Physical health and missed goals: one year of mental agony.

“Don’t it always seem to go
That you don’t know what you’ve got
‘Till it’s gone”

– Joni Mitchell, Big Yellow Taxi

I’d been struggling to write this piece, but figured now would be as good a time as any to let it out.

Act I

Almost exactly one year ago, I dreamt of running a marathon. Prior to that desired goal, I had been an active runner and basketball player. Completed nine half-marathons to my name in varying locations and altitudes.

I’m flat-footed and will never be mistaken for an athlete, or for being fast. Running, however, was one of the few things that brought me joy. I am a completely solitary runner. Give me some earphones and let me zone out to some relaxing music, and I’ll hit the pavement. One foot in front of the other. Nothing better.

My stamina was my pride. While I could never be the fastest person in anything, I could outlast people. This usually meant that in the second half of basketball games, while people more skilled than me stopped to catch their breath, I could still run up and down the court. It led to a lot of opportune layups.

Give me the mid-range J, and I’ll make it more often than not. At my peak, I could settle my legs reliably and make open jumpers with consistency. I owed that to my stamina more than anything else.

While I was never truly good at doing these things, I prided myself on being able to do these things, over and over again.

Maybe the issue was giving my knees too much of a beating over the years. Or perhaps it was a lifetime of improper running on flat feet. Maybe the culprit was my relatively weak core and lower body strength — I’d always preferred the freedom of the road to lifting dumbbells.

Whatever the reason, in September of 2018, I hit a major obstacle to my dream.

It started after a relatively mundane and innocuous run. I don’t remember the exact distance, but it was around 10K. (What the fuck James, 10K is nothing! How did that mess you up?) I hadn’t been running that much, but I do remember pushing myself extra hard during one particular session. The marathon was on my mind.

The day after, my right leg just didn’t feel right. There was a numbness in the upper part of my calf, and my right knee felt strange. I chalked it up to soreness and tried my best to listen to what my body was telling me. I believed that rest would do the trick.

Right around that time, the Chinese national holidays kicked off and I had a whole week to spend with family. Which was just fine — put the running shoes down, rest the body, and resume running later.

But during that period of “respite,” I never felt close to 100%. My leg continued to be sore, to the point that even bending the knee was challenging. I knew, however, that I had ran a routine 10K. What could have happened during a run that I had done hundreds, if not thousands, of times before?

That was the beginning.

Act II

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Fast-forward a few months to the dawn of 2019. The leg still felt awkward. I went to see a doctor, and he recommended that I do an MRI scan to see what was truly going on.

At this point, I was no longer running. I focused on two things:

  • Walking. Aiming for 8,000 – 10,000 steps a day as a viable exercise routine. Beijing air was excellent around this time, so I didn’t mind being outdoors. I also started doing regular morning work for CardBoard Live in coffee spots around my home, so walking to/from those places was a natural part of the daily routine.
  • Gym work. I thought hard about my comfort zone, and how I had always avoided the gym. I committed to getting a trainer and working on the things that I had always found lacking about myself — upper body and core strength. I created some goals for myself to shed fat and get a lot stronger.

While in the gym, I had “tested” my knee in an informal way by using the treadmill to run. I experienced zero problems with it and felt optimistic about my recovery process. Mentally, I told myself that it was OK to put the marathon goal aside in pursuit of other health-related ones.

Furthermore, my health insurance did not cover the MRI. It was fairly expensive to get one, and I believed that natural rest would solve everything.

One episode changed my thinking. Around March or April of this year, I resolved to get back on the basketball court. My core was stronger, my body was tougher, and I had dropped to 15% body fat. For the first time in my life I could perform military pull ups. With these gains, I really wanted to test myself again. I needed to feel whole again.

The first basketball session felt fine. I wore a knee brace to minimize impact and avoided going at 100% of my real capacity. When I play hoops, holding back is hard. I probably ended up going at 85%. As a person with low athletic ability, hustle and effort were the only things I could contribute to the winning and losing of games.

Basically, the first session was fine. Second session, a week later, was when the proverbial wheels came off.


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In the second roundball session, I played for about two hours. Felt really good during the game and stretched a ton before and after. The problem was that my right leg felt really, really sore for almost a full week after.

I knew that this wasn’t right. In my heart, even though I could not intellectualize the impact, I could feel that I was damaging my body. Deep down, I knew that getting back to the court was a mistake.

I beat myself up a lot, mentally, for attempting this “premature” comeback. I had worked hard in the gym, but running and jumping took its toll.

Fortunately, as hard as I am on myself, years of mental refinement and career-related decisions have taught me to avoid living in any form of self-misery or regret for too long. The most important thing was to look forward, figure out what could be done, and then do the damn thing that needed to be done.

