Random Thoughts from a Restless Mind

Transparency is the new buzzword in medicine. Systems should be transparent with regard to prices, if not costs. Doctors and other providers of healthcare services should publish their costs and fees, too. Various ratings and measurements have been developed in an attempt to measure that nebulous and elusive entity “Quality”. Calls have been made for transparency here as well; hospitals, doctors, and others are browbeaten to release any and all manner of quality measurements so that we might create something one could call an “informed patient”.

The first, and therefore most important challenge in the quest to measure quality is to agree on a definition of just what quality is. Like all rational discussions the first order of business is to agree on terms and the terms of engagement.

Let’s take the question of evaluating the quality of an individual surgeon. What are the salient metrics? Are we concerned with only outcomes? You know, success rates, complication rates, stuff like that. Is there more to the measurement? Should we be concerned with EFFICIENCY, the ability to obtain high quality outcomes in a more timely manner? How about VALUE, the soft and difficult to measure combination of quality and COST? In this day and age of “economic credentialing” in which doctors, hospitals, and other providers are held responsible for the cost of care, not only on an individual basis but also a societal one, it seems as if value is an inescapable aspect of quality, at least in the eyes of our government and the people who actually pay for healthcare.

Quality measures will be different for surgeons of different stripes; we will want to evaluate different complications and their rate of occurrence for an ophthalmologist versus, say, a cardiothoracic surgeon. Even similar adverse events like infection rates will have a different meaning across specialties. One classic example of a surgical complication is post-op infections. From my limited reading about heart and chest surgery it appears that the post-op infection rate is around 1-2%. This would be scandalous in eye surgery where the post-op infection rate is 100X lower, closer to .01-.02%. Stuff like this should be fairly easy to uncover, or at least you’d like to think so. It turns out that even this metric is rather hard to come by since multiple doctors will participate in the treatment of post-op infections, and literally no one offers up these stats uncompelled. Similar issues apply to specialty-specific complications (vitreous loss, graft leak) for similar reasons.

Right away the difficulty of measuring quality is obvious: even the simple quality measures appear to be something other than simple to discover right now.

Outcome measures are even trickier. Since I know eye surgery best let me stay in that arena and use cataract surgery as my example. For our discussion let’s assume that we have magically been granted unfettered access to every eye surgeon’s charts (and that they are all legible, and that they all contain the same basic information). It should be a rather simple proposition to draft meaningful criteria–let’s say “how well do the patients see after cataract surgery.?”  Would that it were so. The answer to that very simple question–how well do you see after surgery–depends on several variables, and further varies if you ask the question slightly differently. How much improvement did the patient achieve compared with pre-op? How fast did the improvement come? How well does the patient see without eyeglasses?  Is the patient more or less dependent on eyeglasses following surgery? What level of vision constitutes a success? Does the surgeon get the same results with complex cases?

I imagine these issues are not specific to ophthalmology. I can see the same types of questions and complexities in orthopedic surgery, for example. Think about hip replacement–along with cataract surgery and cardiac bypass surgery, hip replacement is arguably one of the most significant medical developments when we think about the quality of life enjoyed by an older person. What defines success in hip replacement? How long do you allow for success to occur for it to be deemed one for the  ”win” column? Do we give bonus points for speed in the OR, both from a patient’s standpoint and an economic one? How about a surgeon’s ability to achieve the same level of success in a thin 70 year old tennis player and an obese, cart-riding smoker?

Seriously, if docs can’t come to an agreement about what constitutes “quality”, how can we in good faith measure it? Furthermore, if we WON’T define it we have no one but ourselves to blame when some nameless, faceless 30 year old sociology major in D.C. does it for us.

Nobody asked me (again), but as long as I’m here let me offer up a 3-part proposal to measure and promote quality using surgeons as a theoretical template. Let’s start with a thought exercise borrowed from CrossFit. Fitness training using the CrossFit methodology involves high intensity exercise while trying to maintain near-perfect movement and form. One is shown three targets from a shooting range. The first has random bullet holes all around the bullseye, the second has every shot dead-on perfect, and the third has 95% of the shots within the center bullseye and 5% on-target but not perfect. Which one represents the most desirable CrossFit training strategy?

