Nikhil Joshi, M.D.

The Longest Journey

Even the longest journey begins with a single step

Today, as any day, begins with one’s breath, with subtle movements of mind and body. Action grows from within and allows us communion with the world around us. Through movement we navigate and explore – retracing the steps of those before us, forging a way for those to come.

My own story is one of movement, of action and exploration. In fact, the story of all life is one of perpetual motion – endless dynamism, change, rebirth and growth. The seemingly simple prose of the Tao Te Ching, recorded more than a thousand years ago, is a collection of poetic and profound observations of the Way of things. The Way is one of motion, outside of conceptions of time – a stream of ever-flowing consciousness and revolution. All beings, from our grandfather mountains and grandmother rivers to all beasts large and small to our own brothers and sisters, flow within existence. Whether one believes strongly in some religious, spiritual or scientific proclivity, none can deny such simple truths of life. Life began in a flurry of action, on a scale none can fully comprehend and continues, in fashion, absorbing and welcoming each into its current.

Life continues through the pursuit of motion – physical, mental, emotional, social, cultural, spiritual. Whether we choose to acknowledge it or not, our life is a loosely orchestrated improvisation, an adventure through unknown expanses with opportunity to share with others the beauty and struggles of our search for awareness and understanding. Life, also, is a journey in which we can play an active and engaged role in shaping our path.

I have been taught, time and again (hopefully garnishing some learning along the way!), that hope comes not through holding on statically and stubbornly to one’s conception of the way things are. Hope comes through allowing one’s self to move and transform – as a humble blade of grass is rooted yet willing to bend in the wind. Action, in its myriad forms, becomes the medium for life – for continued understanding, exploring, and existence. Though I write of these notions of motion and action from a rather philosophical and existential vantage, I wish to send my message for hope through the telling of my personal experience with and understanding of life’s journeying. One can easily become lost in abstraction in Lao Tzu’s telling of the Way, but make no mistake, even the longest journey begins with a single step. And, surely, that journey is centered within our self – our body, our action.

I began my movement from my natal home, as many teens do, following graduation from high school. I transitioned immediately into study as an undergraduate student – a move that I hoped would expand my knowledge and understanding of the world, providing insight into the multitude of curiosities I had. Following my first year of study, I settled into the longest summer break of my life. I worked and played, dreaming of and interacting with mountains and rivers, exercising and enjoying my physical and mental freedom.

In the final week of summer I was run down by a motor vehicle while crossing a pedestrian crosswalk. As I careened over the windshield and roof of the vehicle I was afforded a unique and, at that point in my life, not-yet-experienced perspective. I did not watch my life pass before my eyes as cliché suggests. As I somersaulted over the back end of the SUV, instead of a rapid progression, a slideshow of events, feelings and memories, my experience of time came to a near halt. I came to a moment of immediate presence through the accidental union of metal and flesh, body and machine.

I returned to previous (or a slightly skewed?) consciousness with a mangled mass of me lying crumpled and prone on the pavement. I was shattered, bloodied and screaming out in pain. To say my body was altered would be more than a slight understatement. My legs were contorted in alien angles with more bends than I had grown accustomed to and the skin of my arms, legs, back, neck and face looked akin to ground hamburger…mixed with dirt and gravel. Maybe I am a somewhat crazy guy but I forced myself into a semi-seated position to purvey the lay of my land. I pushed on my left leg below the obvious breaks. To be honest, the first thing that came to mind was that my leg, hanging limp and backwards bent at the knee and again at a false-knee (i.e., shattered bones!), was now a Gumby leg – able to be twisted and contorted without any conscious responsiveness. My body compensated for the lacking responsiveness with a rather radical dose of incapacitating pain. This comical moment was followed with many more of screaming delirium. My ability to move, my perception of motion and action, had been reduced to nil in the matter of seconds. Needless to point out, I was unable to chase down the driver as he cruised on down the road. Lucky for me, there were many witnesses and others to help with that.

I was stranded; immobile in hospital for weeks before my exodus to bed for the remainder of the autumn months. For the first time since infancy I was unable to run, walk, or even crawl. It was an experience that made me both cry and laugh having to re-learn how to walk as a young adult. I was provided the ability to relive the visceral feelings that in my life, many years prior, I may have shared while first testing out the capacity of my body – locomotion under my own power. It seemed surreal how foreign my legs had become –disembodied limbs lying at the foot of the bed. Even the look of my legs, which had appeared muscular, confident and capable, were transformed into weak, reduced shells of a previous self. Eventually, I was – after considerable effort and focus – able to stand up out of bed and walk with the help of crutches. After countless attempts to scale a single flight of stairs, I finally achieved some semblance of success and was granted release to a bed outside of the hospital. I found I had returned to my parents’ home much sooner than I had anticipated when I left the summer previously. I was forced into dependency and subsequently relearned a valuable lesson in gratitude.

