Links for Wednesday, August 29, 2018: Dirty Kanza Promotions, Dangerous playground comeback, Dutch cycling politics

This Dirty Kanza video showed up in my email yesterday

And this cornball teared up a little watching it. I'll carry a torch for this race as long as I live. 

Playgrounds that are just a little bit dangerous are coming back, baby

When I visited my alma mater last spring, I was pretty bummed out that the old playground, made up largely of concrete pipe:

concretepipe.org

and buried tractor tires:

http://lapaceksorchard.blogspot.com/

had been completely replaced with the same safety-first playground equipment you can find anywhere:

Not Skyline's playground, but it might as well be. They all look alike. (playcreation.com)

The problem with this kind of playground isn't that it's ugly or unsafe. It's that it's boring. And kids don't want anything to do with a boring playground. It can't compete with omnipresent screens. Public playgrounds that allow for slightly riskier play (think swinging and teeter-tottering) on a variety of surfaces--nothing exotic, just sand, grass, gravel, and the like--see 53 percent more visitors than the ultra-safe playgrounds like the one above, and kids are 18 percent more physically active.

“The take-home message ... is: Stop setting your bar at the level of the most anxious parent. If you do that, you’re guaranteed to produce boring and dull playgrounds,” said Tim Gill ... “If you set your bar at the level of the average parent or maybe even at the level of the parents … who do want some more excitement and challenge in their kids’ lives, then, things start to look different.”

I like different. An abrasion, bruise, or even a broken bone here and there is the cost of doing business for raising interesting, innovative, resourceful kids.

The Dutch are known for their everyday, casual love of cycling. But their policies and infrastructure didn't come easily

"Rotterdam, for example, was completely obliterated during the Second World War and rebuilt in this post-war, modernist image — designing cities around the automobile, where people would live outside the city, commute by car into the city every day, and everyone would have more light and space and air. They’d be living happily in the suburbs.

It didn’t take long for Rotterdammers to realize this wasn’t the future they wanted. The spaces they were building were inhospitable to walking and cycling and public transit. Cycling rates were plummeting. There were more road fatalities.

So, not just in Rotterdam, but in cities across the Netherlands in the ’70s, there was a real rejection of this car-centric urban planning.

Some of them resisted better than others. In Rotterdam, they managed to reverse the tide and retrofit some of these spaces for other modes of transportation. But certainly a lot of Dutch cities made mistakes. In Utrecht, they paved over canals. In Amsterdam, they came just a single city council vote away from demolishing the Jewish quarter of their city to build a four-lane motorway."

But now cycling transcends politics:

Chris Bruntlett: ...We had conversations with politicians there and they made it perfectly clear: Even the right-wing in the Netherlands has to support more spending on cycling.

David Roberts: Because of public pressure, public opinion?

Chris Bruntlett: Exactly. It’s not a tenable or realistic position to win an election when probably 80 percent of the population cycles at least once a week.

Building on all that NZ pregnancy cycling momentum from last week. (Pic: Modacity/Vox)

Links are back! (for now, at least): Tuesday, August 15, 2018

The Gravel Boom Could Save Road Biking's Soul

This is true, and mostly for the reasons Aaron Gulley lays out: fewer cars and an attitude of adventure rather than competition. None of the assholery that turns up at road races is present at the majority of gravel races, unless you count a few people trying to change it for the worse.

Gravel Rides Are Saving Small-Town America

I guess gravel riding is "saving" a lot of things today. "Saving" is too strong a word for the effect of gravel races on small towns; a couple hundred riders one or two days a year is nice, but I doubt if it pays for that new school library. But no doubt I have traveled to and spent money in a dozen towns over the last few years I would have completely bypassed if not for gravel racing.

Med students don't go to class. This is not a new phenomenon

I don't mean to pull any kind of hard work card, because people work hard in every imaginable job. But it's hard to overstate how precious your time is in med school. The volume of information is overwhelming, and even a good lecturer can't typically deliver the material in a time-efficient way. It's much easier just to look at other people's notes (as in note service in my day) or to watch the lecture via podcast or webcast at double speed later. And most professors just aren't good lecturers. Not even Nobel laureates. Maybe particularly not Nobel laureates; the skill set that makes a good investigator is far removed from the skill set of a good teacher.

What's interesting here is that the move to pass-fail grading systems--which I completely agree with--has made performance on the national "step" exams that much more important. This, according to Orly Nadell Farber, is what is driving the further diminution of attendance at lectures. My response to this is for NBME to stop giving step scores to residency program directors.