In CrossFit the answer is “C”, 95% accuracy with the misses still close because this represents the optimal combination of form (accuracy) and intensity (speed). Is this directly applicable to surgery? Well, that depends on how far outside the bullseye the misses land, doesn’t it? And in surgery I think we also need a more accurate measurement of intensity; we need a clock. Speed matters, from both a medical standpoint and a financial one. The shorter a surgery lasts while still hitting the target, the less physically and mentally taxing it is for the patient, and the fewer costly resources (OR time, staff time, doctor time, supplies, etc.)  you are consuming during surgery. All things being equal, the surgeon who achieves the desired outcome faster without increasing her complication rate is the better surgeon.

Put surgeons on the clock.

A successful outcome must be explicitly defined for each common surgical procedure. Pre-operative factors that reduce the likelihood of success should certainly be taken into account (e.g. a morbidly obese cart-riding smoker and hip replacement), but care needs to be taken so that a measurement can’t be gamed (two guttata do not constitute a corneal dystrophy and increased likelihood of swelling) in order to work with a lower standard. Surgical societies should show some spine and make a call, define what constitutes a high-quality outcome, regardless of the howling that will emanate from the mediocre and the incompetent. It’s gonna happen anyway, and physicians making the call would be orders of magnitude better than MBA’s and philosophy majors.

Lastly, quality should be measured, publicized and praised, and those surgeons (and other doctors) should be explicitly rewarded with as many cases as they can (or wish to) handle. They should also be paid more. Once we decide what constitutes quality we can measure it and publish the data. People will understand this, just like they understand the data in a box score. Why is it so OK for the baseball player with the highest batting average or lowest ERA to be paid more based on his success, yet somehow the most efficient surgeon who has the best outcomes is labeled a “money grubber” who must somehow be doing something wrong if he is also very busy? We want that high batting average guy at the plate in the 9th inning of a tight ballgame, and we pay him more because of his higher quality outcomes. Why aren’t we doing the same thing with surgeons? The very least we can do is stop accusing surgeons of being successful!

It’s time that we apply basic theories about quality to medicine in general and surgery in particular. Indeed, it should be easier to do it with surgeons. Make a call–define a successful outcome. Pull out a stopwatch. Faster, more efficient surgery is less expensive and generally less taxing physically for patients. Once the data is available be transparent and publish the results. I know what Miguel Cabrera is batting this year; my patients (and potential patients) should know my “batting average” in the OR. While I hold out little hope of being heard on this last point, uncountable articles support the benefit of the carrot at the expense of the stick when it comes to promoting excellence. Higher quality should beget higher pay. At the very least we should stop with the assumption that the busy surgeon is somehow “getting over”, guilty of somehow gaming the system (eg. doing unnecessary surgery) until and unless proven innocent.

She may just be better.

Beth has often wondered why it is that I have so much trouble pulling the trigger on booking a flight. It’s almost pathological, really. I just can’t make myself do it; she books all of my travel.

Now I know why. There was a recent article in some Psychology Something-Or-Other Journal that says it’s classic: judges, doctors, people who must make major, really important decisions all day, every day in their job have trouble making what amounts to relatively trivial decisions elsewhere in life. Has to do with something called “Consequence Fatigue” or “Decision Fatugue”,  something like that. So there you have it.

What do you think? You have a job that involves making significant decisions with measurable consequences–do you clutch on the less momentous ones?

My Dad has been hospitalized for many, many weeks now. My siblings, a couple of the daughters-in-law (including my wife) and I  have taken turns either keeping my Mom company or spelling her and just hanging with my Dad alone. We have tried mightily to keep each other abreast of a day’s events, and we have made yeoman’s efforts to help Mom communicate with all sorts of members of the medical community involved in Dad’s care. Man, has THAT been a challenge. The differences in understanding the lingo of medicine, not to mention the vast gulf between the frame of reference that exists between  ”civilians” and medical workers on the front line create communication barriers that can seem impenetrable.