At this point, I broke it down to:

  • Stop playing basketball.
  • Get the MRI.
  • Figure out a proper diagnosis.

It’s rather embarrassing to think that I didn’t do this earlier. Maybe that’s why I’m writing this here. I know humans can be irrational. I know I’m not completely rational. I know that there was some pride that made me refuse to believe that I couldn’t bounce back naturally from a 10K running setback.

For fuck’s sake, James. 10K. Did you really hurt yourself, for good, while running 10 kilometers? Didn’t you use to run 10K with amazing regularity, and complete 21K runs in two hours? What happened to you?

Some form of that inner thought percolated in my head, but it had to stop now.

I got the MRI done, and the doctor at the Beijing hospital told me I had a slight meniscus tear in my right knee. He suggested a light procedure to fix the problem.

Act IV

(Wait, aren’t there only supposed to be three Acts?)

I checked myself into the hospital, ready for an overnight stay before getting surgery done on my knee.

Something good happened, though, and it stopped the procedure.

The next morning, the same doctor who made the initial diagnosis came to my room. With another younger doctor by his side.

I knew something wasn’t right by their expressions. What I didn’t know at the time was that the doctor’s incompetence proved to be my saving grace.

The doctor said he took a look at my MRI again, and didn’t think that repairing the tear would get me back to 100%.

The day before, I had mentioned to another doctor at the hospital that my goal was to run again. Not walk again, since I could mange that just fine, but to run again.

This information must have made its way back to this doctor, the chief surgeon, who now had a puzzled expression on his face.

Initially, he failed to take a close look at the MRI and must have assumed something different in my intentions. Now I told him, in no uncertain terms, that I did not have any stability issues for walking. I needed to run again. I needed to run a marathon.

The doctor told me truthfully, with his equally puzzled colleague in tow, that the procedure wouldn’t necessarily allow me to do that. The procedure would be mandatory if I had issues walking, but taking out a piece of the meniscus was irreversible. He didn’t recommend following through unless my knee issue was more severe.

“I think, Mr. Hsu, that you’re too young to have the procedure.” He told me this after taking out his phone and calling two colleagues on the spot, asking for their opinions. That did little to inspire confidence.

I was pretty fed up with the hospital at this point and aborted the procedure. They still charged me for my hospital stay, and the initial checkup costs. What a racket!

Nonetheless, a blessing in disguise. Now I had to figure out what was really going on with my knee.

Act V

(Gee, this is long…)

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I was going to travel to the United States in September soon, for work-related matters. But I needed closure.

I decided after visiting a few different clinics in Beijing that I just didn’t trust their judgment. I chose to get the real “second opinions” in Taiwan.

I booked a flight to Taipei and lined up four doctors to give their opinions on my knee. The consensus diagnosis was:

  • The main issue isn’t the meniscus tear, so don’t do anything with that. No surgery needed.
  • The excess fluid in my knee wasn’t anything exceptional, so don’t worry about it.
  • Rest and do regular physiotherapy to get better. That’s it. Let it rest.

This took a huge load off of my shoulders. At least I knew that I had made the right choices up to this point. Sure, playing basketball in the near future would be off-limits, but I could wait it out. I had to wait it out.

One of the doctors asked if he could try injecting a steroid shot into my knee to see if that would alleviate the soreness. I agreed.

It didn’t immediately feel better, but a few days later it did. It felt miraculous, to be honest. Doping works, kids, don’t let anyone tell you otherwise.

Act VI

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As I write this, it’s been almost a full month since that steroid shot.

Last week I ran these distances over three days: 5K, 8K, 8K.

Just ran a 5K today. Was going to go above 5K but didn’t want to push it. I plan to run a couple more times this week.

Knee feels good. Next to no soreness. To paraphrase Kesha, “Wake up in the morning feeling like 2017-era James Hsu.”

I don’t want to jinx it, and I don’t know if I’ll ever be myself again. All I know is that signs are positive. I think the closure of the diagnosis eased my mind — so much so that there might be a “real” placebo effect at work here. The human mind, man. It’s mysterious.

I don’t really care why it’s gotten better. I just wanted to share my journey and remind myself to revisit the marathon goal again in a few months.

I don’t know if the story is truly over, or there’s Some New Thing that will materialize on the horizon.

I’m not even sure if there’s a lesson here. Maybe it’s this? Let me try:

Persevere, don’t give up, and don’t be so hard on yourself.

Nah, that sounds pretty lame. I’ll settle for this:

Listen to your damn body.

If you’ve made it this far, thanks for reading.



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