Monday, November 24, 2008

Don't Worry

Mahaboob - that was the name on his license - hauled auto to get me home from Kanteerava Stadium. My first couple of weeks in Bangalore I found careening through traffic exhilarating the way people do when they forget that they’re not watching TV and that what they’re doing is actually dangerous. Now the moment driver’s start weaving and wedging their autos between vehicles at intersections as if they’re playing a game of rickshaw Tetris, I post wide in the backseat like Spiderman climbing an air duct. I’m always prepared in case I have to roll inverted like a carnival ride or run like a gerbil in a ball. I’ll choose my strategy at random depending on physics and my relative ankle dexterity which has deteriorated thanks to the Nandani milk truck incident. Today I appreciated efficiency and speed though I’m not sure everyone the driver sideswiped did. I gave him an extra few rupees even though he already flicked a tip with a rigged meter that started spinning like a slot machine shortly after the rate started to register.

I had just shuffled out of lifting practice with a wave to the other lifters. I felt like saying, “See ya, wouldn’t wanna be ya – hey, smell you later!” since everything I say sounds like ‘beepity, beep beep beep’ anyway. My accent and often my speed of delivery far exceeds their understanding of the English language and makes most of what I say pure gibberish but they’ll almost never ask me to repeat anything. After weeks of communicating with exaggerated facial expressions, monosyllabic noises and elaborate hand gestures I think they’ve elected to enter me in the ‘Three Stooges Division’ at the so-called lifting competition that will occur on ‘Don’t worry’ of next month. You see, every time I ask when the competition is that I’m supposed to be training for, I get the answer, “Don’t worry” which, as far as I’m concerned should only be used to answer the question, “Should I worry?” but not to answer questions of date, time or location since - and I’m being a stickler here – it’s not an actual answer.

I lamented as I bid Boob adieu, that I couldn’t find sweet relief in the hands of a good masseuse since I’m still recovering from my first shocking attempts at relaxation. I first went for a facial at the Spa on the rooftop terrace next door. A shy, gentle creature wafted over to me and, as I lay their nearly sedated by the jasmine in her hair, she attempted to recarve the nose on my face with a clay tool. As New Englanders say, it was a lot like having your liver removed with a warm spoon. Not content with the results of her rhinoplasty, she ran vigorous circles on my cheeks with her fingertips as if getting a running start so that she could jump her hands off my nose and clap them together directly over my face. It was so unsettling I recommend the technique only be used on shock victims to keep them from passing out. I now have a Pavlovian response to the smell of jasmine and I cower whenever some fragile little auntie shuffles by me on the street.

Since I’ve been known to race passed a red flag in any relationship as if it marked pole position, I went back for a full body massage after a particularly harrowing workout where I missed so many snatch attempts that dodging the crashing bar in front and behind me began to make me feel like I was caught in an air raid. I could drop the bar but I have a harder time dropping the pursuit and I left feeling frustrated and in need of some pampering. But the hopes of relaxation vanished immediately when she whipped the sheet off my naked body with all the subtlety of a table cloth swiped from beneath a full table setting to leave the china undisturbed. I wish I knew the Kanadda equivalent of ‘Ta Da!”

Understanding how well I generally handle myself in these situations, I engrossed myself in the mantra ‘must not laugh’ so that the only discernable acknowledgement that my full-frontal nudity was an unexpected plot twist was that my ‘zoinks!’ reflex loosed the cottonballs from my eyelids when my eyes snapped open sending them tumbling down my cheeks. And having your chest rubbed by a sweet-faced Indian woman may increase the number of hits on the YouTube video undoubtedly recorded on a cell phone from the next building; it did nothing to relax me and only reminded me of the Breast Self Exam illustrations in doctor’s offices. Maybe that’s why it’s a ‘self’ exam and not a ‘buddy system’ sort of thing.

Obviously then, recovery was going to depend on good old fashioned food and sleep - both of which I needed desperately. The work is only part of the equation and it’s like buying a plot of land on which to build a house. Securing the site is a logical first step but without raw materials or the time to complete the work, you’ve gotten nowhere. Raw materials for muscle mass of course consist of protein which can be rough to find in this outpost.

“If nutrients needed for protein synthesis (to maintain or repair damaged tissue) are not sufficiently available from dietary sources, the body will take them from its own stores. In essence, the body will rob Peter to pay Paul in order to maintain function. By ensuring adequate dietary protein intake, a trainee will be certain to provide the body with the building blocks necessary for protein synthesis, “said Mark Rippetoe and Lon Kilgore in ‘Practical Programming for Strength Training.’ [Pg 49] As it was, I’d been cashing in on my own lean mass since the day I touched down.