Where does the responsibility lie when we enter into a conversation? Let’s define a conversation as the interaction between two people during which there is a purposeful transfer of some kind of information. Let’s refine that by saying that in this day and age we cannot define a conversation as simply as two people talking with one another. We have email, texts, FB chats and PM’s, Twitter @’s and PM’s, phone calls and Skype, and of course plain old face-2-face talking. Any and all of these have been, or yet might be used when we go forward with Dad.

So where does the responsibility lie to ensure effective transfer of information? Upon whom does it rest to make sure that facts or ideas have been successfully transmitted and received? How about the emotional content, the feelings that ride along with the data? Sometimes the emotional content is really the data that’s intended for transfer and is quite obvious, like the color guard accompanying a General. Oft times, though, the feelings attached to the words are as carefully and craftily hidden as a stowaway on a cruise ship. What exactly does it mean when a nurse greets Mom in the morning with the fact that Dad “struggled” the night before?

Here’s my bid: the responsibility lies on BOTH sides of the conversation. Active listening is key. Engaging in the conversation means engaging the individual on the other side. It starts at the very choice of vehicle: to whom am I sending this message? On the receiving end the vehicle should also be evaluated: who sent this to me? Think about it…the universe of topics you would engage with your 75 yo grandparents via text is awfully darned small, and if you are a grandparent who texts you can’t “receive” disrespect in a message filled with contractions and lingo. By the same token, both sender and receiver must be actively conscious of the frame of reference of any “other” in the conversation.

A Facebook status update is like a billboard, meant to be one-way, neither demanding nor expecting a reply. A conversation, on the other hand, is by definition bi-lateral. It requires active listening and anticipatory listening on the part of both people. It requires a shared understanding of the power as well as the limitation of each method one might choose to utilize. The smaller vehicle (text, Tweet) creates the greater distance and so must transfer the more basic information. More nuance or emotional content requires a different vehicle, at once larger (to include the details) and smaller and more intimate (so that everything can be seen as well as heard). Closer.

In the end we are social creatures, driven always to connect. The rules of communication have not really changed despite our ever-increasing ability to communicate, to connect. The more important the interaction the closer we must be to the other. Communication, no matter what vehicle we choose, requires that we listen better. Listen to what is said to us; listen to what we say; listen, especially, to what the other hears.

The responsibility for a successful communication is shared equally by both or all involved. Despite our newfangled world filled with different ways to communicate the most effective strategy hasn’t changed in a few thousand years:

Listen better.

1) Confabulation. A tall tale that begins with a kernel of truth and grows from there.

2) 3 D’s. For the past 3 days I have been spending the daylight hours with Grampbingo as he struggles to recover from a life-threatening illness. It has been an eye-opening experience, to say the least. One of my take-homes is that Coach is right: the battle is against decrepitude, because that is the only one of the 3 D’s of aging over which we truly have any control.

Dementia, delirium, and decrepitude. This is the kind of 3-D no one wants. Dementia is the disease in which some progressive trauma is inflicted on the brain and results in physical changes that alter brain function. Delirium is the brain’s response to these traumas, the creation of a narrative to explain any event that is the least bit confusing or new. Decrepitude, as we know, is the end-result of dis-use of our physical body resulting in the inability to perform the functional movements of daily life.

Delirium may or may not be permanent; it is, after all, an adaptive reaction which, although negative, demonstrates the plasticity of the brain. The best one can do with Dementia is hope for a full stop, hope for the cessation of whatever insults are hurled at the brain. There is little one can do over a lifetime, at least little that we know, to steel oneself against the ravages of Dementia and Delirium.

