Race After Race, Teenager Crosses Finish Line, Then Collapses | Hacker News Reader

Race After Race, Teenager Crosses Finish Line, Then Collapses

nytimes.com

41 pointswlmsng36 comments

"I can't breathe!"

"Am I getting a medal?"

Well done, American society, well done parents.

Edit: I realize this is a snarky comment but this was my initial reading of the article. Sure she is brave. I guess? This just seems rather extreme. It's sure not the kind of values I would want to see in my kids. You know, breathing, and staying conscious, and not depriving one's brain or body of oxygen, these are sort of important things, especially throughout development.

Oh, please.

She had a goal and she was pushing herself to reach it, despite the fact that she has an abnormal medical condition. I'm failing to see how that's a failure either of parenting or American society.

The article states that, "All of the doctors they visited cleared Sam to run." The father notes, "If we didn’t have the utmost medical clearance for her to run, she wouldn’t be running." So apparently doctors don't think her medical circumstances should preclude her from racing or racing hard, and the parents are taking all of the precautions that they can and listening to the best medical advice they can find.

Describing it as "Depriving one's brain or body of oxygen" is accurate, but very misleading. Depriving a brain or body of oxygen is quite literally exercise, just phrased to sound more scary. That's like saying, "Would you want to put chemicals into the body of a developing child?" neglecting the fact that H2O is, in fact, a chemical.

but to the extent that you pass out and/or collapse? again and again? each race?

I see your point, and having clearance from a doctor helps argue against my concerns that's for sure.

My wife has NCS, and a titanium pin in her skull from her worst fall. First, her doctor does clear her for exercise as well, the benefits outweight the risks. Second, there is no cure. It gets better with age, over decades. If you're going to restrain yourself because you're sick, well, it's forever. I can certainly understand those who choose to live with the restrictions for increased safety. But I bet you can also understand, if maybe not agree with, those who choose to face the risks rather than the restrictions.

The exercise and the passing out won't kill her, but you can die (or worse) when your head hits the ground.

If I had this condition I'd consider switching to exercises where I'm seated, or in a padded gym. Does your wife take that into consideration when choosing how to exercise? Genuinely interested.

While those with NCS worry more about it, head injuries from falling are a concern of everyone. At almost every cross-country or track meet I've been to, at least one runner has collapsed from exhaustion or lack of oxygen to the brain. Some are more prone to it than others, but it's a risk that participants are aware of and accept. Races rarely happen on asphalt or cement, so falls (by themselves) aren't as dangerous as you might think. It also helps that, even while losing consciousness, runners tend to stick their arms out and cushion their fall.

For most distance runners, their biggest worry is getting trampled. Racing shoes have metal spikes on the bottom.[1] Like fainting, some are more prone to getting trampled than others (typically smaller runners). I've fallen at the start of a race and had my ribs cracked and skin perforated. It's certainly not fun, but it's a risk everyone accepts.

1. https://en.wikipedia.org/wiki/Track_spikes

She's no athlete, but she hits the gym twice a week. A month ago, she took up tennis on a third day per week, which is much riskier, but she's passionate about it.

She usually has symptoms in time to stop and sit down, and she has not had crises in a couple months now. But it's always a shadow.

Sure --- I can see that for sure. It sounds like an awful condition and anything one can do to gain some feeling of control, or overcoming limitations, I can see that.

Still, all of the doctors they visited, Dale Peterman said, cleared Sam to run. “If we didn’t have the utmost medical clearance for her to run,” he said, “she wouldn’t be running.”

We aren't so fragile.

it's true ... chalk up some of my snark to my own anxiety & hypochondria, projected outward

There's really no winning here. Had Sam's school prevented her from competing, there would probably be a comment addressing liability and blaming the litigiousness of US culture. Sam's behavior is not an indictment of American society or her parents. In the article, her parents care deeply for her. They were extremely concerned about her health, and only allowed her to run again once doctors deemed her fainting benign.

