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Off the Clock: Neurology Chair A. Gordon Smith, MD, FAAN, Has Embedded with the Tour De France and Cycles Up to 4,000 Miles a Year

Shaw, Gina

doi: 10.1097/01.NT.0000533818.69759.3d
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ARTICLE IN BRIEF

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Dr. A. Gordon Smith talks about what propels him to cycle nearly 4,000 miles a year in tough mountainous regions when he is not chairing a neurology department, seeing patients, and serving as chair of the AAN Education Committee.

Until March 2018, A. Gordon Smith, MD, FAAN, was professor of neurology and director of the Jack H. Petajan EMG Laboratory and the Cutaneous Nerve Laboratory at the University of Utah. As of March, Dr. Smith relocated to Virginia, where he is now chair of neurology at Virginia Commonwealth University. He is also chair of the AAN Education Committee and serves on the AAN Board of Directors and the American Brain Foundation Board of Trustees.

Dr. Smith's research focuses on peripheral neuropathy in diabetes and obesity. He has a particular interest in biomarker development and novel clinical trial design in peripheral neuropathy. He serves as the principal investigator of two ongoing National Institutes of Health-funded multicenter clinical trials for neuropathy, including the National Institute of Neurological Disorders and Stroke-funded Topiramate as a Disease Altering Therapy for Cryptogenic Sensory Peripheral Neuropathy, the TopCSPN Study, which is being performed by the Network for Excellence in Neuroscience Clinical Trials .

Neurology Today reached Dr. Smith as he was halfway between his two posts, packing up his home and his family for the move from Utah to central Virginia, to discuss his off the clock passion: cycling. Remarks were condensed for space.

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HOW DID YOU FIRST TAKE UP CYCLING?

Almost 20 years ago, my family and I moved to Big Cottonwood Canyon, right outside Salt Lake City, which is at 8,000 feet above sea level. (I don't really notice the altitude anymore except when I come back to sea level and feel particularly energetic.) I did a fair bit of running at that time, and a friend convinced me I should pick up mountain biking, since I can do it from my front door. I'm a bit of an endorphin junkie, and so I quickly started to spend more and more time on the road bike, doing longer and longer distances.

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WHEN DID YOU START ROAD RACING?

That started about 14 years ago. I ran the New York Marathon the same year I bought the road bike, and I was looking for another challenge, so I convinced some friends to join me on a one-day, 206-mile bike race from Logan to Jackson Hole, called the LoToJa Classic, which is a USA Cycling-sanctioned race with about 1,000 participants. It's held in September, but even so, the first year we did it, it snowed, which was pretty remarkable, and we were lucky we were able to finish. People called it SnoToJa. About two-thirds of the field had to drop out because they hadn't brought winter clothing, but fortunately we had brought backup clothing because we didn't know what we were doing and overpacked. Since then, I've done that race seven times with varying groups of people.

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WHY DO YOU KEEP GOING BACK TO THAT RACE?

At first it was the challenge. It's nice to have a goal, I think, in any given year. It became almost a quest, and in the first year, the snow certainly fulfilled that objective, because the challenge really seemed insurmountable. But after doing it three or four times, I knew how fast I could do it, and it became about the training, social aspects, and the community of people doing it, and less about the challenge.

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SO WHERE DO YOU FIND OTHER CYCLING CHALLENGES?

I keep doing other “double century” races, like in Death Valley, and the central coast of California. I'm always looking for races that you can do in a day that are challenging.

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HOW MANY MILES DO YOU PUT ON YOUR BIKE IN A YEAR?

I spend a fair bit of time in California, so I probably put in somewhere between 3,500 and 4,000 miles a year.

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WHAT IS IT ABOUT BIKING THAT APPEALS TO YOU SO MUCH?

There is a freedom that one has on a bicycle. It's the joy of a kid on their bike, able to go wherever they want without any constraints put upon them. There's also definitely the physical challenge, particularly living in the mountains, to do things that are quite difficult. And it's beautiful, certainly here — a great way of seeing the natural beauty of the mountains here and other places. Finally, it's engrossing, which may sound strange. You sit on a bike and ride five or six hours. I don't think about work when I'm cycling; in fact, I often don't think about much of anything, except what I'm doing. It's a great escape and very effective way to prevent burnout.

