Thursday, November 19, 2009

Cycling heroes

The summer soundtrack to my childhood was the Channel 4 theme tune to their Tour de France programme. Whatever I was doing during the day (usually looking after my sister), I would get back in time to watch the highlights of epic three-week, three-thousand kilometre plus cycling race. The colour, the language, the countryside, the record-breaking crowds, all of it was new to me, but the biggest impression was undoubtedly left by the riders themselves.

From the hurtling, headlong roller coaster thrill ride of the sprints, to the lung-busting, leg-breaking slogs up the mountain, I had never seen such mental and physical exertion. You could see the pain and the internal battle the riders were experiencing as the climbers struggled to keep up with the sprinters on the flats, and vice versa as the big men were being blown away by the mountain goats as the race hit the Alps and the Pyrenees. It made me want to be a cyclist, to push my body and my mind to its limits.

Few people who have watched though, can forget the accidents. Pile ups caused by a rider cornering too fast, enthusiastic spectators getting too close to the action, punctures, wet weather, animals, wrong turns, all of those could change the complexion of the race and a riders dreams of glory in a moment. One such moment befell my former favourite rider, the kamikaze Uzbek Djamolidine Abdoujaparov with a spectacular nickname: The Tashkent Terror. Three-time winner of the Green (points) Jersey for the most consistent sprinter, he had a unique (and actually rather dangerous) riding style and would stop at little to win. On the final stage of the 1991 race, as the peleton approached the Champs Elysee in Paris and the finish line, Abdoujaparov got too close to the barriers and crashed. Very badly. With speeds approaching 70 km/hour, other riders sustained injuries as he and his bike somersaulted into them, but Abdou undoubtedly came off worst: extensive facial injuries and at the very least a fractured clavicle. A reminder of how dangerous professional cycling can be.

The crash and his will to return to Le Tour (and indeed win the final stage in Paris) in 1993 served to increase my admiration for the Uzbek. However all this changed as I learnt that even heroes had their (major) flaws. Abdoujaparov had been doping to enhance his performance and was kicked out of Le Tour in 1997, subsequently choosing to retire. He was not the only one, however. Indeed, the past couple of decades have been a bad time for cheating in cycling, with other favourites of mine, including Il Pirata Marco Pantani, the best climber I have ever seen, Bjarne Riis, Erik Zabel and Alex Zulle all being banned.

I still follow the Grand Tours of cycling (The Tours of France, Italy and Spain), but no longer hold the riders in the same esteem. There is always the suspicion that these outstanding feats of human achievement may be tainted by illegal and often dangerous performance enhancement. That’s not to say there’s still much to admire. All of the peleton must have made enormous sacrifices and undertaken thousands and thousands of hours of training to reach where they are. Hopefully they’ll have dodged injury and illness and be at peak fitness by the start. Now they just have to ride the three-thousand or so kilometres as fast as possible. Any rider with serious intentions on the race must also be able to work well as part of a team, but also have the courage to grit their teeth and bear the pain when trying to ride away from their rivals or match their attacks when their mind and body is telling them to stop. For the lesser lights of the team, riding back down a mountain to help a stronger member that’s fallen into difficulty or to collect drinks for the others is often required. Collapsing in a heap and/or fainting must be left for after the race, but with the knowledge that the cycling must begin again the follow day as the race to Paris continues.

I have other heroes now but Abdoujaparov, Pantani and co inspired me to take up cycling and have left a very strong impression.

Friday, November 13, 2009

Cardiology emergency - no students allowed!

Spent in the echocardiology lab. The teaching was good and we were learning quite a lot. Midway through examining a patient, however, the doctor was called urgently to the next room. A lady had become unresponsive following surgery to replace one of the valves in her heart, and it was looking likely that she may need be to resuscitated. "Run, please doctor!" the panicked secretary whispered after summoning him. My fellow med student and I followed in the hope that we could learn first-hand how such an emergency is managed by the healthcare team. Unfortunately, when we arrived the curtain surrounding the bed was shut it our faces. "We must respect the patient's dignity", one of the staff said.

I accept that she wanted to call the most experienced healthcare staff and that if we were inside we may have been getting in the way, but we are senior enough now to recognize this, which is why we wanted to observe from a distance. Besides, we also may have been able to predict and fetch any equipment that may be needed during treatment. Respecting the patient's privacy and dignity is of course essential, but I don't see how us watching would have been compromised this, or indeed the care delivered to them. And in my six years at medical school, aside from the more sensitive topic area of gynaecology, out of hundreds of patients I can count on one hand the number of patients that have refused my presence in the consultation or examination room.

In the hyper-aware state an emergency renders you, it would have been a tremendous learning opportunity for a situation we are bound to experience as junior doctors next year. What a pity we weren't allowed to be a small part of it this time around.