I started relying more heavily on protein powders. Not that I hadn’t been enjoying my role of American auntie to young Babu at ‘State of Punjab,’ putting the dear boy through college one tikka order at a time, it’s just that I was beginning to wonder whether gastronomic monotony would permanently damage my palate if not my sanity. I knew I was going to need to change things up after submerging my chicken into the same mysterious “chutney” in the accompanying condiment cup and wondering whether or not anybody would say anything if, for the sake of variety, I instead darted across the food court to dredge my kabob through the faux butterscotch gelato displayed in a freezer case with an enticing ripple pattern. At least it was distracting contemplating whether the malnourished and slack-jawed gelato vendors could actually catch me. Anything but the same meal again, please.

The ‘cleanest’ protein powder I could get was a local brand that didn’t appear to genetically modify, hydrolyze, hydrogenate, ‘supplement’ or cut with soy. I couldn’t however determine how much sugar was in the mix since nutritional labels never indicate an actual serving size choosing instead to break down information based on an irrelevant measure of 100 grams and, even then, most of the data is incomplete. As far as I could tell, I could be drinking Black Market Ovaltine. The other common problem, even in the states, is that serving sizes don’t always match the scoop provided though wouldn’t the world be simpler if only that were so.

Most people blanched when I told them I bought locally because, even when the quality of the ingredients is good, the quality of the manufacturing and the cleanliness of the facility are always questionable. I had no illusions. I handed Ganesh a chunk of Peanut Chikki one day that I dug from the emergency supplies in the endless front pocket of my duffle bag. I couldn’t afford to let the big man swoon as he’d be an impossible mass to drag.

He paused mid-chew and said, “There’s dirt or something in this.”

“Yeah, it’s dirt,” I said dismissively. I find dirt, pet rocks, and petrified pests in most foods here so I wasn’t concerned. I like to call it the ‘toy surprise’ happily reminiscent of Cracker Jacks. Frankly I was pleased to know that this country might awaken the appendix. I’m personally taking part in evolution simply by coaxing an organ out of retirement.

“Why didn’t you tell me there was dirt?” he said and stopped examining the Chikki to glare at me as if he’d find it unsettling given the things I’ve seen him eat. It’s true however that insect larva won’t break a tooth and usually goes down without much of a fight. Dirt is harder on dental work.

“Oh, I thought you knew. Peanut Chikki is like that sometimes.” In true Indian style, my response should have been a head wobble followed by, ‘It’s like that only.” The ‘only’ at the end of the sentence is a pointless modifier and could probably be replaced with the word “shazam!’ without straying too far from the meaning.

But I had to do something about the protein problem just like I had to do something about my programming. After weeks of training at the stadium where I believe reps and sets were configured with the help of a numerologist choosing auspicious loads, I elected to go rogue. I’m not saying the coaches didn’t know what they were doing, I’m saying they never said and though I had tried to be quiet and not be a ‘backseat driver,’ I was wondering if that meant quietly watching as we swerved into a ditch.

“We’re doing another heavy day today?! But we lifted heavy yesterday” I’d say in surprise.

“Don’t worry. You do. Light.” The coach would say with a reassuring smile.

“But you said heavy,” I’d say, puzzled and then ask, “Front Squat?”

"Back Squat,” another quick and confident reply.

“We did back squat yesterday,” I’d say.

“Front Squat,” again another quickly delivered response.

I liked to call it goldfish programming – when the parameters change every few minutes and we all pretend we have no memory of it. I’d glance over my shoulder at Ganesh and he’d give me an “I heard. Keep quiet” look with wide eyes and a thrust of his chin for punctuation.

‘Light days’ always turned into heavy days when one of the coaches would stand across the room and flick his hands at me in the universal symbol for ‘add 10 kilos’ at least as far as I knew. It could also mean ‘pick up the tempo in the horn section’ but that seems less likely.

Practical programming addresses this in regards to the intermediate lifter. It reads, “What were once easy 10-pound jumps for sets of 5 reps become difficult 5-pound jumps for 5 reps. With standard 2 1/2 pound plates, sets of four is the inevitable result. The object is to use sets of five, for the metabolic effect produced by five reps, and training is designed around a certain number of reps for this specific reason. So it is necessary to be able to make incremental increases while holding the reps constant, and this requires that the increments to be small enough that an adaptation can occur during the time allotted. A trainee who has correctly followed the program will eventually not be able to adapt to 5-pound jumps between workouts.” [Pg 158]

It’s fair, yet also frightening, to say that some of the coaching decisions were based on what equipment we actually have and apparently someone had long ago stuffed the smaller plates in their shorts and walked out perhaps pocketing any remnants of a game plan while they were at it. At least somebody did a Pooja on the squat rack, I’d think as I’d eye the last residual smudges of vermillion.

At some point I’d say, “But this is my one rep max.” Perhaps when he said ‘light day’ he was referring to our moods which is a word that described his mood much more than mine.
“You do,” The coach would reply and I don’t know whether it was a command or the standard ‘think positive’ approach that sometimes spackles over the holes where actual skill or knowledge is missing.

