Monday, October 19, 2009

Cycling, Suffering, and the Cold-Pressor Test

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Introduction

A couple days ago, preparing for a big bike team party, I filled a cooler with beer and ice. I like to use a lot of ice, so no two bottles are touching. The beers are all surrounded and ensconced in the ice, like fruit in Jell-O. My wife said, “If you use so much ice people will have to dig through it, which is painful.” I replied, “Yeah, but these are all cyclists.” At that moment I remembered that, when I threw a similar party a few years ago, I actually administered the “cold-pressor test,” a standard test for measuring pain thresholds.

I also remembered that I’d written about that experience then, in the context of suffering in general and bike suffering in particular. I had tried to work this all in to a story I wrote about a Coors Classic bike race reunion I’d attended in December of 2006. It didn’t fit, though, and I had to scrap it. (The actual reunion story is here.)

Since I’m way behind on blogging, I found this old scrap and worked it into something I think is worthwhile. (By the way, I have a bunch of other posts in the works which will reach albertnet shortly.)

The value of suffering

At a party I attended in Boulder, a reunion of bike racing people, I chatted briefly with Dale Stetina, one of my childhood cycling heroes. Stetina had won the Red Zinger Bicycle Classic stage race in Colorado in 1979 before retiring a year or two later. In 1982, he began coaching a number of young racers in the Boulder area, including me. Then, to our delight, he returned to racing in 1983, and in a stunning breakaway on the last day of the Coors Classic managed to win the whole thing.

I recalled that breakaway victory to him at the party, and he described it modestly. “I wasn’t doing anything that ambitious, I was just being careful because of the strong crosswind. Wind like that can really break up the pack so I made sure to stay near the front. When the group fragmented, Bauer wasn’t paying attention and got caught out. All I did was capitalize on his mistake.” I commented on the importance of that lesson—pay attention!—and Stetina replied, “Actually, that’s not one of the more important lessons from cycling. The most important thing about cycling is that it teaches you how to suffer. And once you know how to suffer, you can do anything.”

I imagine that anybody who has raced bikes for any length of time, or pursued any difficult athletic endeavor, has contemplated suffering at length, but nobody had ever spoken to me about it as simply, and yet profoundly, as Stetina had with that comment. The point is not so much that success requires suffering, but that suffering is something you must learn how to do. It’s instinctive to avoid suffering whenever we can. Avoiding suffering is perhaps the most primal reflex we have, and in a privileged society this avoidance can become a bad habit.

Fear of suffering causes all kinds of laziness; it’s why people stand on escalators, and it’s why they coast when they could pedal. But beyond mere physical discomfort, fear of emotional or psychological suffering is why people delude themselves into complacency instead of looking inward and challenging themselves to be better. Of course bike racing isn’t the only way to learn how to suffer, but it’s got to be one of the best ways.

How I learned about suffering

When I got interested in racing bikes I was totally ignorant of what it would require of me. I imagined speed, and fun, and glory, and above all a way to distinguish myself from the masses. That’s all we saw when we’d watched the original Red Zinger Bicycle Classic, which is what turned my brothers and me on to bicycle racing to begin with.

Our first race was a nine-day stage race for kids called the Red Zinger Mini Classic (modeled, of course, after the pro-am Red Zinger). In 1981, very few kids knew anything about bike racing, so the organizers of this race required that all riders participate in a bicycling clinic they put on a few weeks before the race. We all met at The Spoke, a Boulder bike shop. People I knew from school were there, which felt like an insult—weren’t these the same guys who teased me for wearing a cycling cap to school? On our way out of the parking lot, I tipped over because I’d just gotten toe clips and straps, so I felt like a complete dork and the ride hadn’t even really started yet.

We made our way to the base of a climb, and once it started, I immediately got dropped. It didn’t occur to me to put up a struggle. The leader of the clinic was an honest-to-God racer (if memory serves it was Dag Selander). He dropped back and rode next to me, trying to encourage me. He suggested I get out of the saddle and go a little harder. He told me it was okay if it hurt. This concept seemed completely foreign to me. What this guy was asking me to do was to suffer—to knowingly and willingly inflict suffering upon myself. This just didn’t make any sense.

He left me alone and cruised back up to the group, and I pondered his words as I continued picking my lone way up the road. I eventually began to understand what he was saying. Don’t get me wrong, I had been well aware that there was suffering in the athletic world, but on some level I viewed the willingness to suffer as an idiosyncrasy of certain competitors, not the whole point of sport. Of course you can laugh at my naïveté, but take a moment to think back on what a typical eleven-year-old has seen of sports first-hand: mainly it’s ball sports in gym class, where the physically talented rise to the top automatically, without any special effort. (And I mean talented in motor skills and fast-twitch muscles; there is exactly zero opportunity for an uncoordinated and/or slow-twitch kid to distinguish himself.)

