The Dark History of Polio: More then just a Virus

 When I finished reading "The Moth in the Iron Lung" by Forrest Maready, I found myself fact-checking the publication date multiple times. Written in 2018, this book challenged everything I thought I knew about polio's history in America.

Like many, I grew up seeing the aftermath of polio. People with distinctive limps or affected lower limbs were living testaments to the disease's impact. In school, we learned about Jonas Salk, portrayed as the hero who created the vaccine that vanquished this terrible illness. But as with many historical narratives, the full story proves far more complex – and troubling.

The Two Faces of Polio

What most surprised me was learning the crucial distinction between polio and poliomyelitis. While both conditions cause similar symptoms – particularly paralysis of the lower limbs – they're distinctly different entities. Only through post-mortem examination of the spine could doctors definitively distinguish between them, a fact that complicated diagnosis and treatment for decades.

Traditional polio, caused by an enterovirus, typically begins in the intestines. In rare cases, particularly in infants whose intestines lie close to their developing spine, the virus can infiltrate the central nervous system, leading to paralysis. Remarkably, this paralysis affects only motor control, leaving sensory functions intact.

A History of Toxic "Cures"

The story takes a dark turn in the late 1790s, when doctors began treating childhood intestinal symptoms with what was then cutting-edge medicine – containing mercury. Today, we understand mercury's devastating effects on the nervous system, but then, it was considered a breakthrough treatment. As its use increased, so did cases of infantile paralysis.

The Agricultural Connection

Post-Civil War America faced an agricultural crisis. Moths and beetles threatened entire crops, leading to desperate measures. Enter Paris Green, the first widely-used pesticide. Its active ingredient? Lead. When insects developed resistance, farmers simply used more. Later, arsenical pesticides were introduced, followed by DDT after World War II. Each new "solution" brought its own set of problems.

What's particularly chilling is that polio outbreaks consistently peaked during growing seasons, yet this correlation went unnoticed or ignored. Laws even mandated the use of these toxic pesticides, with fines for non-compliance.

The Truth Behind the Decline

While the Salk vaccine is credited with eradicating polio, the timeline tells a different story. By the time the vaccine was introduced, polio cases had already dropped dramatically – coinciding with bans on mercury, lead, arsenic, and DDT. Today, polio outbreaks persist primarily in regions where DDT remains in use.

The Power of Propaganda

Perhaps no image better encapsulates America's polio panic than the 1953 LIFE magazine photo showing 33 iron lungs in California. We now know this photo was staged, yet it became deeply embedded in the national consciousness, driving public fear and policy.

Learning from History

This story illustrates how fear, limited information, and misguided solutions can create cascading problems. Farmers desperate to save their crops, parents trying to help sick children with mercury-laced medicines – all were making what seemed like rational choices with the information available.

The true lesson of polio isn't just about vaccine development; it's about understanding how environmental toxins impact human health, and how our solutions to one problem can inadvertently create others. As we face modern health challenges, this history reminds us to consider the broader context and potential unintended consequences of our interventions.

In an era of increasing environmental awareness, this historical parallel becomes particularly relevant. Perhaps by understanding this complex history, we can approach current and future health crises with greater wisdom and a more holistic perspective.

Iceman 2023: Mistakes Were Made

 It would appear that my blog has become a defecto race report on various events.  The last race of the year per usual in the Mitten State is the Iceman Cometh.  I can't remember if this is 7,8 or 9 Icemans.  Most blend together into a blur.  There was Mudman, several Niceman and an occasional lived to the billing Iceman.  

2023 wasn't warm, but with sun shining and no rain, temps in the upper 40's, it will be remembered as a Niceman.  The race where a lot of mistakes were made.  

I had shifting problems going into the race.  If I had ridden my bike a lot more before the race, perhaps it was something that could have been sorted out.  As is, I rode my gravel bike and indoor trainer.  I assumed the problem would be the same thing that has cropped up in the past.  It wasn't.  Don't Assume.  Test your race gear over and over.  

This lead to shifting getting stuck around every ten min dropping to every 2-3 min much later in the race.  Frustrating.

I had planned to use a water bottle that I had used with my bike every ride I had used it, and also use my USWE back pack that holds about 50oz of water.  The day of packing I decided to leave my back pack home and take a larger water bottle I have used on most of my gravel rides.  

15 min into the race I realized I couldn't physically take the bottle out of its cage.  It was locked in like a vise grip.  To drink I had to get off the bike and yank it out.  Frustrating.

This was my only nutrition.  Calories in the bottle.  Test your gear!  Don't change your plan without testing it.  Carry an emergency gel or something like that.  

