West Coaster musings

View from the West Coaster trail run

It must have been the first week that I arrived that I met Simon, briefly, while running.  I was on East Tamaki Drive, running along the trail on the waterfront sporting my Mt. Baker Hill Climb shirt.  A tall fellow (6'4"?), who would have passed me easily, ran with me a short distance and asked about the shirt.  Our conversation quickly turned to trail runs and he mentioned that I should consider the West Coaster trail marathon in November.  I hadn't seen him since.

Trying to snap photos while running can be quite tricky

Knowing that I did not have the training miles necessary for a full marathon, I signed up for the 28k Speights West Coaster off-road adventure run.  The run starts at Bethell's Beach, a well-known surfer's paradise only 45 minutes from Auckland, on the west coast of the north island.  Apparently, 300 people were entered in a variety of races: 42k, 28k, 18k, and 10k.   There were a small number at the start of the 28k, including seven or so women.  Each race started approximately 2 hours after the next longest race.  A 9am start made for a somewhat leisurely race day start.

Before the race...

Stethanie and I did not really grasp what we were about to embark upon.  I thought I had misread last year's winning time for the women's 28k of 4:19.  Thinking that time must be for the 42k, I hoped to come in at 3:00, half of my slowest marathon time (when I walked and skipped much of the marathon).  I should have realized it was a bit different when I got the email about the required items to race: a space blanket, minimum of 1.5 litres of fluid, extra food, rain gear, cap, gloves, and a fully outfitted first aid pack.  This in addition to the three aid stations on the course.

Officials running down the starting chute...

The race started across the beach, running through a river, then up along the bluffs overlooking the ocean.  The views were spectacular.  I ran the first 9k, thinking it reminded me of trail runs at home, but the trail was at times smaller, muddier, and the footing less predictable.  I did not know it at the time, but I ran a good part of that with Simon's wife, Penny, who had entered the 42k distance.


After a brief connector on a dirt road, we entered another track, the bush track.  Some of these trails were meticulously maintained, wide footpaths with well-cared for steps, until we got to the waterfalls and the river. There the river had to be crossed dozens of times, the trail sometimes marked by a mere triangle on the rocks along the edge or in the middle of the river.  Bouldering some, running some, slipping in mud, falling on my rear in the middle of the river, I happily traversed the trail. (Fortunately, the cell phone in my back pocket survived the river and only a few pictures, all of me, were lost due to smudge on the lens).  All the while, I  marveled at the lush kauri forest.  I got passed my many who seemed like mountain goats, sure-footed and unmuddied runners.

Stethanie emerging from the bush

Eventually, we looped back to join the 18k runners who looked fresh by comparison.  I ran for much of the last 15k alone.

Running has always provided me with a time for contemplation.  This run's theme seemed centered on ethics of the dying patient.  In the United States, the health care system is centered on the patient's choices.  This is mostly true for New Zealand as well, but it is a socialized system and the ethics of the community  as a whole effects the care of the dying.  Some of the most costly care occurs at the end of life.  Not palliative, comfort care, but heroic efforts to save folks whose time is near.

Views from the trail

Many folks have the notion that CPR  will bring folks back to life.  Indeed, it has to many a healthy person.  However, for those people who are old, frail, or in the process of dying, the success rate falls dramatically.  For those of us in medicine who have witnessed CPR on dying folks, it truly can be an inhumane and undignified way to die.  Although we may communicate this belief to our dying patients, in the US, if the patient wants CPR, they have the last word.  CPR will be done.  In New Zealand, it is different.  Most everyone still has a right to declare whether or not they want CPR.  In the case of the dying patient, if the doctor notes that CPR is futile, then no attempt will be made to resuscitate the patient, regardless of the patient's wishes.

Views from the trail

I had a long and fruitful discussion with one of the palliative care physicians on Friday.  He said that the outcomes for palliative care were much better in NZ than in the US because of this difference.  While here in NZ, I have also witnessed CPR on the very frail, elderly patient who is otherwise healthy.  They do not practice ageism or deny it for very ill patients.  The "futile CPR" is reserved for those who near death. As with all ethics and much of medicine, there will be grey areas.  I wonder about the grey in both systems.  Patient choices, adequate patient information, physician intervention, bias on both sides, social pressures, family ties, all contribute to decisions around care of our patients.

Yes, the trail goes through THAT.

Working in medicine can be hard on the spirit.  Special cases come to mind.  Patients with a fighting spirit who eventually die.   Exercise is my therapy, the bluffs and crashing waves, the mud, the wet shoes, the hills all helped.  I will continue to try to care for my body, to use it, to experience all the beauty in nature.  As I write this I am struck by the realization that the most beautiful thing I saw this week was not the finish line, the waterfalls, beaches, bluffs, hills, rivers, but the strength and love of a family supporting their dying father.

And the trail traverses this. Quite varied terrain!

I finished the run with plenty left from a cardiovascular standpoint, but not much left in my legs or feet.  I am not sure of my official time, but my watch (after getting my timing chip off) was at 5:15.  The race photographer wanted a picture of me as the epitome of the run: covered in mud, thoroughly wet, smiling.  The run was sponsored by Speights, a kiwi beer.  A beer, sausage sandwich and fried bananas topped off the day. I met Simon for the second time as I was commiserating with his wife over her sprained ankle.  He recognized me by my accent, stature, and dirty girl gaiters. (Dirty girl is a brand name of patterned running gaiters). I soaked my legs in the river I had crossed earlier this morning, thankful for the opportunity to witness this corner of the world.  Stethanie finished shortly after my soak, but looked like she did when she started, unmuddied.  For those techies, you can look at the trail route via my garmin site: http://connect.garmin.com/activity/55728531

See what I mean, Stethanie's after photo... she looks as fresh as she did at the start.

Tomorrow another week begins.  Today, I clean house, write my blog, connect with my family and friends.  Be well, all of you. Take care of yourselves and know you are well loved.