“The goal of any model of weekly periodized training is to produce a disruption in homeostasis through the cumulative effects of heavy training days, and then allow supercompensation to occur with the inclusion of light days and the rest it provides,” said Rippetoe and Kilgore again in ‘Practical Programming for Strength Training’ (page 193-198) which I began reading obsessively at night and pumping my fists in the air with a ‘booYAH!’ every time I found evidence that I could but never would present to the coaches at the stadium simply because they’d already made it clear that they aren’t interested, “The light day is an absolutely essential component of the program; it is a recovery day. A light training load should not be enough to induce an overload and disrupt homeostasis, and it is not really a part of the overload event. It should be light enough to allow for recovery while at the same time providing enough work through the movement pattern to prevent any loss of fitness. Failure to include the important and frequently overlooked light training day will lead to overtraining and reduce the program’s success.“

Since all my light days had turned into a game called ‘Let’s see who can make the white girl cry,’ it was time for an intervention. I had been making decent progress on the clean but it couldn’t be matched by the jerk since practice was slowed by the ankle sprain and the swelling on the bottom of my heel as a result of the auto accident. The snatch looked more like a strong man throwing event. Instead of a ‘catch’ it was more of a duck and cover because of a faulty shoulder position and a slight niggling feeling that squatting under a falling barbell might be kind of stupid.

Still the impatience and optimism by the coaches at Kanteerava was easy to understand. There were meets to train for and they were all gifted lifters who would never have come in contact with a middle-aged woman with limited skills who was willing to invest the time in training and who would actually show up on game day. Especially – and this needs further emphasis - one whose skills were limited. This would be rare in India as most Indians have better things to do and more sense. In what was beginning to look like my life’s theme, I was an oddball and folks weren’t quite sure what to do with me.

One of the female lifters had beautiful form and precision and an enviable 50K physique. She told me one day that she wasn’t a powerlifter because her 160K squat wasn’t very good – a weight I can only imagine having on my back long enough for it to drill me into the floor. When she was there, I could always count on some insightful information about what I needed to fix, but in cases of inflexibility or just plain stupidity on my part, she had few ideas of how to fix it other than the standard, “you do.”

Though Dipti*, another female lifter, never developed a squat that could even break parallel, at 19 she could essentially power snatch 80K. She’d put her gold necklace in her mouth and bite down to keep it from flying up and chipping a tooth and then make a ‘cha,cha,cha,cha’ noise reminiscent of a snake rattle that was fierce and unnerving. Clearly whenever a coach says ‘you do’, she did which somehow bought her a pardon when it came to the squat.

At one point they were all clearly coached but now what I see is a dirty facility with decaying equipment and programming with no changes in rep scheme or planned load variations and no training logs to chart progress. Again, I can’t say for sure that they don’t have more extensive feedback from say ‘Charlie’ over intercom or ‘the Great and Powerful Oz,’ because they ‘find he is a Wiz of a Wiz if ever a Wiz there was,’ it’s just not evident. But a lack of solid training would be more consistent with the experience of athletes in India whose secondary pastime outside their sport, it seems, is ‘making do.’ The 50K lifter gets coaching from her husband who has been kind enough to work with me before and I’ve found his guidance very helpful but according to Dipti, the actual coach hasn’t stepped foot in the gym for a couple of years though she thinks she might have seen him at one of the meets.

Poonam Kaushish wrote about this not long ago in an article for called ‘One Gold, Two Bronzes doesn’t total Sporting Nation,’ referring to India’s 2008 Olympic showing in which a nation of over a billion people could secure only three metals. “Much of the problem with developing Olympic champions here seems to be rooted in the very same things that make India a perpetual also-ran to China in economic development: poor infrastructure, entrenched political corruption and infighting, and chaos and disorganization. Money earmarked for Olympic training is often mysteriously sidelined, facilities for training are in poor shape and equipment goes missing. Any wonder that India has only won 25 medals in Olympic Games since 1928,” Kaushish said.

Take the case of swimmer Nisha Millet as reported by P.S. Phadnis in ‘Swimming star cries out for competition’ who went on to swim for India in the Sydney Olympics in 2000 and came in 37th out of 39 in the 200m freestyle, “The Karnataka government had promised Rs. 50,000 for every record broken and Rs. 30,000 for every gold won by its sportspersons. Nisha broke nine national records and won nine golds, but the government decided that it needed to pay her only Rs. 150,000 on the ground that each medal and record could not be taken into consideration separately. However, even the scaled-down payment is yet to be made.”