Now my biggest takeaway from the race besides test your gear is how you deal with problems.  Monday morning I was working with someone and they inherently asked how the race went.  Somewhere in the conversation, I came to the epiphany of why didn't I just take the water bottle out of its cage and put it in my back jersey pocket.  

The answer was I became fixated on the problem, instead of brain storming a solution.  Tough lesson learned, but a valuable one.  Seek to be a solution oriented thinker.  

Besides the disappointing race time and frustrating mechanicals, riding your bike in the woods and hanging with your friends can never truly be disappointing.  Always grateful when the opportunity presents itself.  

Test your gear, seek solutions, pedal on.  

Lumberjack 100 Race Report

 I came for a challenge, it over delivered.

I never thought I would ride my bike for 11 hours.  Welcome to Lumberjack 100.  The premier 100 mile mountain bike race in the state of Michigan.  3 loops in the beautiful Manistee National Park.  It was a perfect day to ride a bike....a very long time.

At the start of the year I picked out 3 races between the spring opener Barry Roubaix and the fall closer Iceman: Black Fork gravel in Ohio, Lumberjack 100 in Michigan, and third, Last Best Ride in Montana.  

I have been riding a decent amount this year.  Enough that I had some hubris going into the race.  Maybe it has been around my friends and patients lives so long, that you start to feel a bit non challant about the race.  Yea, it will be hard, but not like hard hard, you know.  It humbled me 2 hours in.  I was already cramping.  Cramping?  This was something I thought I had conquered with adequate training, a thing of the past.  But there it was before I had even hit the first aid station.  

A key element of racing bigger events or any endurance event is learning to not project your future feelings on your current situation.  It is very easy to say, man I'm hurting this much now, in two hours it's going to be way worse.  Stay focused on the present, the future changes.  

Stick to your nutrition plan.  I think this saved me.  Part of me thinks I was really undereating, drinking going into the race.  Some work/life stuff came up that had me extra busy leading into the race and I think I payed a price on the first lap.  Eating and drinking consistently, I actually felt the best on my last lap.  Be Disciplined in your eating and drinking.

Whenever I came to a point that I just was tired of riding, I would hit a spot of amazingly pretty single track through tall pines, with the sunlight hitting just right, that made it feel like you were riding your bike in some place magical.  When the legs got really crampy a fast stretch of rolling gravel that had a canopy of tall trees making tunnels, guiding you along.  When your mind started to wonder, a hundred yards of green moss lined trail pushed you on.  Allow natures magic to unfold. 

The whole day, something hurt, but it was always changing.  Quad cramp, shifted to an adductor cramp, shifted to a hip flexor, shifted to a left side, always moving, searching replenishing, back and forth.  I found myself in awe that my body could find fiber angles to keep moving.  To keep figuring out new ways to pedal the same crank.  Your body is Amazing, be thankful. 

On some weird side notes, you have a lot of thoughts pedaling a bike for 11 hours.  I hit hard on lap one,  head, shoulder elbow.  I popped up and found my brain saying no biggie.  Something I started in like 8th or 9th grade after taking big hit in football, it was a mantra all through college.  My body seemed to remember getting hit and my brain reverted back to 25 years ago.  

My first work out tape was an Army Ranger cadence.  When I started running in the woods with a walkman as a middle school kid,  I would hum along to these.  Sometime along 8 hours in the words and cadence started coming back again.  How weird I remember thinking that I would remember something like that.  

The people at the aid stations, the Unpaved crew that puts on the race, the setting, all where amazing.  If you want a challenge, this is a great one.  Every lap, will teach a lesson, every lap unlocks something different.  Some things can only be learned through time and effort,  Lumberjack is a great teacher.  

Should We Chase Efficiency

The last few months I've been thinking a lot about the concept of efficiency.  Don't waste time.  What is the most efficient use of time?  Chasing efficiency.  What part of this procedure could I cut out to still get the desired results.  Cut the fat.

In some ways, I think this is a good filter to use, what is redundant.  Chasing after the efficiency idol is a slippery slope though, it can bleed into other areas of your life where efficient starts to mask the good stuff.  

Another word that can be used is optimization.  Optimize and efficient started to mean the same thing to me, and that I believe is a problem.  

Efficiency can produce (not always) fragility.  A hiccup comes up and your assembly line of well intentioned, perfectly timed dominoes fall.  Stressful.  For example, If I packed my schedule and one patient shows up late, my day will snowball late.  If I put a buffer of an open slot in there, (inefficient) I can withstand some late visits.  