I agree that allowing her to run is a little dangerous, but it's important to compare it to other risks we accept in high school sports. It's not worse than say... pole vaulting. On average, pole vaulting kills one high schooler every year in the US. Dozens suffer traumatic brain injuries. Football casualties are even worse. Distance running is quite tame in comparison, even if one is predisposed to fainting.

Now if you're wondering why someone would subject themselves to fainting, you should also wonder why anyone competes in athletics at all. It seems crazy to spend so much time training and suffering just for a silly medal. I ran competitively in high school and college, and I agree. It is crazy.

That's why you see this sort of behavior in top athletes. There is a huge selection effect. You do not get to the top 0.01% without the right combination of genes, training, and borderline-monomania. Well-balanced people don't win races. I once asked my high school coach what the best personality for distance running was. He grinned and replied, "Sadomasochist. You have to enjoy pain and enjoy inflicting it on others." He was only half-joking.

So take it easy on Sam's parents and US culture. Both seem quite interested in letting her pursue her desires as safely as is feasible.

---

Side note: If you're curious just how competitive my running was, my high school PRs were: Mile: 4:18. 2 mile: 9:07. 5k: 15:09. I also ran a 3k in 8:32, which was (for high school) the 11th-fastest time in the US that year. I was captain of my high school's XC team, which was the best in Washington state[1].

In high school, 3-4 hours of each day was lost to training. By college, it was almost a full-time job. I was running 100+ miles a week. It wasn't long before I was constantly fighting overuse injuries, so I quit competing. NCAA Division I is a meat grinder. Despite all that, I still enjoy running today.

1. http://www.jcrawford.net/boys4a02.html

Pole vaulting used to kill about 1 person per year in the US, but after rule changes in 2003 it went down to about 1 every five years -http://www.ncbi.nlm.nih.gov/pubmed/22582223

nice times!!!

I take your points, it does sound like people around her have concerns and maybe the quotes I selected to illustrate my snark can be more chalked up to typical adolescence.

Being able to thrive and do well at something physically demanding in spite of a disease is very empowering. Her mind being on her next medal is probably better than her mind being on her next fainting spell.

Sure, I see that. I'm all for empowering oneself that's for sure.

Setting aside my snark, there's no doubt that she is courageous, ambitious and clearly successful.

Or she loves running and competing so much that she's willing to let herself go through that?

On HN there are workaholics, people who sit too long programming, people who smoke or drink in excess, etc.

I hit my head a fair amount of times wrestling in junior high and high school, but turned out fine. (I think.)

If she loves running on her own accord, let her. If she runs like that because her parents want to live vicariously through her, then it's absurd and wrong.

> Well done, American society, well done parents.

Does she not get to make her own choices about her own life?

sure!

but I'm not sure what that has to do with my comments or anything else.

But yes I 100% totally agree with your statement.

It seems insulting to suggest that someone's well-informed personal choice about their own life is wrong. Doublely so when you put the blame for the wrong choice on others, as if she was so incapable that she's blameless.

Just saying, if I were her, I'd be insulted you thought so little of me.

100% snarky, and has no place in the comment section here on Hacker News. I expected better.

Back in the early 90's, a fellow runner and a friend used to do this after cross country races. She never won a medal. She would push herself like this because she enjoyed it. That said, I don't think it's healthy either. Not from the lack of oxygen[0], but rather from the need for the endorphine high.

[0]: at 18, you can't push your body hard enough to do permanent damage from running. I know several people who tried, though.

Endurance sports like running will lead (even in healthy individuals) to very very mild cases of orthostatic intolerance.

If you go from sitting to standing, you might get lightheaded for a few seconds as the body is too slow to react. More here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2343225/pdf/tjp0...

I've noticed this too back when I ran a lot. The trick I use when this starts to happen is to tense my thigh and abdominal muscles. I believe that the legs have veins designed to return blood to your core (and hopefully reach your head) when muscle contractions squeeze the veins. It seems to work for me (almost instantly).

