How My Friend’s Death Inspired a Scientific Discovery

The passing of Jack Kelly inspired this former surgeon to find a new purpose in life.

May 18, 2017
science waves

Editor's Note: Irv Dardik is a former vascular surgeon at the Montefiore Medical Center of the Albert Einstein College of Medicine; recipient of the American Medical Association's Hektoen Gold Medal for developing the Dardik Biograft; founding chairman of the US Olympic Sports Medicine Council; recipient of the Preparata Prize for his work on the physics of condensed matter nuclear science; and discoverer of the SuperWaves Principle. This is an excerpt of his book The Nature of Nature, in which he discusses how he discovered SuperWaves and offers a lens through which to see the world, life, and science in a whole new way.

Jack Kelly, brother of Grace Kelly (Princess of Monaco) and a close friend of mine, died unexpectedly in 1985, at age 57. Jack's death was both unexpected and shocking to me because he was a four-time Olympic oarsman and in top physical condition. Yet he died of a heart attack while taking a long run, something he did frequently. Shortly before his death, Jack had been elected president of the United States Olympic Committee and had reappointed me as chairman of the Olympic Sports Medicine Council. And then he was gone.

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It just didn't make sense to me. Jack was a well-trained athlete. The best of the best. His resting heart rate was about 40. I had measured it when we used to run together: I would sprint ahead and recover while he caught up, running steadily. It just didn't make sense to me that Jack, an Olympian who could run many miles, would die. He should have adapted to it. He should have been able to handle it. He should have survived. 

But he didn't survive. Isn't all of athletics about being in top physical shape, to perform and survive under extreme conditions?

Yet it was not only Jack. Over 2,500 years ago, Pheidippides of ancient Greece ran 26 miles after the Battle of Marathon to alert his people of victory in the battle and the threat of the approaching Persians (read more about Pheidippides' journey from author and runner Dean Karnazes). "Victory is ours!" he is said to have cried when he got to Athens—and then, as the legend goes, upon stopping his run he collapsed and died. We now run marathons in his honor. We run to celebrate a physical feat of great endurance—which ended in sudden death. After Jack's death, I was struck by the poignant irony of this.

Then there was Jim Fixx, who wrote the revolutionary The Complete Book of Running in 1977. He died under a tree, having stopped to tie his shoelaces during a run.

Jack, Pheidippides, Jim Fixx, countless other athletes who have died after extreme bouts of prolonged exercise—all died during the recovery from exercise. You would think, if anything, the heart should give out in the extreme peak of exercise, not in the recovery afterward. Something didn't make sense.

In the famous book Running Without Fear, which he wrote after Fixx died, Dr. Kenneth Cooper—considered to be the father of aerobics—talked about the "great cool down danger." The book suggested you keep jogging and walking after you complete a long run because of the risk of dying afterward. (This advice was itself based on an explanation that appeared in an article in JAMA: The Journal of the American Medical Association.) It was known that intermittent leg muscle contractions, during running and walking, cyclically compress the veins and thereby push venous blood back to the heart. The authors of the study reasoned that blood wouldn't pool in the legs during exercise because of these contractions—but could afterward, while the runner was standing still or sitting, in the absence of those muscle contractions. The subsequent lack of blood-flow back to the heart, this model suggested, could drop blood pressure, causing an arrhythmia, potentially a heart attack, and ultimately sudden death. Dr. Cooper's suggestion to continue jogging and walking during recovery was supposed to keep the muscles pumping the blood back to the heart as you slowed down, thereby preventing it from pooling in the legs.

Something else must be occurring during recovery that could cause sudden death.

I found the need for the idea of running without fear to be odd, to say the least. Why was it necessary to write a book called Running Without Fear—with a chapter including "the Great Cool Down Danger" in its title, no less—when endurance running is supposed to be great for you? To me that rang a serious alarm bell. If it is healthful to run in the first place, it doesn't make sense that you have to be afraid of dying—especially during recovery. Running is a natural human activity. And these athletes should have acclimated to their routines. Shouldn't running have enhanced their cardiovascular health, performance, and longevity, instead of exposing them to the possibility of sudden death? Why were their heart rates plummeting after exercise?