There is all kinds of optimization for your sleep now.  In fact, I do quite a few of them.  Dark room, limit blue light, no caffeine after 4, take some magnesium, cooler room.  But, in a way, we are learning to rely on these things for a good nights sleep.  The first time you have to stay in a hotel that is different from your routine, can you sleep?  Before a big race? Perhaps there is some value in not optimizing all the time, even if it results in a few more tired days.

I rode my bike at a winter groomed trail today.  A lot of gear to be able to ride in a Michigan winter.  Between driving there and home, the packing and the gear retrieval it was a two hour commitment.  I rode for about an hour.  I could have literally walked into my basement and cycle on my trainer for two hours, and achieved a better workout.  It was an incredibly inefficient use of time.  

How do you measure being in nature, stumbling upon a herd of deer and chasing them on the trails.  Alone with your thoughts, not another human for an hour, like a private playground.   Snaking around a few corners and keeping the bike upright.  Chatting with one of your best friends in the parking lot.  These are all things that created a great experience and made for a wonderful use of time.  

What is fitness?  Getting more and more efficient at the task you ask to achieve.  Training is just biology adapting to the averages you stress it to.  The more you do something, the better, more efficient you get at it.  Performance is great, but perhaps training should have some inefficient tasks in there as well.   

The thoughts for this blog came into my head on the way home.  I had been thinking about efficiency and fragility for some time, but this seemed to cement them.  Don't chase. Evaluate. Don't let efficiency become your only filter.  You will miss out on art, life and the good things that it composes.  

Amish Pizza

 I started traveling to an Amish farm around 7 years ago, treating all my Amish patients at once.  This allowed them to not have to pay a hundred dollars to get a driver to come see me, and only have a few at at time at that.  

My first time there they asked if I would stay for dinner.  Picky eater, by nature, I didn't really feel like staying and trying to eat something I didn't really like.  Then I heard, we are having pizza.  Pizza!  Easy.  Pizza with the Amish, what a great story.  

What came out was not pizza!  It was loaded with vegetables on top of some type of cream cheese(?) on top of some soft bread.  It did have a bit of shredded cheddar.  But to call this pizza was a stretch.  A big stretch at that.  It was actually pretty good though.  

Through the years, I've stayed for dinner after every visit.  I've had close to 10 variations of "pizza" none of which would be classified as pizza to the outside world.  Fruit pizza, ground beef pizza, mashed potatoe pizza to name a few.  

Over the years, I've asked many questions on different aspects of their culture.  They ask questions about my travel with sports teams and countries I've visited.  I ask questions like taxes, school, marriage and work.  One thing I never asked was about the pizza.  

I've told many friends about the pizza, and my basic comment was that if it has cheese on it, they call it pizza.  A misunderstanding I never corrected.  Until this last weekend.  

I always have loved the Origen Stories they do in movies now.  I now know the Origen story of Amish pizza.  

My host that does all the cooking is probably in her early 60's.  We sat down to eat some fruit pizza and she asked if their was any foods I didn't like.  "I hate onions.  In fact, when I was traveling in Germany with bobsled, the only German I learned was Nine Zwiebel.  No onion."  

She responded by saying that her Dad, since passed,  also hated onions.  The only time he had pizza it was loaded with onions, and he told his daughter, my host,  how disgusting pizza was.  My host would not have a real pizza until she was 20 and she goes, "it was so delicious". There was no onions on pizza!

About 15 years ago, she was gifted a recipe book of all the different pizzas you could make.  Over 50.  She started cooking them for her dad before he passed.  The myth of Amish pizza died.  Misunderstanding was cleaned up.  

In this story is something I hope to remember.  Ask questions.  Sometimes it is just pizza.  Sometimes it is much bigger then that.  How often do we think "onions" ruin a thing and think that is for everything?  

Keep digging.

Stress, World Championships and Life

Elite athletics has always been a place to showcase the best and worst of human qualities.  It's a microscope on all the things we love and hate.  It has inspiring performances and also humbling ones.  They can't exist without each other.  The classic yin/yang.  Can we learn from them?  That is always the part that interests me, and I think deep down that is why "people" are still drawn to sports.  That is why something that is live always has bit more interest than if it already happened, even if you don't know the outcome.  

The saying "that's why you play the game" resonates.  All of us want to see the underdog win, or the favorite succeed despite the pressure to perform, or some unknown surprise the field.   Human potential, put on display, to actualize that potential is riveting.  

World championships are one such event.  It is basically an Olympics.  Medals.  Rounds.  Days of competition.  After every major event, I always try to sit back and think about what happened after a little bit of time has gone by and the emotion has left the room.   Coach Dan Pfaff calls this a debriefing.  He would do it with athletes.  I do it for myself.  What went well, what went poorly.  Everything from operations, like meal timing, travel, sleep, to the actual event.  