I have that problem, and I don't exercise at all. Happens probably once or twice a week. Almost always from going from sitting to walking too quickly.

Usually, as long as I grab onto something and stay still, it passes after about 20-30 seconds of my vision blacking out and my thoughts getting all jumbled and incomprehensible.

I've only fully blacked out from it once, coming to and realizing I was twitching on the floor.

I've been led to believe that it's a fairly common condition, though.

Interesting. I've been a runner for over a decade and run 50+ miles/week. I experience light-headedness going from sitting to standing a few times a week.

I bicycle 150 miles a week mostly on steep mountain roads. I seldom faint, but hopping out of bed to go take care of chores in the morning usually results in brief loss of balance and eyesight as my head loses blood pressure for a few seconds.

Sometimes I have to sit down in the bedroom door frame so that I don't faint and collapse. Once I'm up though, my body is full of vigor.

Do you mean that this condition is caused by endurance sports?

Oh no, I just wanted to mention other more common faults of our poorly parameterized blood pressure PID controller.

The article points out that everyone will experience this at some point due to extended exertion. This girl's condition makes it happen more quickly than average.

> The worst instance, her father said, occurred last fall, when she fell a quarter of a mile from the finish of the state cross-country final and was out for 40 minutes.

What?? This does not sound healthy, especially as there is more and more attention on the long-term adverse effects of traumatic brain injury (concussion). But I guess good for her that she is staying active despite this condition.

Trying to compete in athletics when you have serious medical issues is not easy... I was so goddamned stubborn that I played basketball through my chemotherapy treatments for Hodgkin's Disease in HS.

I was starting games at less than 50% of my baseline red blood cell count when I was 16. I could only play about four or six minutes at a stretch before I would have to come out, completely exhausted. That, and pissing bright-red urine in the locker room on those days when I had to get my treatments in the mornings and play a game in the evening were lots of fun. Oh, also seeing the towel come away covered in hair as I mopped up the sweat after playing a shift.

More power to this gal if she can strive through her issues and succeed.

"Physical activity, he said, pools blood in the lower half of the body, reducing blood flow to the heart. In response, the heart pumps more vigorously. In people with NCS, the brain misreads that as high blood pressure and tries to lower the pressure, which leads to decreased blood flow to the brain and, thus, fainting."

I like how it sounds like an engineering flaw. Hopefully one day our software will not be bound to randomly generated aging hardware.

This is a very odd story. When other runners finish the race, they stop and have a drink. When she finishes she is carried like a resurrected messiah by her entourage who then fawn over her while she wakes up. People are complicated... I would be wondering if there was an element of secondary gain and abnormal psychology in this behaviour. That she wants to study medicine to cure NCS is another read flag for abnormal illness behaviour.

I also wouldn't clear her to run if she collapses every time - I mean if she falls and dies from a freak head injury, and she had fallen the same way in the last 50 races, how can the doctor defend themselves? It's just common sense. She should at least wear a crash helmet.

I can't believe people think that the benefits of running outweigh the risks. First, the benefits of extreme running are questionable. Moderate exercise is fine (if done right), but extremes are never healthy. In this case, and, in general, fainting is not something that doesn't carry negative effects. When you accumulate so many incidents, I'm sure many millions of brain cells will die. Boxing does the same, but doctors still give clearance and that's why one should question the ethics of these doctors as nothing that has an accumulating harm should be okayed by them.

The even crazier runner is the one with MS who continues to run and is now one of the best distance runners in the country. She also collapses at the finish line. There was an ESPN short video piece about her last year:

http://espn.go.com/video/clip?id=11909407

The NYT wrote an article as well and it is linked in the above article but I thought I would call it out here:

http://www.nytimes.com/2014/03/04/sports/for-runner-with-ms-...

Yeah I remember the video. I think it was shared here inclusive.

It's incredible how amazing is the people. Even with their fragility, their own limitations and problems and yet they can do amazing things.

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