Strength and Vulnerability, A Two-Edged Sword

This is a tribute to our ultra friend Matt Watts, who died last Friday, and to my extended ultra family.

I’m writing this with love and concern, to clarify and remind, and to encourage everyone to keep on going. He left behind his partner in crime and wife Anne. She has always been at the events with him, a strong ultrarunner herself, and a great support not only to Matt, but a great friend and kind soul to everyone who knows her. I wish there was something, anything- that could comfort her right now.

Ultrarunning is that two-edged sword- at the same time as it makes us physically strong and mentally resilient, it can put us at risk. Especially as we get older.

Matt was a veteran ultrarunner. His sense of humor, spontaneously funny remarks, Cheshire Cat grin and “Matt in the Hat”, as I came to think of him, were a welcome fixture at so many ultras.

Matt used to sneak up behind me when he’d lap me at Across the Years and bark. LOUD. Scaring the crap out of me, even though I should have been expecting it.

Matt was trying to get 100 100 milers. He came very close- his 95th was his last.

Trying to explain what happened in plain English

People are asking me what happened. Since I wasn’t there, I don’t know exactly, I can only tell what I think I understood and try to piece a puzzle together. On Matt’s last ultra, apparently he fell and broke some ribs. I don’t even know if that’s what caused his quick demise.

I'm not sure if it was the broken ribs, a resulting pneumonia, or some other cause of the infection that eventually took him down, but Matt didn’t realize how sick he was. I don’t know if he had some underlying immune system issue, or another illness that had not been diagnosed, or if it was just his pain tolerance or willingness to endure discomfort past the point where he needed to seek help.

I do know that at age 62 our bodies don’t bounce back the way they used to at age 25 or 40. But that might not have been a major factor here. Maybe it was a complete fluke. Maybe he was just tired and worn down from consecutive ultras, or maybe his immune system was a bit weak from several years of running a lot of ultras. Maybe Matt had a blood cancer or another illness that weakened his immune system and he didn’t know it. Probably not, but we will never know. It doesn’t matter now.

I’ve seen it wrongly described as “he contracted sepsis”. No. I’ll try to explain the medical jargon in plain English. Sepsis is an advanced stage of infection, where the body’s ability to fight it off is less than the strength of the infectious process. It’s not something you can “catch”- it’s a consequence of an infectious process.

He had some kind of infection that progressed until it overwhelmed his immune system, resulting in sepsis. Sepsis has the ability to eat you alive from the inside, because it damages the most vulnerable organs- kidneys, gut, brain, heart, lungs. In Matt’s case it ate his heart valve. Sounds like they had no choice but to replace it. That’s a risky thing even in an otherwise healthy person, and with other complications it’s one of those life-or-death decisions.

Sepsis does funny things to your blood- it can cause little solid pieces of debris floating in the blood- septic emboli- that can travel to small blood vessels and clog them up- leading to death of the organ tissue. Or it can cause a state called DIC- disseminated intravascular coagulation- where your blood clots too much at the same time as it doesn’t clot enough, causing uncontrollable bleeding, or forming clots that travel to plug tiny vessels in organs just like the septic emboli do.

They replaced his heart valve to try to save his life- but the risk was that he could have a stroke or other organ damage. And that is exactly what happened in the days following, first a small stroke, then another huge one, from which he wasn’t coming back.

Again, I don't know the exact details but I am making an educated guess, to try to clarify for people who want to understand because it's part of their grieving process.

Now

Anne will need our support and while we need to respect her grief, we also need to remind her that we are here, and that we always will be here, and then follow through on that.

What I am saying here is not at all criticism of anything Matt did or didn’t do, he was living life fully and doing what he loved. I think that is the better route for all of us. But with advancing age and declining immune function, you are simply at a higher risk of something going wrong. It’s part of life.

I would have done the same- pursuing my goal, as he did. And I will continue to chase my own goals as I go forward.

What I wish to share with the running community is that our bodies are fragile, and more so as we age- we do need to remember that extreme endurance events can take their toll on us if we don’t allow ourselves to recover. We might feel okay, we might think we’re recovered, but unless we take a look inside our bodies at the cellular level (which is not really practical), and look at the components of our blood (which is pretty easy to do with a simple blood test called a CBC with differential), we can’t really know.

Just remember that we can’t take our health or our lives for granted. A good reason to keep on pursuing our goals, but also listening to our bodies. Sometimes our bodies don’t whisper loudly enough, or sometimes we forget how to listen.

Facing Death

Death truly is a part of life and all of us will die eventually. The best thing we can do is to live each day fully, work toward our dreams, have as much fun as possible, be a force for good and give as much love to others we possibly can.

Facing death is part of a healthy life- psychologically and emotionally, it doesn’t make it easier, but it does make you stronger and more resilient, and perhaps healthier overall. People who have a healthy attitude toward death tend to move through grief with fewer long-term physical and mental health consequences.

Facing death also means not forgetting those who were left behind, not avoiding them, letting them know you care and enjoying the memories when the time is right.

Avoiding death and emotion doesn’t mean you’re strong, in fact, just the opposite. Denying a universal reality does us no good. It’s coming for all of us. We do the best we can to live our best days, and then we need to step right up to it, look it in the eyes, run through the finish line without fear, realizing that it only means we will have arrived at the start of the next ultra.

And here's one thing you can do right now. Make your wishes known. Complete your advance directives- medical power of attorney, living will, and other documents- now. It's a gift to your loved ones to make things easier for them if they have to make decisions for you when you can't, in a time when they will surely be extremely distressed.

Moving forward

Matt’s sudden departure has made me re-think my own priorities and preparations, perhaps tweaking some things in my own advance directives that I could make more specific. And thinking about the real meaning of where I am in my life and what I’m doing. And what I hope is still ahead of me that I cannot take for granted. But mostly, to make sure I enrich my life to the fullest by strengthening my connections to the people I value most.

I'll miss Matt.