I returned to school mid-semester after an excruciatingly extended stay in bed full of Percocet and exhaustive attempts at sleep. I ambled slowly across campus, dragging a swollen purple leg behind me. I arrived late and out-of-breath for every class. In truth, this forced slowing of physicality allowed me to reflect, almost continuously, on life around me. My reflections were balanced with bundles of anguish for my state of being and lacking ability. At no point throughout my recovery was I released from physical pain or mental strife. However, as I continued to practice and exercise I slowly transitioned to independency.

Two years later, after a second corrective surgery, I returned to full mobility and remembrance of previous capabilities. Phew! Over the intervening two years I had returned to activity, engaging once again in the mountain, water, winter and summer activities I had enjoyed prior to the accident. I was able to climb, to paddle, to hike and bike again. However, I continued to be excluded from, possibly, the most natural, intuitive, ancient and least technologically-aided human action – running; an activity I pursued passionately from young adolescent years. After only a few moments, surging pain would end any run, seemingly, before it had even begun. Though the surgeon had done a bang-up job reconstructing my leg, my tibia just wouldn’t get along with its new titanium companions. The second surgery removed two sets of bone screws from my tibia. I was, and am, left with an intertibial titanium bone nail.

The next test came following my second bout of wheelchair and crutches. I was back on my own unaided feet a few weeks after the second surgery. To measure the true success of the procedure, however, I needed to test myself in a run. I headed to the gym, hopeful, donning my runners. It had been an honest couple of years since I had stepped on the belt of a treadmill. Treadmills are a runner’s nemesis – a necessary evil for many and an obsessively masochistic apparatus for an unlucky few. For me, it would be a tool to measure my journey of recovery. I do not recall any feelings of trepidation or anxiety. I had come to expect run-ending pain. I believe it would be difficult to fully understand the pain that came with running on my bone nail and screws for those without screws, plates, or nails in their skeleton. It is not at all like the muscle fatigue, the searing from excessive amounts of lactic acid, or the burning lungs that often accompany running. Rather, it is a jarring and painful pounding – running with an ever-present reminder of alien anatomy – manmade implements that one would more likely find holding together the frame of a house or a ramshackle old toolshed. As I ran through one mile and then continued past the ten-minute mark I grew increasingly excited by the unusual absence of pain. I ended my run after 2 miles and knew, in a visceral and embodied knowing, that I had just ran away from my lingering, nagging deformation.

There must be some conniving and benevolent force present in my dealings as these events coincided with the beginning of my senior year of undergraduate study. I was on the threshold of beginning my honour’s thesis project. I had been struggling to gain access to the population I was hoping to work with (i.e., studying the process of embodiment of those living on death-row in a U.S.A. prison). When I triumphantly exclaimed to my supervisor my small victory of finally returning to running without pain a new project was seeded. A journey of a thousand miles (…or a few thousand as it turned out!) began that afternoon.

I set my sights on building a body (a self) that could run an ultramarathon. Most simply, an ultramarathon is any footrace that exceeds the marathon (i.e., 42.2 km) distance. For metaphorical, symbolic and pragmatic reasons I selected The Canadian Death Race, a 125 km race in which participants run over three mountain summits, through forests and fields, and across ridgelines before fording a white-capped river in the Canadian Rocky Mountains near Grand Cache, Alberta. Runners have 24-hours to cross the finish line, climbing and descending over 17,000 along the way. My project was a study of my own body and experience. I wonder if I could build a body from scratch that could complete this ridiculous feat. I measured my feelings and perceptions through journaling, my physical body through anthropometric testing (e.g. weight, metabolic rates, body fat and skeletal muscle percentages), blood testing (e.g. cholesterol, triglycerides, hemoglobin A1c, etc.), spirometric (i.e. lung function) testing and performance testing (e.g. VO2 max, lactate threshold, etc.). I set out on a journey to experience and observe the transformation that I would make – physically, physiologically, mentally, emotionally, metaphorically – as I traveled from absolute immobility through normal mobility and on through to the extremes of human-powered mobility.

I measured baseline values and recorded baseline thoughts and feelings. I set my own daily, weekly and monthly training regimens and nutritional programs. I was measuring human transformation, rehabilitation and change. However, I was also, inadvertently, measuring human capacity for self-empowerment and self-sufficiency, the ability to play an active role in crafting the outcome of one’s future.

Over the course of ten months I attempted to hone my form, inner and outer, to carry me across the extreme distance and terrain that waited in the coming summer. I cycled, swam, and ran miles upon miles. I lifted, squatted, pressed, pushed and pulled weights to strengthen my body and harden my resolve. By the end of my study my physical body had changed, a tad. I was surprised by how my physical self did not appear much different at all – a few pounds lighter, a smidgen less body fat, a slightly higher basal metabolic rate, etc.