I began to think about recovery—since that is when people were dying. Something else must be occurring during recovery that could cause sudden death.

The link between recovery and sudden death demanded answering a different question first, however. The question, a most basic one for me, was: What is recovery? Recovery had always been treated as an "interval" and not as its own phenomenon.

It occurred to me then that recovery from exercise has defining qualities. I realized that it is a physiological phenomenon in its own right, one that is physiologically identical to meditation—a practice whose value was just coming to medical attention at that time. No one had ever understood that before.

Meditation induces physiologically favorable changes in response to stress. Specifically, the heart rate slows down, blood pressure drops, stress hormones come down, breathing slows down, and the muscles relax. Today the benefits of meditation for mental stress reduction are well known in medicine.

I recognized that these mind-induced changes during meditation are identical to what happens during recovery from physical exercise: The heart rate slows down, blood pressure drops, stress hormones come down, breathing slows down, and the muscles relax.

Recovery from different forms of exertion marks real, significant changes and processes in the body. 

I saw that recovery from exercise is an active process! There is an active physiological recovery response going on, as active and dynamic as the stress response of exercise itself. This was not a passive event like turning off an engine.

I had never even considered that. I had certainly never seen it discussed in literature on medicine or athletics or in fitness journals. It seems obvious now when I say it, but recognition of this fact had somehow been missed. Recovery from different forms of exertion marks real, significant changes and processes in the body. Good changes—changes that we bring about purposefully through meditation. This was new. 

I wrote a paper in the journal Advances that outlined how the meditation response and recovery from exercise are identical. The paper described both the idea and how to make use of it:

In this paper, I propose a new method to induce physiological relaxation—through exercise . . . a program founded upon the premise that exercise and recovery from exercise involve physiological processes that, respectively, are synonymous with stress and relaxation.

The program uses heart rate controlled exercise as a stressor, and the complementary recovery period is exploited as a process of "active" relaxation.

The program tapped into the anti-inflammatory, antioxidant benefits of recovery. It even surpassed meditation in that respect, in that it took a person through a fuller range of recovery. It dropped a heart rate from, for example, 180 to 60 instead of 70 to 60, as meditation did. This to me was crucial: being able to induce a full range of anti-inflammatory and antioxidant responses.

At the same time, I was astonished to realize that the unity of those physiological processes—the single identity that characterizes both exercise/recovery and anxiety/meditation—provided a bridge between the physical and mental realms. One process—a physiological, documentable stress-relaxation process—is shared by both mind and body. One rise and fall is done by both. Right there was the mind-body connection that so many scientists had been searching for. No one had ever been able to define a mind-body connection, and here, suddenly, was an explicit commonality, of a physiological stress-relaxation process, that the two realms share.

If recovery is good for you, how could it be a danger? How was it that people were dying during recovery?

In my experience at the Olympics, we had taken recovery for granted because, though you had to go through it at some point, it was more of a necessary evil. It had to be done because the body demanded it, but overall, the focus of training was on exercise. Endurance was—and still is—the ideal in most sports, as well as in fitness training for the general public, and that necessitated minimizing the need for recovery, which in any case was considered best if you kept jogging and walking through it. The idea of training recovery—to monitor its progress as an essential process just as we do with exercise, and to establish ideal patterns just as we do with exercise—would have been an oxymoron. No one even considered training it.

What an epiphany!

Would you ever tell anyone who is meditating to keep being anxious while he relaxes? Would you tell someone who had not slept in 24 hours that it is best to stay perky and alert when she finally falls asleep? Well, that is what we were doing when we told people to keep jogging during recovery after a run. I saw that the remedy for the "great cool down danger" did not make sense. Why would one stress oneself during recovery? It effectively prevents the systems of the body from going through normal, healthy, and expected restorative processes. Jogging and walking through recovery must, to some degree, compromise the anti-inflammatory, antioxidant, anti-stress relaxation process and the benefits that come with it.

Recovery, no question, is good for you.

The big question then stepped forward: If recovery is good for you, how could it be a danger? How was it that people were dying during recovery?