For the first time, I entertained the idea that all athletes suffered. Why else would this guy encourage a nothing kid like me to make it painful? Maybe winners weren’t just intrinsically better; maybe they simply suffered more. I decided this must be the case. So did I follow this advice? Did I get out of the saddle and push myself, and close the gap to the rest of the kids? Of course not. This wasn’t an ABC After-School Special, it was real life and I was a loser. I understood the coach’s point intellectually, but lacked the drive to take any action. It would be many months before I developed the psychological mettle to actually make use of his lesson. But this was the starting point.

How I learned to suffer

I got crushed in my first Mini Zinger (I finished second-to-last, thus failing even to earn the dubious honor of Lanterne Rouge). For some reason, though, I didn’t give up the sport. That fall and the next spring, I learned a lot about cycling. For one thing, I learned how to draft. My brother Geoff taught me how, first explaining the principle and then heckling me during rides if I didn’t do it. Eventually he didn’t even need to use words: if he thought I wasn’t drafting closely enough he’d hold back his hand, thumb and forefinger an inch apart, to remind me how close our tires should be. And of course he’d ride really fast, being three years older than I, so really I was getting two lessons: how to draft, and how to suffer. If I failed to keep up, he wouldn’t ride with me anymore.

The next year, I was much stronger in the Zinger, but couldn’t figure out why I still didn’t crack the top ten. Later that summer was when Dale Stetina started his coaching. This was less structured than what he went on to do with his 7-Eleven junior team a few years later; in ’82, he simply charged a monthly fee (something like $30 I think) to informally coach any kid who was interested. I don’t frankly remember anything in particular that Stetina taught us; rather, the training rides we kids did with him gradually impressed upon me how complicated a sport this was. There were different types of training rides; different types of racing; even descending could be viewed as a discipline unto itself. I began to see the sport as a giant assembly of small details; getting enough of them right could add up to a margin of victory. But the foundation, I still believed, was the willingness to suffer, hard and often. And little by little, I embraced the ethos of suffering and started dipping into the red, ever more deeply and more frequently.

Of course, it’s well and good to claim that cycling taught me how to suffer, but suffering is a highly subjective matter. Could I have learned suffering even better through another sport? I’m sure any cyclist would tell you it’s among the very hardest sports out there, but what’s to keep a golfer or baseball player from making the same claim about his sport? Well, I had no reason to doubt that Stetina was authoritative about suffering, and that cycling was among the most painful sports, because a few months before I’d conducted a pain threshold experiment that gave me objective proof.

The cold-pressor test

During an orientation for my wife’s first childbirth, I learned that the medical community is beginning to consider pain as a vital sign, just like heart rate, blood pressure, or temperature. Of course pain is a more elusive sign than something objectively measurable, but it’s getting plenty of attention. Back in 1998, I read a fascinating article about pain by Atul Gawande, a surgeon, assistant professor at Harvard, and popular writer. He described a simple pain threshold experiment called the cold-pressor test in which subjects immerse a hand in ice water and keep it in as long as possible, before the pain becomes too great and they can’t help but pull out. The duration of submersion is the subject’s pain threshold. The test is limited to two minutes “to prevent injury.”

Countless researchers have used this study; the one Gawande cites compared ballet dancers to university students. The female students pulled out, on average, at thirty-seven seconds. Female dancers lasted almost three times as long (though they didn’t last the full two minutes). This result doesn’t surprise me; ballet dancers are known for high pain thresholds, given the rigors of their activity. Gawande tried the test himself and lasted the full two minutes, which he attributes to the toughness that he developed in medical school. I found another incidence of this study in which thirty-six men and thirty-six women averaged 56 seconds in the ice water. The obvious question: how would a cyclist do?

Cyclists take the cold-pressor challenge

When I hosted a party for the Berkeley area cycling community, I saw a perfect opportunity: I had a giant tub of ice water (for the beer) and a house full of bike racers, stuffed full of green enchiladas and ready for any challenge. When the party had thinned out to maybe half a dozen guys, I suggested the test. Of course not a single guy declined. My wife manned the stopwatch and we all plunged our hands in at once. Thirty seconds in, someone asked, “So, is anybody feeling some pain?” There were a few nods. “Yeah, I guess it hurts,” someone admitted. We passed the minute mark.

It hurt—in fact, it hurt plenty—but nobody was fazed (at least outwardly). It wasn’t enough to keep the hand in; each guy felt the need to show how conversational he could still be. We chatted merrily away about how the pain was unmistakable but totally manageable. Ninety seconds in, I swear somebody affected a yawn. Another thirty seconds passed. “Two minutes, you’re done!” my wife called out. She and somebody’s girlfriend looked a bit relieved for a moment, until they realized we weren’t pulling out. We all just sat there. “Theoretically you’re supposed to take your hand out at two minutes to prevent injury,” I mentioned casually. But nobody wanted to be first. We went at least another half a minute until, citing boredom, somebody withdrew, and the rest of us unhurriedly followed.