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HAVE YOU HAD ANY STRANGE OR UNUSUAL EXPERIENCES ON YOUR RACES?

I do have a funny neurologic story from our first LoToJa race. The course takes you over a pass called Strawberry Summit, which must be around 8,000 feet, before you descend into this little town called Montpelier, ID, which was robbed by Butch Cassidy and the Sundance Kid. It had been snowing pretty hard over the summit, so it was mayhem, with lots of people being loaded into ambulances to go to the hospital for hypothermia. So the way they checked riders for hypothermia was by testing pupillary reaction. The threshold for allowing us to continue the pass was if our pupils reacted to light. I thought, “Yes, well, if your pupils are nonreactive, you're certainly not going to be able to ride your bike.” I was actually doing the race with another neurologist that year, and we just sort of chuckled and went on our way.

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WHAT'S THE HARDEST RACE YOU'VE EVER COMPLETED?

There's an amateur ride that accompanies the Tour of Utah — the professional stage race — and takes the same course that the pros ride, appropriately called the Ultimate Challenge. It's a shorter distance race, but it involves a lot of climbing and is often extremely hot. I've finished it about seven or eight times and it's probably the hardest one I've ever done.

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WHAT WAS YOUR MOST MEMORABLE CYCLING EXPERIENCE?

That might have to be a gift from my wife a couple of years ago, when I spent a week with the Tour De France. A friend of ours has a high-end travel business largely focused on cycling and other cool immersive experiences, like Formula 1 racing and Fashion Week. She was signed by Cannondale in 2014 to develop an “inside the ropes” experience on the Tour, where people would embed with the team, travel with them, and eat with them. They were testing it out, and a friend of mine who's an orthopedic surgeon and I were the guinea pigs. It was still expensive, but nothing like what they were expecting to charge their target audience! It was quite something. We had our own team car, rode pro bikes, and were able to ride the Tour course for a week ahead of the riders for the Cannondale team, like Peter Sagan. The sheer scale of the event is hard to comprehend. You have several hundred thousand people lined up on the mountaintop, the entire Tour comes flying through, and then they pick up the next day and repeat the same thing. We were riding close enough to the Tour that when they tried to close down the course, sometimes we'd end up arguing with the gendarmes trying to sneak through.

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DID YOU EVEN DO THESE CRAZY MOUNTAIN STAGES?

Yes, we did all the Pyrenean stages, the Col d'Aspin, the Col du Tourmalet, and Luz Ardiden — probably over 112,000 feet of climbing on that one! This past summer I went to a meeting near Barcelona and afterward, drove up to the same area and did some of those same rides, and was able to see the Tour again.

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AFTER SO MANY YEARS IN UTAH, YOU'RE MOVING TO VIRGINIA. HOW WILL THAT AFFECT YOUR CYCLING?

I don't quite know what the next thing will be — I'm just working on getting settled in and turning my mind toward what might be on the horizon. I don't think I'll have too much trouble continuing road and mountain biking. There are mountains in Virginia, too! I'm looking at a double metric century (124 miles) in the Blue Ridge Mountains this May called “Mountains of Misery,” something like 13,000 feet of climbing. That sounds about right!

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WHAT WOULD YOU TELL OTHER NEUROLOGISTS ABOUT WHY THEY SHOULD PURSUE CYCLING?

Having something that is immersive that can divert your attention from the travails of daily life is useful, no matter what it is. It's hard to explain — it's certainly very physically engrossing, and the same is true of running. Before I rode, but when I was doing a lot of running, there was an article in the New York Times about what competitive endurance athletes think about when running. As I recall, they fell into two categories: either externalized and focused on the events, such as how fast they're going, split times, distance to cover; or internalized, focused on things like heart rate and biological data and how they were feeling. Now, if you're the sort of person who jumps on a bike and spends a lot of time thinking about work, it's probably not the right escape for you. To me, the best thing about cycling is that it allows you to leave your troubles behind for a few hours. And it's good for the brain, too!

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“Off the Clock” is a new series featuring neurologists and neuroscientists who pursue a rich array of hobbies, interests, and passions outside of their work. Want to nominate someone for a feature? Send your suggestions in (and why they are good candidates) to NeurologyToday@WoltersKluwer.com.

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