As an experiment, I took a few triathletes and distance runners and checked their heart rates. All had low resting rates, about 40 beats per minute, like Jack. I had the athletes run up several flights of stairs to raise their heart rates to a peak, around 170, after which I had them immediately sit down. As I watched, their heart rates rapidly dropped down to the low 30s and even the high 20s. It was a shocking drop. It was perhaps all the more shocking because a rapid recovery after exercise was supposed to be good for you. But I realized that such plummeting, low heart rates could easily cause an arrhythmia or even a total loss of the heartbeat—and sudden death.

The training we were doing was all wrong. The endurance athletes trained in the spirit of the popular phrase "No pain, no gain." 

The American Medical Association's idea of blood pooling in the legs had missed the mark. The prolonged stress of exercise preceded a significantly sharp descent into recovery, and the athlete's recovery physiology could not pull out of that dive. I realized that training recovery, so that a person does not experience such a rapid drop in heart rate, must be vital for preventing arrhythmia and cardiac arrest.

The training we were doing was all wrong. The endurance athletes trained in the spirit of the popular phrase "No pain, no gain." It glorified the idea of the burn; in fact, it was all burn, with no chance to pull in a deep draw of refreshing recovery on a periodic basis. Yet hours' worth of straight exercise compared to a mere 5 or 10 minutes of recovery was like a chronic panic attack: all go, go, go; stress, stress, stress—exactly what meditation was meant to counter in the mental realm.

For some reason, these athletes' recovery was forced to happen so fast that the heart rate shot down (and along with it, blood pressure, of course) and went below the already-low resting heart rate. That exaggerated, sharp descent meant it might keep dropping, and unless the athlete continued jogging and walking to counter the dive—until the heart rate could swing back up and stabilize—the heartbeat could crash.

My endurance runners had demonstrated it through sprinting up the stairs and then immediately sitting. The cause was not blood-pooling itself but what I now saw as an inadequately trained physiological recovery response. The combination of a trained, low baseline (resting) heart rate and a rapid descent into recovery—both of which were supposed to be good for you!—was a perilous danger.

I considered the behavior of an endurance runner in contrast to that of a sprinter, who runs more like an animal in the wild.* A sprinter is all stop-and-go behavior, bursts of activity alternating with recovery. Unlike endurance athletes, sprinters do not push off recovery endlessly; rather, they avail themselves of the physiological changes of recovery between sprints. Sprinters in general are not predisposed to sudden death after exercise.

I tested this on myself and some other healthy people, none of whom were distance runners with low resting heart rates.

How did our heart rates respond to a strong sprint and immediately sitting down? All of our heart rates shot up and then naturally dropped, going down perhaps two or three beats below the baseline (where we had started)—and then, unlike the endurance runners' heart rates, went back up.

So when I started with a heart rate of 60, for example, took a quick sprint so my heart rate went to 180, and then sat down, my heart rate went down and then bounced back up to around the baseline instead of crashing. From 180, it dropped to 174, 163, 151, 137, 128, 116, for example; whatever the specific numbers were, over the next few minutes, it eventually went down to the low 60s and then climbed back up and settled in the low 70s.

My heart rate didn't go down as fast, was certainly not as low, and didn't drop too far below my original baseline heart rate before climbing back up, even ending up slightly higher than the original baseline. This was far better, the opposite even, of what had happened with the long-distance runners.

I realized that marathoners do not train recovery in a healthy way. They are all about endless burn, whereas sprinters incorporate recovery into their training. Training recovery properly is crucial. It seemed to me that exercise physiologists should be trained as exercise-recovery physiologists if their ultimate goal is to improve performance and health.

I saw a definite similarity between these endurance athletes and people who succumb to drug addiction or suffer from post-traumatic stress disorder. Drug addicts who overdose die after falling into a coma—not while high but while in a crash after the high. Post-traumatic stress disorder, as the name clearly underscores, doesn't kick in during the stress that is experienced, but afterward. Sometimes people cannot recover from the recovery that naturally follows their upswings. They cannot pick back up again. From this perspective, the key was that whatever the cause of Jack Kelly's death, it somehow involved the overall process of exercise followed by recovery. For me, blood-pooling was, definitively, not the complete answer. If one pointed the finger at the pooling of blood, it did not lead to understanding the primary problem to begin with. It still endorsed chronic stress. It led to the idea of jogging through the important phase of recovery. It barred recovery from taking its rightful position as a necessary complement to the stresses of exercise.