I thought I had my answer—cyclists really are particularly good at suffering—but the next morning, hung over and tackling the horrendous mess from the party, I spied the beer cooler and second-guessed the pain experiment. Sure, it had hurt, but not intolerably by any means. Could our success have simply been the result of alcohol? I had to know. I made sure the tub was still frigid (there were tons of ice cubes still) and repeated the experiment. Three minutes, no problem.

Pain vs. suffering

So how painful was it? If zero is no pain, and ten is a perforated eardrum (the most pain I’ve ever suffered), cold-pressor (with hangover) is about a six. Whacking my funny bone is about a three (brevity being a mitigating factor). Having a cavity filled without Novocain is about a five. A hard punch to the biceps by a big brother, a four. A hard climb during a bike race, at least a seven. But here is a crucial distinction among painful stimuli: control.

The reason that the perforated eardrum was so painful is that the pain came from outside of me, represented unknown damage to a sensitive organ, and couldn’t be made to go away. It was a physical sensation compounded by strong emotional responses: fear and alarm. The ability to back down the pain makes all the difference in the world. Before getting a cavity filled, I tell the dentist I’ll raise my right hand if the pain gets too great; then he’ll stop and give me Novocain. (I’ve never needed to raise my hand but I always give myself the option.) With cycling, it’s even easier: relief is just a downshift away.

Before I became a bike racer, all pain was alarming. I didn’t differentiate between external and internal sources until I became competitive. Learning to suffer meant learning how to ratchet up self-inflicted pain through sheer will, tolerating it because I knew I could back it off. I experimented, over the years, with just how hard I could push myself, just how miserable I could become, before I faced the consequences of having ignored my body’s signals. I developed, as does every bike racer, the ability to recognize that terrible suffering is not just an unavoidable by-product of riding hard, but also a vital sign, like a gauge on your dashboard. Pain is something you mete out strategically instead of something you flee from. In this way, mastering the suffering actually becomes a strange source of liberation.

Why suffering is so important

Let’s return to the other point Dale Stetina made: once you know how to suffer, you can do anything. This is a natural extension of what I’ve described regarding pain: what difference does it make if suffering is emotional or psychological versus physical? Once you’ve learned to differentiate between external and internal sources of suffering, you can take an abstract view of suffering, taking it beyond just the physical realm.

Consider the case of a junior sales rep assigned to make cold calls. I think it’s extremely rare to find somebody who enjoys cold calling, but it’s absolutely necessary for a sales rep. Those who make it in sales have learned to appreciate the difference between making a cold call and fielding a call from a telemarketer. They suffer through cold calls, but it’s a suffering they choose, a part of a greater goal, and most of all, they control when and how they make the calls—so it’s tolerable. They can decide beforehand to stop after twenty calls or five appointments, whichever comes first.

Robert Pirsig, in Zen & the Art of Motorcycle Maintenance, writes about “gumption traps,” his term for anything that disrupts a person’s gumption. When you set out to ride a bike fast, pain is the first and most basic gumption trap there is. Overcoming this pain, and mastering the ability to endure suffering on the bike, is a solid lesson in building gumption. My dictionary defines “gumption” as “boldness of enterprise; initiative or aggressiveness; guts; spunk.” Suddenly this humble word—gumption—comes to represent the foundation of what makes anybody successful at anything.

Looking back at my own difficult childhood, I see how my growth in cycling—that is, in suffering—tracked right along with my growth in everything else. Once I learned to make myself suffer on the bike, I did better with boldness, initiative, and confidence in general. I stopped trying to serve a volleyball underhand, like a girl, and found I could nail my serves overhand. I stopped being the last picked for basketball. I pushed past my shyness, making forays into social situations that eventually paid off, so that many of my current friends who didn’t know me as a kid refuse to believe I’m essentially an introvert. It’s all because I learned, through suffering, how to overcome my own weakness. So I completely agree with Dale Stetina: cycling teaches you how to suffer, and once you know how to suffer, you can do anything.

Postscript

Rereading this post years later, I note that at the time I wrote it, the most painful injury I had suffered was a perforated eardrum, so that was my 10. Well, years later, I suffered a third-degree separation of my shoulder, which became the new 10 and knocked the eardrum down to about an 8. Years after that, I broke my femur which took over as 10, making the shoulder about a 5 and the eardrum a 4. That lowers the cold pressor to about a 2.5. Cavity filled without Novocain becomes a 2.  

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