After Arriving in Sydney, Nisha was asked about her foreign competition in an article for written by Mathang and Apurvo Parthasarthy. She said “There is a marginal difference in talent, but a vast gap in other aspects. Indian swimmers are physically weaker than the foreign contenders. The foreign swimmers are literally bodybuilders, who train themselves on heavy weights from the very beginning, which we don't. I'll have to be more cautious with heavy weights as I have a bit of a shoulder problem. Abroad training is gradual, whereas in India it is forced. That apart, they are gifted with excellent infrastructure and facilities like scholarships and grants more or less equally for all sports, unlike in India, where corporates as well as the government concentrate mainly on cricket... and just cricket. We swimmers have to literally hunt for sponsors to finance our training!”

Interestingly enough, cricket which is much beloved in India, is not the national sport, Field Hockey is but India’s national Field Hockey team couldn’t even qualify for the recent Olympics in Beijing. Cricket however lends itself quite nicely to advertisers with ODI, One Day International, games that score hundreds of runs to keep the population riveted in spite of frequent commercials. Even the shirts of referees urge ‘Fly Emirates’ and apparently it’s their call.

Finally, by the end of her career, Millet said in an article for IBNlive written by Shwetal Kamalapurkar to mark her retirement, "I'm really tired. In 15 years all I got was one scholarship in 2004, which came through eight months after I applied. I did apply for a scholarship last year too, but didn't get a response from SAI [Sports Authority of India]. Over a period of time I've realised that I cannot achieve anything at international meets by training in India," she said.

The money never seems to trickle down from the Sports Authority of India which was created specifically to cultivate athletes but the attitude towards and the disregard of athletes does trickle all the way down to the regional level which I get to see at Kanteerava. The gifted few whose genes defy malnutrition and a lack of training structure are herded off to Sports Hostels where they live on sparse room and board and a stipend of 4,000 to 6,000 rupees monthly. That translates into the cost of one pair of imported name-brand track pants and one pound of protein powder per month. It’s not enough to inspire a great deal of effort on the part of the athlete or for that matter the coaches that train them. And even if the athletes I train with have stalled, though I’m not sure that’s true, it’s fairly safe to say they’d medal just by showing up at a meet deplete of expertise. I too, am a medal hopeful under these conditions.

“It is very true that many novices start out on terrible programs, training with no reason or logic, or adopting programs that are designed for more advanced trainees which prevent them from progressing as quickly as they could. But the magical adaptability of the novice is often strong enough to overcome even the poorest of decisions. Beginners can seemingly make progress even under the worst circumstances. But for the intermediate trainee, progress is harder to come by, and the body is much more particular about what it responds to when it comes to improving an already-honed performance, “ wrote Rippetoe and Kilgore. [Pg 176]

“An already-honed performance” might not describe where I started when I walked into Kanteerava but the fact that I walked in with lifting shoes that weren’t personally designed with the help of the local cobbler and a pair of rugged leather retro sneakers hinted at an expertise I didn’t actually have. I also walked in the door able to push press as much weight as I’d need to split jerk and front squat as much as I’d need to clean to win at a meet. Connecting the dots seemed pretty simple when you’re overly optimistic about what you don’t know you don’t know.
Since I had a foundation of powerlifting way more weight than I would need to lift to compete here, it would seem that working with an insignificant load in a snatch would be a snap. Rippetoe and Kilgore address this as well only this time in ‘Starting Strength, Basic Barbell Training' [pg 171-2], “What this means is that if heavy weights are lifted at a slow speed, the lifter gets good at lifting them at a slow speed. He does not get good at lifting them at a faster speed. So slow deadlift training will not make the clean move faster. And if a lifter gets good at pulling a weight fast, as in a power clean, he gets good at generating force at that faster rate of speed. The rate of speed that is trained is the rate of speed to which we adapt. But this rule only works well in one direction: strength developed at a high rate of speed can be used at that high speed and at speeds slower than that.”

Of course, there were parts of my lifts that looked promising but there appeared to be a timing problem. When the coaches loaded me with heavier weights and my speed suffered, they’d simply give me the instruction ‘faster’ which I understood in theory, but I couldn’t execute. “There are slow and isometric components in explosive movements that benefit from the strength developed at slow speeds. A clean has a slow phase off the floor that benefits from the strength it takes to maintain the position until the explosive phase, so deadlifts are useful for training the clean. The actual explosion at the top does not benefit from the slow strength developed in the deadlift and squat, but the whole of the lift does, from the pull from the floor, to the ability to hold the back locked, to the catch position and finally the support position at the top,” Rippetoe and Kilgore explain.

I remember training clients in Seattle who worked at Microsoft and one particular manager lamented that the Indian computer programmers were proficient at memorizing code but had limited understanding of it and even less creativity. What I saw here was lifting code and a disinterest in learning what any of it meant. Of course, we could have had the conversation all day about why I was slow and it wouldn’t have helped or we could have kept working with heavy loads and it might at some point help if I didn’t get injured first or finally, we could have backed off and worked on speed.