And then it clicked. It was an idea that resonated with my lifelong awareness of nature's cycles and rhythms. 

And then it clicked. It was an idea that resonated with my lifelong awareness of nature's cycles and rhythms. It was a novel idea whose simplicity belied its significance.

One half of the idea was that aerobics, or training exercise, is pro-oxidation, proinflammatory: It elicits a stress response. The second half was what I had just realized, that recovery is an antioxidant, anti-inflammatory, anti-stress, relaxation response. The "click" was seeing their connection. There is a relationship that connects exercise with recovery, the same that binds stress with meditation. Pro-oxidation then antioxidation, proinflammatory then anti-inflammatory, stress response then relaxation response, over and over again; no process persists alone, forever. The changes always give way to one another. They are all natural, indivisible cycles.

Exercise and recovery are not isolated behaviors. Exercise and recovery is a wave.

Our behavior itself is the best witness to this truth. You cannot exercise without recovery and you cannot recover without exercise. They clearly cycle and are recognized as cycling, back and forth. Yet even though they must cycle back and forth, we have always treated exercise and recovery independently, indeed, even as opposites. In truth they are a continuum. 

The conventional way of thinking had shunted attention away from the reality of this continuity. Exercise and recovery have been treated as two separate entities, that they are connected. But in truth, the back-and-forth flow from one to the other means more than that they are connected: They are not disconnected. They have never been disconnected. Neither has an identity independent of the other. The natural flow of exercise into recovery and back into exercise belies the separate way we have regarded them. Treating them as a puzzle is not warranted, and it serves no benefit. It is far more instructive to contemplate the changes of recovery as a process continuous with, and descending down from, the peak of the exercise it follows.

The nature of this wave was a far cry from the popular notion of exercise through workouts or fitness classes that people schedule for a half hour or an hour several times a week. This was a reality of unboundaried, cyclic changes that we all experience, wholly different from a discrete dose of something to do in a punctuated segment of time. An aerobics class is over and you go home. Exercise and recovery cycles are an experience of change that flows back and forth throughout a person's lifetime.

The wave does not "end" after you recover. The heart rate picks right back up when you get up and walk after recovering. It will drop again when you sit down to change your shoes. It rises when you run down the stairs, drops when you sit in the car, and so forth throughout the day. This is true to the nature of waves, which exhibit no natural boundaries.

Indeed, the origin of such waves stretches back in time, to the beginning of our lives, and they keep going forward as we age. This is the reality. Waves are a pattern of repetition. They move not just "up" and "down," so to speak, but cycle, repeating forward through us, as regularities of nature so stellar that they persist regardless of the details in our lives.

What I realized is that the pattern of their inherent connection provides a unique vantage point from which to conceptually understand exercise and recovery as a wave. The wave is natural and real, like the waves I had been aware of since childhood. Science also addresses waves, defining a wave as a disturbance in a medium or a pattern or form that moves up and down. Given either perspective, a wave of exercise and recovery is quite noticeable. It is a physiological stress-relaxation process that certainly qualifies as a disturbance in a medium or a pattern that moves up and down, which naturally repeats as it travels through our bodies. It is an observable wave.

My recognition of this wave, which was a relatively small but significant act of identifying an otherwise unrecognized natural phenomenon, was the first of what would become a cascade of recognizing heretofore unrecognized natural phenomena, a discovery about motion—of waves waving. And that ultimately led to my discovery of the SuperWave.

* Before civilization, when we lived in nature, we surely did not run and run and never rest as long-distance runners do. To survive, we hunted and gathered cyclically, in daily cycles, as seasonal cycles allowed, alternating between activity and recovery. Only the heightened necessity of pursuit (us pursuing prey or being pursued as prey!) kept us going, but that happened in cycles, too. The rhythmic tasks of living meant we would not have run and pushed endurance, day in and day out, for years.

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