But Decrepitude, ah now that’s a different story altogether. The battle against decrepitude starts as soon as you start to move in a purposeful, planned manner to train your body. To build strength, power, and endurance. These may actually be the magic elixir that pushes against Dementia and Delirium, but we know for certain that if we are more able physically we will be better able to persevere. Imagine how much more is the psychic trauma of Delirium if you cannot raise yourself up, cannot walk away. It’s frightening to watch when the realization that you are unable to help yourself becomes the only thing that you know is real.

In the end I hope that I know where I am, what I am doing, and where I am going, though I realize I may have nothing but hope to offer in this regard. But I’ll be able to do and to go because I fight decrepitude here, chez CrossFit. The fight against Decrepitude starts today.

3) Team. Greg Popovitch, coach of the San Antonio Spurs, has a pretty good handle on what it takes to get a team t function as a unit rather than a collection of individuals. At the core of his strategy is the necessity for teammates to care about not only the team but also about one another. Before this can happen, though, they must first be interested in each other. They don’t need to hang out; they don’t even really have to like each other. Just be interested in who the other folks are and what makes them tick.

Interesting, huh?

Makes some sense, and seems to be a pretty actionable thing for any of us who work in or with a group. You know, like an Affiliate. Or a doctor’s office. Or whatever team you might be on at work. Think about your Affiliate. Chances are you really know all kinds of stuff about the people you work out with. You probably know more about them than your neighbors, co-workers, or even some family members. Not only that but you’ve come to really care about whether they are meeting their goals not only in the gym but also outside. This wasn’t anything you set out to do, but once you were interested it just kinda happened as a matter of course.

Popovitch has found that when his players have some degree of caring about and for one another, they tend to be more successful. This is probably a universal truth if you think about it. Caring about your teammates means being concerned about not only your success but also the general success of your team. My bid is that this is just one more bit of the CrossFit experience that is transferable from the Box to everyday life, bringing that interest in your teammates out into the world and letting that interest morph into caring.

It’s easy; all it takes is a little interest.

I’ll see you next week…

There’s a certain story I’d like to read or hear following the harrowing week in Boston. A postscript, if you will. There’s also one in which I have precisely zero interest. My bet: you feel the same.

Do tell me about the heroes. Tell me about the men and women who turned and walked TOWARD the blast. Talk to me about the civilians who chose not to run away, but to run TOWARD the chaos. Let me know their stories. What were they thinking? What is their back story? How did they come to be at that spot at that time on that day? Make sure to follow-up and tell me how they are doing now, too. Don’t let me forget them either as the white, hot glare of the moment cools inexorably into the impersonal embers of history.

Tell me the stories of our public servants. How they worked around the clock to save the victims, went without sleep to find the perps. Give me the details of how a city’s doctors and nurses and other healthcare workers performed better under pressure than any episode of M*A*S*H, and did so without ever really, truly training for such carnage. Who are they? What did they sacrifice? Make sure that I don’t forget them, either, once the video fades to black.

Impress me with the work of our public safety personnel. The Boston city cops and their suburban brethren in Watertown, Cambridge et al. The Mass State troopers and the FBI agents. Tell me about the teamwork, the absence of turf wars between the services. How everyone was united in the single-minded pursuit of the demons who created such horror. Let me know some of their stories, too, at least the ones that aren’t secret without jeopardizing their ability to do their jobs. When all is said and done keep the stories of the cops, the troopers, and the special agents alive so that we may cheer their bravery, resolve, and results.

But don’t…don’t tell me anything about the cretins who did this other than that which might be used to stop others from following in their footsteps. I care not for their troubles. I care not about their back stories. Tell me only those things about the background story that apply to the hunt for any accomplices, any others who lent succor to these two who had such little regard for life that they purposely sought not only to end it, but to ravage it. No, I don’t wish to hear anything about their wretched lives or their warped rationalizations, nor do I care to see their roles paraded in front of our nation as the survivor is tried. Let us learn what we must to exterminate their verifiable “supply chain”, and then redact any mention of their very lives.