“Coaches and athletes must understand why successful programs are put together the way they are so they can develop their own program specific to their circumstances. Copying and cannibalizing successful programs without understanding why they were successful is never a good idea. An understanding of the realities and practicalities of progressive training and periodization is.” Again, the words of Rippetoe and Kilgore. [Pg 15]

I couldn’t help but feel that I’d been on a death march program and was about to stagger out of line to be left for dead. Now that could simply be my own attempts to overanalyze my situation because sometimes finding reasons for failure is easier than finding solutions to problems but I don’t think so. Take Dipti for instance.

Dipti is already feeling the pressure to marry by her family and she’s reluctant to tell them that she’s chosen somebody who, by their definition, would not be suitable. She’s concerned about money and knowing that she and her suitor will essentially be on their own if they decide to defy the caste system, she’s looking for ways to support herself. She’s approached me because she wants me to teach her kickboxing since she sees this as a scheme for gainful employment though any attempts to advise her otherwise have made me look like a buzz kill even though I have the actual math to back me up. Eventually I agreed anyway since she’s my lifting partner most days and selfishly, it had become clear that until I taught her something, she was going to grind my training to a halt.

Over the course of a couple of weeks I taught her the components – punches, kicks, some conditioning – but she wanted a ‘routine’ to memorize. I told her that a routine depends on the floor space and the talent in the room and I explained that my class is different every day and that maybe she could take a couple of classes so that she could understand how to fit the pieces together. I was even willing to teach those classes at the stadium after practice. She however wasn’t willing to put in the time, she wasn’t fit enough to complete most of the work and she wasn’t willing to understand the logic. As a result, she sulked.

After that, she went through a bout of mysterious injuries that had her sidelined and on a cell phone through entire sessions. Shortly after, a week went by in which she simply disappeared from the stadium all together. There were personal dramas that explained away absences and more sulking. Meanwhile, I had already written my own programming and moved on. Within two weeks she’ll compete and whether she practices at all between now and then, she’ll win.

One of the most glaring issues for me as I started putting together my training plan is that the organization of the work made no sense. Squatting usually happened first, each incremental increase was performed for two sets of between 1-4 reps, and the progression was by ten kilos. By the time we got to practice the lifts I would be competing in, I was tired and my timing was off.

“Fatigue decreases the precision with which motor unit recruitment patterns can be managed and has a direct bearing on the skill with which a movement can be executed and practiced. Movements that depend highly on skill of execution – those for which technical components are more limiting than strength level for determining the 1RM – should be done first in the workout, before fatigue has blunted the unimpeded contribution of efficient force production of the movement.,” Rippetoe and Kilgore wrote [pg 130] and it produced a rousing booYAH! from my bed one night, “A snatch is limited by the ability of the lifter to execute the movement in a technically correct manner more than by the absolute strength of the athlete. But if the athlete’s strength is compromised by fatigue, the ability to apply that strength in the correct way will interfere with the technical execution of the lift, since correct technique depends on the ability to deliver maximum power to the bar at the right time in the right position, all of which are affected by the ability to produce maximum force, the very thing that fatigue affects.”

As I mentioned, speed was already an issue. One of the suggestions in Practical Programming was to replace heavy squats on Friday with Speed Squats. This acted like a heavy day in the sense that it created a need for greater muscle fiber recruitment but was easier to recover from than another heavy day. And it made all the sense in the world to train speed in order to increase speed.

I was off to a grim start however when I tweaked my back during a warm up set. The work continued and lest we blame the speed squats, the back issue that flared up was actually inflammation as a result of the changes in my diet. I suspect the mystery protein triggered it but at the moment I was too tired and too poor to replace it. I can always tell when back pain is triggered by a food allergy because the onset seems fairly random and I’m stiff when I get up in the morning. To slow the nerve response and keep it from spasming, I began icing my back post workout while I watched the first three of seven ODI cricket matches against England. By the time the fourth game was played in Bangalore, I was hooked and I may have developed both frostbite and a crush on ‘The Turbanator’ Harbhajan Singh.

In spite of the back issues, I seemed to be making some progress. In two weeks following new programming and increasing protein intake, my jerk was up to par, my clean was more reliable and my snatch hadn’t killed me yet. I had changed the order of the exercises and began to strictly monitor my rest times. I successfully lifted light on my light days and I incorporated some pulling work at Gold’s which helped to shorten my workouts by limiting my time at the stadium to less than an hour and a half. My stopwatch kept me from attempting PR’s before I had recovered enough while also holding me to task when my mind drifted towards deciphering words in Tamil pop songs Shiva played for me on the way to the Stadium. He’d snap his fingers and say, “You like, Madame?!” and I’d always have to shake a limb or he’d be disappointed.