The thing I kept coming back to this time was the management of stress.  Perhaps that is all there is.  Again, these are just my thoughts. 

The Great Ones are stress managers.  Imagine every human has an energy score.  Let's make up a number and call it 100.  Let's make up some other arbitrary numbers as well for this example.  Zero is death.  We can almost never obtain 100 it's mythical, kind of like Madden football.  99 is coveted and only a few people ever will get it.  The 99 doesn't always happen every year either, keep that in mind.  40 is sickness, like the cold.  You hit 40 and you get a cold.  50 is some nagging injury.  

If we want to make it a little more complicated lets robustness of the athlete has a genetic component and some will have 100, but some will have 90.  Again, these are made up. 

Training is 30 points.  Every day, if you were to train the maximum amount of your ability it takes 30 points. 

How do you recover points after training.  Sleep, nutrition, mental health, social bonds, ect.  all the things most people have heard of.  Have you ever thought of it from a performance perspective?  Does my off training periods align with my truest recovery.  I'm bringing a 26 instead of a 30 to my training every day.  Every day.  Over the course of a year, that little bit less adds up to that coveted few pounds on the bar, few tenth or seconds off the clock, a few more percentage points at the plate.  

The scary thing is that athlete, that coach, they all think he or she is at their optimum.  Unrealized potential.

The other side of the coin is that they recover enough to bring the heat when they need to bring the heat in the workout but the ability of the body to adapt to stress (training) is always a function of how healthy the body is.  Recovery is impairing the work they are doing.  Their recovery score is 27 instead of 30 consistently.  Again, they recover enough to train at maximum, they are improving.  But not at the rate they could be.  Unrealized potential.  

At the most elite level, it's not just showing up and training hard with talent.  It's everything.   The 21 hours per day are just as important as the 3 hours of training.  Perhaps even more important.  The more lifestyle stress you accumulate the less stress you can put into your training.  The more lifestyle stress you accumulate the less stress the body can adapt to. 

The better you are at the total picture, anxiety becomes nerves.  Nerves are good.  Nervousness is free energy, the butterflies, it's a symbol that you care about what is about to happen.  Anxiety is the man in the mirror test.  It's showing up with perhaps a subconscious pattern of knowing you didn't do all that could have been done, or perhaps you are coming with less than ideal circumstances, sickness and injury come to mind. 

The great ones are not great by accident.  They are great managers of stress.  Look at your lifestyle when things don't go your way or when they do and a record is broken or an achievement is made.  It works both ways.  Where was my head and life the months leading up to a break through moment.  Obsess over the other 23 hours of the day.  

Weekly Learning: Number One

 I might try a new weekly or semi regular installment of a concept called weekly (even if it isn't) learning. Mostly thoughts on what I've read or experienced in clinic.  I'll see how it evolves.  I've been thinking that it would be good practice to sit and think about the week.  

A win:  Had a patient that was getting repeated knee pain for months after exactly half mile of running.  Swelling on the outside lateral knee.  I had treated the foot and hip and knee in all various combos.  Big rocks were checked and rechecked.  One evening I sat and throught through the anatomy and reviewed some old French Anatomy notes I have.  Taken from the 1800's before Fascia wasn't eliminated.  I reviewed an old Guy Voyer video and throught through some joint jumping techniques that I have learned from a Guy seminar taught by the amazing Brian Murer.  Some individuals will have a lateral sesamoid bone and can have various IT band attachments (up to 5).  I worked the tissue and joint pumped the joint in various ways.  Two days later I got a text he had run 5 miles with no pain or swelling!  Pretty cool.  

A Loss:  A profesional runner I have worked with retired from foot pain.  It was a frustrating experience for him, to state it mildly.  I'd get to check it every 5-6 weeks.  I have probably read more about the foot in the last year than any other anatomy to try to figure this out.  Worked on trying to create exercises to emphasis better control in the foot and in the body.  Just nothing ever clicked.  Very bummed for him.  The goal for any athlete is to retire because they aren't good enough or they have accomplished what they wanted to.  Not to let injury decide for you.  Very humbling to know you couldn't help.  

But it also puts into clarity the importance of keeping learning, keep thinking, keep tinkering.  I'll cross paths again with injured athletes from various things.  I owe it to that future athlete to get better.  When an athlete trust their career and dreams to help keep them healthy,  it's not a thing to take lightly.  Keep learning, get better.

The Adductor Magnus really has 4 parts if you take the blood vessel areas as zones.  Zone one acts as a hip stabilizer, 2 and 3 are middle zone and are conductors of movement.  Zone 4 is basically acting like another hamstring.  Interesting stuff.