Bury them, and all mention of them. Deprive them of any legacy whatsoever. We cannot erase the reality of their acts, nor can we erase the memories of this tragedy. What is once seen or heard cannot be unseen, or unheard. The cold, hard facts of the story will live on, as they must. The stories of the victims and their families, as well as the law enforcement officers, healthcare workers and civilian heroes,  can live on through the conscious will of we, the people. But not the monsters. Not the story of the men who did this. No, don’t tell me their stories. Don’t write or speak or show their names. Deny them the very history of their existence.

Deny them their name.

You know those liquor ads, all sensitive and such, where they show you a picture of a bunch of young folks warm and close. “You save your good stuff (presumably THEIR stuff) for your best friends.” My friend John Brown thinks otherwise. Maybe you save your best stuff for your Mom or your Dad as sign of respect or as a thankful gesture, but your REAL friends are the one’s with whom you can drink the really bad stuff. The rot gut. The “Old Crow”.

If you think about it for just the littlest bit John is absolutely right. With your best friends, your real friends, it’s not at all about the what or the where but only about the who. You are sitting, standing, sweating…whatever…with your friend. “Old Crow” is just fine.

Try this. Someone, probably my Dad, told me long, long ago that your closest friends were the people you could hang out with in silence. If there’s nothing to say, you say…nothing. No awkward silences, just silence. That’s one way I knew my wife Beth was “the one” by the way.

(Lifts glass of Old Crow)

Cheers.

Back in the day, before the astronomic growth of the CrossFit Affiliate program and before there were jokes about the number of CrossFit gyms vs. Starbucks, a CrossFit program was really a much more personal endeavor. Unless you were one of those very fortunate souls to belong to the first 100 or 200 gyms you did CrossFit alone, or in a very tiny group. Everything about CF was really “you vs. you” because the three people in your gym were “me, myself, and I”. We could truly say that the omnibus CrossFit really was for everyone, at least everyone who was willing to learn enough to adapt and scale the WOD. Only those given to self-loathing had any problems with the community aspect of their gyms.

Now? People new to CrossFit are often unaware that an online version even exists; they are clueless when you ask them about anything that might be on CrossFit.com. Some large percentage of people only know the CrossFit Affiliate model and are introduced to CrossFit by someone who knows someone at some CrossFit Somewhere. Their first exposure to CrossFit and the CrossFit community occurs when they walk through the front door of the Affiliate. This changes the conversation. With a very few, really unique exceptions CrossFit is STILL for everyone. However, every CrossFit Affiliate may not be for everyone.

In my son Lil’bingo’s Affiliate on Saturday I listened to one of the members who quite sadly related the tale of a good friend who was turned off by the vibe at the Affiliate he visited. He felt right away that he didn’t fit. Didn’t feel welcomed. Why he felt this way is probably not all that important because someone else surely walked in the next day and felt right at home. It is a bummer, though, because he has extrapolated his initial experience in this particular Box to ALL Boxes and to CrossFit itself. That’s really a shame because from all accounts he’s a guy who would not only benefit from CrossFit, he’s a guy who would really enjoy a CrossFit community.

What went wrong? No idea. Could have been any number of things, really. Maybe no one greeted him, or said hi. Maybe he’s a little far from his prior athletic peak and he was intimidated by an advanced class, or worse made to feel that he didn’t measure up. Might have been something as easy to understand as he showed up on a day when the Open was being judged and all of the trainers and member-ambassadors were just tightly focused on 13.5. Older than the group, younger than the group. Whatever.

I certainly don’t mean this to be a critique of this particular Affiliate, or even the vibe given off there. The beauty of the explosive growth to the CrossFit Affiliate model is precisely that you can find a Box that fits both your fitness goals and your “community comfort zone.” Each one of us should go out of our way to counsel newcomers to explore the various Affiliates in a community, go out of our way to tell them that how a place feels can be different for different people, and that they shouldn’t walk away from CrossFit if the first Box doesn’t feel right. Trust me, it’s a blast when a friend hits up the Affiliate you suggest and falls instantly in love with everything, so much so that they get a bit angry when you remind them to check out other Boxes! Your gym becomes your “third space” and we should all remember to include comfort in the community when we are making  CrossFit suggestions to our friends.