The real significant changes came in my perception and understanding. My relationship with space and time was altered. I had considerable more confidence in my ability – a strengthened determination and a bolstered willingness for and acceptance of pain and suffering. My performance was greatly enhanced. My body became a more highly tuned machine capable of efficient use of resources (including food, hydration and oxygen consumption). However, the greatest benefit was my evolving mindscape. I was building a body that would push its bounds and crafting a mind that was shedding conception of limitation.

The race began early on the Saturday morning of the August long-weekend. I headed out into the unknown alongside 250 or so other ridiculous guys and gals. Maybe we were all deluded in thinking this adventure was sane. Either way, I believe everyone that entered that or any other ultramarathon is seeking answers to questions they hold of themselves. These questions invariably revolve around searching for and pushing boundaries and perceived limitations, shedding expectations, long-held conceptions and finding hope in action.

After a few hours I found myself gripped by cramping that left me exhausted. As I charged down the mountain ridges my quads would seize sending me into fits of howling agony. I struggled with bouts of hypoglycemia—low blood sugar—that was cured only, intermittently, through consumption of liquid sugars. As the day wore on and my resolve wore thin, I began to fight with fatigue (the ‘sleepies’ as many ultrarunners call this), gastrointestinal distress, and hallucinations. I found myself dealing with involuntary expulsions of previously ingested ‘energy goo’. My body was revolting in a way I had not experienced before. I ran through the heat of the day under the blazing sun. I ran into the night and through the forests cloaked in darkness. The miles clicked on by. As the sun rose on the second day, I finally ran across the finish-line. The scene that the handful of spectators witnessed likely conjured images of a zombie from a B-grade film lumbering after some hapless protagonist. That said, I swear I was sprinting along during that final hundred metres. I slumped onto the nearby benches to greet and thank my support crew and enjoy my delirious contentment at being able to stop.

Following the race I needed help to shower and dress. I was unable to walk for a day or more and could not wear shoes, comfortably, for weeks. I lost nearly all my toenails and was left with blisters instead. My muscles revolted leaving me sore, achy and unable to do much. I had prematurely aged into a feeble old man! However, I achieved my goal. I successfully built a body that had transformed from immobility to mobility only to reach immobility once again – a proverbial phoenix rising from the ashes only to burn again – ashes to ashes and dust to dust.

I gained considerable insight into rehabilitation, performance and embodiment throughout the course of my project. However, I learned more about myself and the power and strength that lies, however dormant and undusted, within each of us. Action builds momentum which, in turn, can lead to limitless imagination, transformation and invention.

My story need not be confined to those suffering injury or dis-ease. It need not be a lesson solely for sport and competition. Rather, I see it as a rather poignant tool that can be used by all for summoning those pearls of hope and reassurance that each of us need (often daily!) throughout our life.

I was gifted a kernel of wisdom as I entered into my process of rehabilitation and re-evolution that I will share now. Simple enough, its truth and profundity ring more clearly as one progresses along their journey: The first steps determine the trajectory of the whole path. All great achievements begin with small acts and small efforts just as drops of water forge mighty canyons and seemingly imperceptible shifts create the grandest mountain peaks. The natural world shares this Way with the ultrarunner- unrelenting forward progress progressively shaping body/mind/landscape. With that awareness, my experience can teach us that we are capable of monumental change. We are capable of self-directed empowerment, of self-powered learning and transformation. Even in the face of great anguish, strife, pain and suffering we are able to forge a new path of our choosing and direction.

We live in a time of growing awareness. Ironically (and frustratingly), we also live in a time of stifling ignorance and ineptitude expressed by many governing forces. Considerable changes must be made on many fronts from individual to community to environment in order to live in a balanced and healthy way. We cannot fall prey to believing that we are not capable. We cannot allow apathy to best us – non-motion creates a most vile, sucking dis-ease. We must be active and engaged in events that impact us. The world evolves and so do we, as individual and as a collective. My wish is to pass on the assurance that each of us has the capacity to be active and mindful within our life, contributing greatly to the world around us. Small steps become long journeys – great transformations arise from small acts.

When we become inspired we can realize our inner power to be active in our own self change. And through self-transformation we may realize our capacity for successful and healthful societal and global transformation, re-evolution and re-birth.

In following with a thread of Taoist perspective and sagely advice, I finish with a second excerpt from the Tao Te Ching—allowing us to realize that inextinguishable potential within our self and the world around us.

The Way is limitless,
So nature is limitless,
So the world is limitless,
And, so I am limitless


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