Doctors are pulling their hair out trying to get parents to limit screentime

U.S. kids get an average of over 7 hours daily in front of screens, almost all of it because increased use of smartphones, tablets, and other devices. Not that anyone who has seen a kid in a grocery cart at the store lately needs to be told that. Why is this important? Because the more time you spend zonked out in front of a television, the more fat you tend to have (what we five-dollar-word types call "adiposity”). And adiposity means bad things later on, like heart disease and diabetes.

So the American Heart Association is recommending--again--that children and teens to get no more than 1–2 hours of recreational screen time a day. They also warmed my heart by continuing to recommend against having screens, including phones, in bedrooms and while eating.

Paris-Roubaix 2018. I love bike racing.

Peter Sagan finally winning the Hell of the North is no surprise. He hasn't won three World Championships in a row and Flanders and dozens of Tour de France stages by accident. But Silvan Dillier rode like a hero to get second. And Taylor Phinney gave Americans some hope with a fantastic eighth-place finish. Wow!

How to break up with your phone, Double Arrow Metabolism edition, days 20-23

Well. That did not go well. My Saturday was fine. I raced in the first race of the Rage Against the Chainring series, and finished 16/55 in the "B" race, about as good a result as I could have hoped for:

I spent precious little time on my phone Saturday, but I can't prove it since I deleted Moment over the weekend. I just couldn't handle the notifications, and I couldn't justify having the app without having it remind me to stay off my phone. So it's gonzo. 

Sunday, though, was tough. I started strong and left my phone in an inconspicuous place, and I did well staying away from it through the morning and early afternoon. I did fun things with real people, per Catherine's instructions. I didn't even get any Rubicon consults. Come evening, though, the seeding for the NCAA men's basketball tournament came down the tracks like a locomotive. And I just. Couldn't. Stop. Myself. from looking to see where my beloved Kansas State Wildcats ended up. I didn't even consciously cheat. I just walked by my phone and casually picked it up and tuned into the NCAA website:

Answer: on a collision course with a first-weekend exit. 

And once I'd peeked to see where the 'Cats were, I couldn't resist looking to see where the rest of the Big XII ended up, and then where Wichita State was seeded, and then a bunch of posts on The Ringer and ESPN about how easy the Xavier/UNC bracket was. I killed an hour, easy. On a day I was supposed to be phone-free. Sigh. 

But yesterday (Monday) was a new day. It was the first day of My New Relationship with my phone. Catherine told me to answer a series of questions she calls "See/Think/Feel/Wonder."

What did I observe (see) about myself and my behavior and emotions during my twenty-four-hour trial separation?

When I actually managed to keep away from my phone, say before and after the hours of 4-6 pm CST, I felt great. I did meaningful work around the house, I asked my kids questions, and I did the laundry in silence (sans podcast). I was a better person than I am with my phone distracting me. 

What do these observations make me think about? When I reflect back on my experience, what thoughts come into my mind?

I feel like, even after three weeks of conscious effort and months or years of half-assed behavior modification before that, I still have work to do. 

Now that i've made it through the Trial Separation, how do i feel about my phone itself, as well as my relationship with it?

I still feel like my phone is very, very valuable for specific tasks, like my to-do list, my calendar, and podcasts. And being a phone, of course, And texting, to a smaller extent. But the rest of my phone is an elaborately designed distraction device. It is definitely expendable for large swaths of the day. 

Now that I've completed the Trial Separation and begun to deeply observe my relationship with my phone, what do I wonder? What questions do I have? What do I want to know more about? What would I like to investigate further or look into more?

I wonder if I could really go back to having just a home phone and a paper planner, or if I could at least revert to a flip phone. I know it would cause me to carry a paper planner around, which would be a drag, but I already carry a notebook and pen most places, so it wouldn't be a big deal. I'd miss being able to coordinate my calendar with my wife. I'd miss getting my kids' school calendars automatically through Google on my phone. I'd like to investigate more how I could handle those issues through my work computer. 

What was the hardest part?

Finding the results of NCAA tournament bracket seeding in a house with no cable subscription, obviously. 

What was the best part?

I had several Beyblade battles with my son without the threat of phone interruptions. 

What surprised me?

I was surprised that I fell back into phone use so easily. It really disappointed me that I was so weak.

What did I learn from the experience that I can use once my official breakup is over?

If I really want to stay away from the device, it needs to be in a different room. It's that bad.

Day 23, Tuesday, today, was to Phast. Catherine said to pick a time today to take at least a half-hour break when my phone would be either unavailable or turned off. This was easy. I knew I had a couple high-level tasks to complete this morning before going to lunch and then going to KUSM-Wichita to teach at one pm. So I silenced my phone at 10 am and stuck it in my briefcase. I used a desktop computer to order Chipotle for carry-out. Then I sat down and ground out a couple hours' work on the use of the Diabetes Prevention Program for osteoarthritic pain. It felt great to work without interruption or distraction from my phone and to have something to show for the morning. 