And that Affiliate? In my opinion an Affiliate does have a responsibility to be an ambassador for CrossFit “the fitness program” and the CrossFit community at large. Welcoming the newcomer to your gym might be welcoming them to CrossFit itself. Very little is actually asked of Affiliates in the way of CrossFit as a whole. No purchasing agreements or requirements, no mandatory programming or equipment. An annual check to mail in and an informal understanding not to disparage Crossfit. That’s pretty much it. My call is that there should be just a little more, a tiny bit of ambassadorship for the program and the community, and all that both can do for all of our friends and family, each time someone new graces your doorway. Greet them with a smile and answer a couple of questions. If you’re really busy ask them to come back when you both have a little time. Tell them about your particular version of CrossFit and your very particular CrossFit community.

Each Affiliate may not be for everyone, and that’s really OK. But CrossFit itself, with few exceptions, is STILL for everyone.

This phrase comes courtesy of “Crankshaft”. How good is that phrase? There are all kinds of ways to draw that particular curve. Crankshaft, a bus driver who had a cup of coffee as a minor league pitcher, limits himself to very rare occasions of reminiscing. He wanted more in those days, and he misses those days terribly. Yet, in his tortured wisdom, he realizes that he can’t go back, and he can never change either what came before or what came after.

So he visits that time, opens the window to that little room tucked away in his attic rarely and for the briefest of moments, lest his yearning increase.

Times like those, times like Crankshaft’s stint as a pitcher for the Toledo Mudhens, are the classic double-edged sword. When distressed a quick visit can re-set your compass or fill your tank just enough to get through whatever it is that’s got you down. Spend too much time there, in Toledo for example, and nothing in the here and now might measure up. The yearning can overwhelm the living.

Some places and some times were so special that the yearning can become an irresistible force, driving you back in real time to bring your present day self to Toledo. The yearning curve as a boomerang, if you will. My in-laws gave in to this and just visited Cap Ferrat in Southern France. They yearned to walk the quaint streets of their young marriage, to eat a breakfast of fresh milk and baguettes left in the box outside their tiny apartment while gazing at the impossibly blue waters of a harbor dotted with tiny sailboats. What they got, of course, was the hustle and bustle and hurley-burley of a modern tourist trap en francais.

The yearning curve is never a circle.

A very nice bunch of college buddies, mostly football teammates, recently include me and a couple of other “youngsters” in an epic email thread dedicated to college memories. It’s been fun reading it for sure. We all had 4.5 second 40 yd. dashes. Everyone maxed his bench each time we lifted. Each or us had a full head of hair, and we always got the girl. A magical place and a magical time, indeed. It can be easy to yearn for a place like that.

But it, like Cap Ferrat ca. 1975, is no longer there. It only exists in a picture, or an email thread, or behind a door or a window in the attic of our minds, available for a brief visit when the yearning curve peaks.

Like Toledo.

There is an antielitism in the air in much of society, Western and otherwise. It all seems like something new and shiny and unique to the young, but it’s just that part of the cycle right now. We’ve been here before, we’ll move past this soon, and we’ll get there again. A part of the nastiness of today’s particular version of this antielitism seems to stem from the intimate knowledge that we all have of the minutiae of the lives of the elite, in all its presumed glory. Moreso, a substantial portion of our modern elite seems not to be immune to the rampant over-sharing so prevalent today. And that just feels like bragging, doesn’t it?

There needs to be room for elite and elitism and elites, though, and there needs to be this room in all walks of life. Even more importantly, there needs to be room for those people who openly seek to become elite, better than most, maybe the best. Elitism is simply a harsher form of “meritocracy”, the notion that one can be rewarded for being better in some way at some thing. Elitism is synonymous with “best”, at least when the elite are gracious enough not to rub the rest of our noses in it (see above).