“Rest time between sets should be adequate for recovery but not enough to allow “cooling off,” or a decrease in preparedness for the next set. Too much time between sets represents wasted training time and, in institutional contexts, an inefficient use of the training facilities. Too little time between sets costs reps and completed work sets and defeats the purpose of training. Make sure that enough time is allotted that the whole workout can actually be done in one session. Any workout that takes longer than two hours probably involves too many exercises, too many sets or too much talking,” from, need I say, Practical Programming. [Pg 173]

The trainers at Gold’s were even mentioning that my back was getting broader, my waist narrower and my arms bigger. These are the comments folks in India will make to you at around the same time they ask about your salary, why you’re not married and how much you actually weigh which generally follow the question, “have you had your breakfast?” which nobody in the states ever thinks to ask.

One secondary bit of preparation almost like men lubing their nipples in preparation for a long run, I finally caved to Ganesh’s urgings that I dye my hair black because I really felt like I’d be more comfortable if I blended with the other competitors a bit since, hard to believe, I’ve always been shy in public. And where else would I go but the spa on the rooftop terrace next door. As you’d expect, there was some slight miscommunication so that the ‘darker’ hair color became a shade I’ve come to describe as Blackety Black, a shade so inky you’d swear it stains the furniture. I look like the Desi undead and I’d describe it as Goth if anyone here had any idea what that meant.

And just as I started feeling optimistic about the whole thing thanks in part to the black hair and it's unintended but much appreciated reduction in Auto fare quotes, I found out that the ‘don’t worry’ date is actually less than two weeks away.

I’m worried.

*her names has been changed to protect her privacy

Sunday, November 9, 2008

What to do?

Though forty five minutes on the back of a motorcycle sitting sidesaddle in my sequined skirt and sparkly sandals would seem like a long ride to some, it was not nearly long enough for me to complete a list in my head of all the ways I could have been startled, nudged or bounced off the back of the vehicle into oncoming traffic without Ganesh noticing. I primly clutched a book on my lap and planted my slippered feet on one foot peg in such a way as to keep from absentmindedly slipping a shoe into the spokes as we sped along a road that was sometimes suitable for highway speeds and sometimes fit for only donkey carts and barefoot pedestrians. This is how it’s done in India after all and I gazed at the women perched lightly behind their husbands in their perfectly pleated saris as they sped passed Ganesh and me. I slithered one arm like a meat hook around his waist at least secure in the knowledge that he is one solid hunk of human being and that even if I were flapping behind him like a windsock, he would barely budge.

In consideration of my lack of expertise here, he refrained from his normal speeds if only to keep me from yelling “Jesus Christ!” in his ear again since it just makes keeping us upright that much harder for him. A Hindu, I’m not sure he recognized my outbursts as blasphemous as much as he feared I was one of those missionary types trying to convert him to Christianity at vulnerable moments when death looked certain. The first time I did it, he made it clear that he found it startling though I’m not sure how the Land Rover pressing its front grill against my person didn’t startle him more. This was a time in which I felt a gentle tap on the shoulder followed by a whispered, “um, pardon me . . .“ didn’t capture the urgency. But this is India where the motto ‘adapt’ is sometimes a gentle reminder to be peaceful and sometimes a virtual court order so I resigned myself to tolerate the Land Rover until actual blood was spilled.

If Ganesh had thought this was going to be an ordinary trip to Tamil Nadu he learned otherwise the moment I landed on the seat behind him. Not always the daintiest of creatures, I pole vaulted off his shoulder onto the motorcycle and deflating both Ganesh and his back tire simultaneously as I landed. “What?” I asked when I saw his look of astonishment, “Where’d you jump from?!?” he asked, “Beside me stood a cat and then on my seat lands an elly-fant!” No long journey with a woman is likely to go well when you’ve started it by calling her an elephant. “What do you weigh?!?” I refused to answer and just stared silently at the spot on his back that when punched hard enough, would bruise his spleen.

Of course I had forgotten about his more vulnerable organs by the time we arrived simply because I was happy to be alive. I sauntered into the restaurant and slid into a booth like I was a regular though it was obvious when everybody stopped what they were doing and stared that I was not. Not many white people arrive at this particular village at this particular restaurant for any particular reason.

As Ganesh got up to wash his hands, the waiter handed me a glass of tap water. I could feel the grit of the road in my teeth and as I pondered whether or not my stomach could handle the local bacterial brew, I noticed that Ganesh was standing inside a small stall with two sinks and I thought, ‘please, please tell me that’s not the bathroom.’

Now I realize in a country that smells this bad and is populated with this many people, privacy is a luxury. And in Ayurvedic medicine, practitioners warn against the dangers of holding back any natural bodily function which then leads to certain brashness that American’s aren’t accustomed to. I constantly see signs all over Bangalore that kindly ask its residents not to pass urine on the street and I constantly step over the signs that they’re doing it anyway. I couldn’t help but ask Ganesh one day why it is that whenever an Indian man is standing still it’s because he’s peeing. I don’t think he had an answer or even understood the question since, in his mind, it sounded rhetorical. A recent acquaintance recently pointed out that all of the signs are in English only which sparks a whole new set of questions.