How to break up with your phone, Double Arrow Metabolism edition, Days 18 and 19

Day 18 is to Meditate. Spoiler alert: I didn't do it. I know meditation brings many people a lot of joy and meaning. I know that some very high-functioning, productive people like Yuval Harari swear by it. I know some good evidence (albeit tainted by low adherence rates) exists for its practice. 

Here's the thing: I hate it. Every time I've tried meditation, on my own or in groups, I've heard a voice inside my head yelling "You're wasting your life. You're wasting your life. YOU'RE WASTING YOUR LIFE," over and over. I don't think that counts as an insight.

 There is one exception. I have trouble going to sleep at night. It's not a new problem. Once upon a time, someone taught me to repeat a mantra to myself as I lie in bed. I take a deep breath and think to myself, "I'm relaxing my feet, I'm letting go." I exhale and do my best to completely relax my feet. Then I take another breath and think to myself, "I'm relaxing my calves, I'm letting go." I exhale and relax my calves. And so on, until I'm either asleep or to the top of my head. It works. But I don't think true meditation is supposed to put me to sleep.

And since the entire reason I'm trying to break up with my phone is to stop wasting my life in a different way, I refuse to meditate. And I damn sure refuse to download a "meditation app." Using my phone, which I'm trying to free myself of, to engage in an alternative activity that also makes me feel bad is what they call a "double whammy" in my neck of the woods. No thanks.

So on to Day 19: Prepare for Your Trial Separation. Catherine tells me to identify what it is I'll be taking a break from. She recommends going screen-free, including movies, computers, and television. I'm not sure I want to do it. My kids loooooove going to movies, and A Wrinkle in Time just came out, and I'm not sure I want to miss seeing it with them. Plus, Catherine says to make plans for fun things to do. So I'm making plans to see a movie.

Then I'm supposed to tell people what I'm doing and get them on board. This is actually pretty easy. I don't want to be obnoxious about this. My goal here isn't to make people think I'm superior. And I suspect people who can't get ahold of me will just call my wife. She recommends setting a phone greeting to let people know I'm phone-free, but I don't think I'll need it. I don't have a landline, so I can't forward calls. 

Preparing with hard-copy instructions is next. I have a bike race Saturday that I'll be using my Garmin to navigate. No phone needed. But Sunday, I'm expecting no travel. So I shouldn't need a map.

Catherine says to carry a pen and paper for a "to-phone" list once I'm done. I've already started doing this, so I'm set. 

Podcasts: those are gonna be hard. I'm not sure how I'll brush my teeth without the sweet, sweet, honey-filled timbre of Mike Pesca's voice in my ear. But I'm committed to giving it a shot. 

Are triathlons dangerous?

First things first: I've never done a triathlon. I swim like a St. Bernard. But I've done a lot of endurance bike racing, and I've been at more than one event with a death, the most recent the 2017 Dirty Kanza. So I was interested that in the latest Annals of Internal Medicine, investigators looked into a sudden death database to identify 135 race-related deaths and cardiac arrests in American triathlons between 1985 and 2016. Interestingly, right at two-thirds of deaths and arrests happened in the swim part of races, which usually comes first, before the bike and run. The editorialists spend a lot of energy trying to link swimming to some special form of stress from cold water or other factors that might be extra-dangerous. But to me, the swimming link seems consistent with the finding that in autopsies, about half of subjects had cardiovascular abnormalities, most often old-fashioned atherosclerotic disease. Swimming caught most of these people simply because it was the first event. Had running or cycling come first, I suspect one of them might have been the death leader. I'm not convinced by their observation that most marathoners die toward the end of races; anyone who's seen the scrum at the beginning of a triathlon knows that it's inherently different than the often walking pace seen at the start of a marathon: 

From http://www.zwemza.com/?p=5515, triathletes tempting fate. 

85% of victims were male, but I'm not sure the significance of that number, since >60% of participants (at least in pro Ironman races) are male:

From https://www.outsideonline.com/1964906/fight-gender-equality-ironman

And if you look at total Ironman competitors, the distribution of sex comes much closer to the death/cardiac arrest statistics:

But sex aside, we're forced to see that cardiac arrest and death are not rare among triathletes. Between 2006 and 2016, their incidence was 1.74 per 100,000 participants in the study. The risk of death increased with increasing age, unsurprisingly. Don't let this dissuade you from being more active. The benefits of physical activity far, far outweigh the risks in almost everyone. If you're inactive now and thinking of becoming active, or if you're active now and thinking of doing really hard-core things like triathlon, consider taking the American College of Sports Medicine's new-ish algorithm to your doctor and talking it over before you hit it really hard:

We don't know how really weird stuff like performance enhancing drugs effects this. My suspicion is that it's not good.