What’s hard for us who are not elite is to separate our jealousy and our anger at those who are truly elite from a couple of important things. We must realize that without the elite we would forever be mired at the mean. Part of a curve under which the volume never changes. It’s also vitally important that we rein in our apparent need to stop any and all who openly express their desire or their efforts to achieve anything above the mean by aspiring to something elite. After all, who knows which of those aspirants will become an elite thinker or doer, one who will drag us all to a higher mean?

Whether it’s in fitness, or in science or finance or philosophy or letters, the area under the curve is driven upward by someone who had whatever it took to become elite. We can learn from them, become a bit better at whatever it is that we do or we are, if we spent a bit less time seeking to drag them back to us.

1) Mongo. A person who salvages treasures from trash. Funny, I always think of Alex Karras when I see “Mongo”, don’t you?

2) Impression. “You only get one chance to make a first impression.” Twain, I think.

“The first time someone shows you who they are, believe them.” Maya Angelou (who recently had a birthday).

I always thought Angelou was a little soft. A bit too touch-feely for my tastes. Uh uh, not that quote. That’s some fine advice. People change and they grow and all, but who and what they are at any given point in time is quite likely to be who and what they will be for some time to come. Best to believe them.

Think of this quote as inter-personal situational awareness and act accordingly.

3) Spirit. Lil’bingo and I were guests at the 13.5 “coming out party” in Santa Cruz. Man, I could spend several Sundays just musing about walking around downtown Santa Cruz (thanks for the tour, Gabby!), but that would be too easy. Nope, howsabout I point out some of the tiny details about our CrossFit world as expressed by a couple or our most famous athletes.

Did you know, for example, that Rich Froning was the houseguest of the Jason Khalipa family this week? The boys did all kinds of off-the-charts workouts and training, then broke bread with Clan Khalipa. How about the shirts Rich and Jason were sporting for their 13.5 duel? Rich had on the latest t-shirt statement from the fashionistas at NorCal CrossFit (owned by Jason), while Jason was repping CrossFit Mayhem with his shirt (owned by Rich). Hardcore, cutthroats these two, eh?

CrossFit the competitive sport is one of the 3 pillars of CrossFit as we know it (more in a bit), and the friendly, supportive ethic so well demonstrated by Froning and Khalipa has long been a part of our competitive DNA. I remember standing about 5 feet from the rowers at The Ranch and marveling as an earlier finisher slumped off his C2 and literally crawled over to urge on his neighbor, his competitor. How about all of the teams that finished the final event 2 years ago rallying around the team that pushed on through the time cap, unwilling to surrender? This competitive spirit, the realization that we are really competing against ourselves and need not wish anything but the best effort from our foes on the pitch is so ingrained in us that the failure to do this stands out like a zebra in a kennel. CrossFitters simply compete differently.

There’s a boatload of money in the game now. Prize money. Endorsement money. Money for on-air “talent”. Despite that, we have managed to retain this very special part of who we are as CrossFitters. The biggest cheers still come for the person who is DFL.

It’s up to all of us to preserve this.

4) Soul. Open 2013 is completed. 13.1 through 13.5 is in the books. We’ve survived our Wednesday night OCD and we are about to finish our 2013 version of Scoreboard obsession. The biggest deal in the calendar of the regular CrossFitter is over for 2013 and now we all step back and watch. Right?

Of course not. The spirit of CrossFit lives on through the competition you may or may not have engaged in during the Open, but the SOUL of CrossFit lives wherever people are actually doing CrossFit in the never-ending quest for a better version of themselves. It’s a personal quest, a kind of walkabout of the mind and body, whether it takes place in a lonely corner of a commercial gym or garage, or along with a couple dozen like-minded folks in the 5:00 class at CrossFit Somewhere. The soul of CrossFit is the Newbie in front of a mirror working with an old, frazzled broom to parse the secrets of the push-jerk. It’s Rich Froning, hours after that outlandish training session, being “caught” by Jason Khalipa in the garage doing front squats.

The soul of CrossFit lives in each person who takes CrossFit–the fitness program–and uses it to explore the ultimate competition, to best the only foe that really matters: yesterday’s version of you.

I’ll see you next week…