So as I sat poised to drink my water, I had to wonder if I was setting myself up for the worst sort of karaoke experience of which I personally would never recover. My internal debate was put on hold when Ganesh returned and gestured towards the sink, “go wash your hands,” he instructed and I scampered up to rush towards the sink before the American in me could instinctually respond to his demand with a defiant “hey . . . !” regardless of the fact that not washing my hands when ordered was only going to put me in greater bacterial peril. As I stepped in front of the sink, I noted that there were no signs of an actual toilet much to my relief but it still left me wondering, public debut aside, if I would be able to tolerate the tap water. On the one hand, simple precautions are important but on the other hand have I wussified my immune system? What good are biceps if it’s my immune system that buckles?

In a recent Healthlink post Subra Kugathasan, MD, Medical College of Wisconsin Associate Professor of Pediatrics (Gastroenterology) said, "The immune system is there for a reason. It's there to recognize 'the bad guys.' The immune system allows your body to kill those bad guys and allows you to survive. In order to harden the immune system, the immune system requests some kind of stimuli all the time." That doesn’t mean bottoms up on tap water all over India, however. And watching Ganesh wipe his plate with a napkin before serving lunch didn’t convince me I wasn’t dining on microbial appetizers as it was. A paper napkin is probably as effective as ordering pathogens away with an ‘allakazam!’ which I considered doing simply to entertain the patrons who were still staring in spite of the fact that it sounded a little too much like a Muslim blessing in an area where I couldn’t gauge religious fervor.

Ultimately the problem with contaminated water is that nobody knows the recipe. In the book ‘Plague Time,’ Paul W. Ewald, professor of biology at Amherst College, argues that long-term infections may be at the root of chronic diseases including cancer so that any immediate digestive distress may be the least of my concerns putting aside for the moment the benefit of a hardened immune system. As an example, T-cell Leukemia which results from a cancerous growth of white blood cells develops from an early infection, “This cancer has been especially well studied in Japan, where people who die from it are infected as babies from their mothers’ milk. Though infected during the first year of life, they first develop leukemia many decades later – about half the people who eventually develop the cancer do so after their sixtieth birthday. Only about one out of every twenty-five infected people develops the cancer,” Ewald reports.

The deciding factor in the leukemia lottery is anybody’s guess since lifestyle factors are so broad it would be impossible to say. Some scientists though will just say anyway. In research that appeared in ‘the China Study’ where Aflotoxin was used as a starter fuel for liver cancer, T. Colin Campbell blamed the end results on protein intake. The protein in question that seemed to accelerate tumor growth was casein, a dairy protein, but Campbell made the assumption that all proteins would do the same even though he had no specific evidence. Since Aflotoxin is a mold that grows on peanuts and more often than not contaminates peanut butter as a result, it can be assumed that every American child including me who grew up on peanut butter and jelly sandwiches and a glass of cold milk is at risk. At that age, I may still have opted for a potentially damaged liver because frankly peanut butter is yummy and nothing can unstick it from the roof of your mouth quite like milk.

And much like the case of leukemia, the sweet mother who lovingly served the peanut butter sandwiches and milk, may have already gifted other germs that can sneak up later. As reported by Ewald a schizophrenia expert named Fuller Torrey found that nearly half of the schizophrenics tested by his group were infected with toxoplasma gondii. This further supported a study published many years earlier that tested schizophrenics for both the existence of LSD and T. gondii infection, “Over half of their patients were infected with T. gondii, and these infected patients were almost always the same patients who tested positive in the LSD test. The production of LSD or an LSD-like compound in T. gondii-infected schizophrenics strengthens the case for T. gondii as a cause of the hallucinations experienced by schizophrenics, and, more generally, as a cause of schizophrenia.” Since the mothers of schizophrenics were almost five times more likely to be infected, scientists suspect transmission during pregnancy. The only other means of transmission discussed was through the licking of cat droppings which I suspect is far less likely barring unfortunate unsupervised sandbox incidences since cats see a child’s sandbox as luxury accommodations.

