of occasions that I’ve pushed into the high 150s and low 160s, I’ve been overtired and struggled to keep my heart rate up on the following day. Using the rule of thumb of “180 beats per minute minus your age” suggested by Phil Maffetone –  I should be hitting about 140 for my ‘aerobic’ training and that feels right.

Waking my paralysed body

And the reason I am able to do this now? Electrical Stimulation. It has to be. Of course, none of this experience is real until the tests are done and the scientists’ work is peer reviewed and published, but it has to be down to the electrical stimulation of my spinal cord, because nothing else has changed. In fact, if you listen to conventional wisdom about paralysis – 5 years after breaking my back, I ought to be more paralysed, less likely to experience any change for the better.

As I train now in the physiology lab or in the gym in Trinity College Dublin the scientists strategically place electrodes on the skin on my lower back over my spinal cord to deliver painless electrical stimulation. The idea is that this transforms the nerve network in my spinal cord from asleep to a highly functional state; it reminds the spinal cord of its potential. It’s powerful, human, striding potential.

Then, as I walk in my robotic legs, the scientists hope that this weight bearing, this repetition of the walking pattern while my spinal cord is in this highly functional state will jolt it from its paralysis coma. Over time, we hope that this will develop the conditions to encourage my brain to regain some voluntary control over my legs. At that point the robot can power down and let my legs do some of the work. I understand it to be like the robot is performing the same role as a parent holding a baby’s fingers and encouraging him to stand and to take some early practice steps before he even understands what he is trying to do.

Connecting the brain and body

I was just speaking at the RCSI Faculty of Sports and Exercise Medicine Conference. My slot was immediately before Professor Tim Noakes (author of Lore of Running, Challenging Beliefs, Real Meal Revolution, Doctor, Emeritus Professor, runner and low carbohydrate diet proponent). I was in early to test my videos and headed up to the reception area for a coffee where Tim was sitting and unfortunately for him I bombarded him with questions about my new eating plan. In fairness it is his eating plan. Simone is cooking for us at the moment from the Real Meal Revolution book and I’ve lost a tonne of weight and feel really well.

I told him about my recent Natural Born Heroes blog and we discussed my heart rate responses during my gym and lab sessions. He told me that even though I am now hitting 166 beats per minute highs I don’t need to re-fuel with chocolate milk. And he confirmed what my 24 hour ultra runner friend and Life Style Sports Run in the Dark Coach, John O’Regan says when it comes to performance, nutrition and recovery: “Listen to the body”.

 To learn more directly from Prof. Tim Noakes check out his TEDx Capetown talk below.

 

At the conference, Tim Noakes spoke about his central governor theory suggesting that the brain is significantly more important in our physical performances than many of us give it credit for. He believes during physical exertion at the point when we think we have given our all, it is simply a physical response to our brains telling us to take it easy rather than a physiological breakdown. He has written extensively about this and gives the example of finishing spurts in races and suggests that at a time when the muscles should be at their weakest, when our minds know that we’re on the home straight and are safe in the knowledge that we aren’t going to die, our bodies’ systems are allowed to open up and work harder.

So, it seems that not only the paralysed need to acknowledge the mind’s ability to give the heart reason for beating – to power the body to achieve its full potential. It also seems that the addition of a heart rate monitor to our training sessions in the lab is just the feedback loop I needed to encourage me to push on. The full potential of my paralysed body remains to be discovered but I believe that this week’s progress may be telling us that we can dare to try to realise it.

Polar Titans & Our Own Intrinsic Motivation

Last Sunday I dropped into The South Pole Inn in Annascaul, Co. Kerry to honour Tom Crean. He was a titan of the heroic age of polar exploration. He was born in Annascaul and the pub he ran after his polar exploration ended in 1916 still serves beer and is a memorial to his incredible life.

Mark with Eileen Percival who runs The South Pole Inn

Simone, my fiancée, and I toasted him with a beer named after him and Simone described to me the 18/35 logo on the pint glass. Although I had read almost all the stories of polar exploration before my own Antarctic adventure six years ago I couldn’t remember the significance of those numbers. Surrounding us on the walls of the pub were articles covering Antarctic exploration. Crean was on teams led by both Sir Ernest Shackleton and Captain Robert Falcon Scott. As Michael Smith, author of “An Unsung Hero”, points out Crean spent more time on the ice than either of those two Polar heroes performing pivotal roles on three of the four major British expeditions to Antarctica.

Initially he served under Scott on the Discovery from 1901 to 1904, then on his fatal Terra Nova expedition to the South Pole from 1910 to 1913 and finally on Shackleton’s Imperial Trans-Antarctic Expedition on Endurance from 1914 to 1916.

It was during Scott’s ill-fated Terra Nova expedition when Tom Crean made the numbers 18 and 35 his own. At only 168 statute miles (270 km) from the Pole, Scott ordered Tom Crean, William Lashly and Lieutenant Edward Evans to return to base. Scott recorded the sorrowful moment in his diary: “Poor old Crean wept …” Scott went on to reach the South Pole only to find Norwegian Roald Amundsen’s flag planted there first. Scott and his team then died on the return journey.

As Crean, Lashly and Evans made it off the polar plateau one month after leaving Scott and the others, Evans began to display the debilitating symptoms of scurvy. In the harness for up to thirteen hours a day, Crean developed snowblindness and hauled the sledge, his eyes bandaged with a tea leave poultice. Risking crevasses, broken bones and certain death the three lashed themselves to the sledge and slid 2,000 ft onto the Beardmore Glacier to save three precious days of marching and food. But then Evans collapsed and with 2 weeks to travel before the safety of Hut Point, Crean and Lashly began hauling Evans on the sledge.

On the 18th February 1912 they arrived at Corner Camp with food running low. They had one or two days’ food left, but still four or five days’ man hauling to do. So, facing death, Crean volunteered to go for help. He had no sleeping bag or tent and was already physically exhausted. Lashly held open the round tent door flap to allow Evans to see Crean depart, Evans remembered: “He strode out nobly and finely – I wondered if I should ever see him again.” Yet, with only two sticks of chocolate and three biscuits (keeping one in his pocket for emergencies) Crean completed the 35 statute miles (56 kms) in a punishing 18 hours. The rescue was successful and Lashly and Evans were both brought to base camp alive. Crean more than earned the Albert Medal, then the highest award for gallantry.

Crean’s own survival, the rescue of his companions and his desire to return to Antarctica again despite this experience intrigues me. Simone and I travelled on to Dingle for the next couple of days and as I sat in the spring sunshine I thought about Crean and those explorers from 100 years ago. I can understand the motivation for Amundsen, Shackleton and Scott – the adventure, the recognition, the money and the influence. My own 43 days in Antarctica racing to the South Pole was fuelled by my desire to compete, to do something bigger than me, bigger than my blindness, maybe to take a small place in polar history. Everyone else, including me, seemed to have an obvious reason to be there. But why did Tom Crean keep going back? He was not an officer or a leader of any of the expeditions; he gained very little public recognition or wealth. So, what drove him to go? What allowed him to survive?

I asked Crean’s biographer, Michael Smith, and he said, “Crean was the type of man who wanted to see what was over the other side of the hill”. So, maybe curiosity and adventure were the drive. It also may have been that the other side of the hill was a great deal better than life in Kerry in the late 19th century; maybe joining the British Navy was just a job? But this was a job that required him to endure torturous conditions, to put his life on the line. The story goes that the men who joined Shackleton did so in response to his newspaper ad for the Endurance expedition: “Men wanted for hazardous journey. Low wages, bitter cold, long hours of complete darkness. Safe return doubtful. Honour and recognition in event of success.” I am interested in the type of people who would reply to such an ad, because I think motivation is rarely about the extrinsic factors, it’s rarely about money, recognition or status. They are all so easily granted and easily taken away. People like Crean have a drive that comes from somewhere else, somewhere deep within, something intrinsic.

Norwegian explorer, Fridtjof Nansen, whose name and face were on my skis that took me to the South Pole wrote about this:

“It is within us all, it is our mysterious longing to accomplish something, to fill life with something more than a daily journey from home to the office and from the office, home again. It is our ever present longing to surmount difficulties and dangers, to see that which is hidden, to seek the places lying away from the beaten track; it is the call of the unknown, the longing for the land beyond, the divine power deeply rooted within the soul of man; it is this spirit which drove the first hunters to new places and the incentive for perhaps our greatest deeds – the force of human thought which spreads its wings and flies where freedom knows no bounds.”

Perhaps Nansen articulates what we must try to find as we explore our own frontiers when he says, ‘…it is within us all…’ Whatever the challenge, the motivation to keep going must come from somewhere deep inside us. External motivators are always temporary. The answer to the question of why we do what we do is an internal one, often held privately, but one that if answered honestly will be the one that gets us there. I know that Crean must have had an answer to that question when he walked those 18 hours to cross those 35 miles of ice, uncertain if help would be waiting at the end. If he didn’t, he would never have made it.