Given those risks, it’s almost understandable that the western approach is to Clorox the crap out of everything which interestingly seems to mirror our foreign policy. Theoretically however this leads to an immune system imbalance as well as an exaggerated reaction to simple allergens which can develop into life-threatening asthmatic attacks as well as autoimmune disorders. “Exposure to microbes, through active infection or in the absence of infection, may initiate protective responses.[5] In the absence of infection, both viable and nonviable components or fragments of a broad range of micro-organisms found at different concentrations in different environments may be involved. These microbial derivatives, which are primarily recognized by the innate immune system (as opposed to T-cell-specific adaptive immunity), may drive protective responses, especially at the cytokine level. This exposure to microbial derivatives may play a critical role in the shaping of the immune response when encountered at important stages during the maturation of immune responses. This could result in the development of immune tolerance to potential allergens” reported a recent post on Medscape entitled ‘The Hygiene Hypothesis Revisited: Pros and Cons’ by Erwin W. Gelfand, MD National Jewish Medical and Research Center.

"Think about countries in Africa like Gambia, a country that has been studied very well . Ninety to ninety-nine percent of people in Gambia have intestinal worms at some point in their lives. But the chronic immune diseases like asthma, Crohn's disease, or multiple sclerosis are not heard of, never even mentioned in their life. They don't know anything about such diseases in those countries. While one may argue that maybe their population is genetically not predisposed to these diseases, other factors appear to be in play,” said Dr. Kugathasan.

The Medscape piece explains this concept in greater detail by saying, “A major basis for the hypothesis is that improved hygienic conditions in Western or developed countries results in less infection-driven or microbial pressure during early but critical time periods in early childhood. This change in pressure, in turn, results in an important failure to maintain an optimal balance between the 2 opposing T-helper cell responses when cytokine profiles are examined -- the Th1 and Th2 responses. Th1 responses are dominated by interferon (IFN)-gamma and interleukin (IL)-12 production, whereas Th2 responses are primarily associated with IL-4, IL-5, IL-13 (and IL-10) production. In association with reductions or altered exposures to infectious agents or their components, it is proposed that Th2 immunity, predominating from birth, dominates through critical childhood periods, resulting in the higher incidence of atopy and asthma.”

According to The National Heart, Lung, and Blood Institute as reported in ‘Modern Hygiene’s Dirty Tricks, the Clean Life May Throw Off a Delicate balance in the immune system’ by Siri Carpenter for that incidences of asthma are now 1.75 times what it was in 1980 in the United States, and for children less than 4 years old, 2.60 times the earlier incidences.

As I’ve often mentioned, I have suffered from bouts of asthma, mostly sports induced, as well as dermatitis. Both of these conditions can be controlled by keeping my carbohydrate consumption down and omitting grains from my diet completely. My experience so far in India is that my asthma has disappeared completely in spite of heavy air pollution and my dermatitis is controlled regardless of my diet which has suffered as I’ve navigated a city addicted to sugar in all its forms. Is this proof? Certainly not. As in all other ‘studies’, there have been too many lifestyle changes confounding the results. In Bangalore I sleep more, work less, train reasonably and have far less stress. And though I’ve certainly had occasion to challenge my immune system, had I not been inoculated by order of my Dad before I arrived, I’d be at risk for polio, malaria, typhoid and Hepatitis. Interestingly, inoculations themselves decreased the severity of allergic reactions in some children cited while again other scientists argue that low-level infection or exposure to the actual virus provides greater benefit in the long run.

“Several studies have advanced the theory that fecal contamination of the environment (and possibly infections such as hepatitis A), and unhygienic food handling may similarly protect against development of atopy. Intestinal microflora could also exert a continuous stimulation of the immune system, resulting in immune polarization -- the cleaner the intestine or the nature of colonization of the intestine, the more Th2-driven is the immune response,” wrote Gelfand. Fecal contamination? Unhygienic food handling? Check! and check! This is India. If food regulations exist here they’d be followed as strictly and enforced as reliably as the traffic laws.

I followed Ganesh recently on a little adventure south of the city to find an apartment to rent. A client had told him about a newly constructed building where there where flats available and I went with him to check out a neighborhood I hadn’t yet explored. As the highway turned to a dirt track and we started maneuvering the motorcycle around not only the usual pack of stray dogs but families of squealing piglets and a more forthright collection of cattle that were less willing to yield than their downtown brethren, I began to wonder if I was about to be the victim of a ransom scheme. Bandicoots! “Ganesh, did you tell anyone you’d be traveling with a white woman?! I don’t have money, you know!” I yelled at the back of his helmet. When we stopped at a stall to wait for his client, he ordered the most suspect baked item I have ever seen. It had a creamy topping that sat sweating and melting beneath a sun that blazed through the bakery case. It was specked with an equal number of Technicolor candied fruit shavings and common house flies and tossed to him on a corner of newspaper by the same ungloved hand that gave him his change.

Even after he all but ordered me to taste it and/or select a snack of my own, I refused as I pondered what it would take to wrestle an item away from the fly infestation. I pictured walking a plank with Ganesh nudging me unkindly from behind. Hold on there little grumbly belly, mummy isn’t going to hurt you, I whispered soothingly to my empty stomach after again refusing in a tone that made Ganesh look around at the other patrons. Though I’ve had occasion to imagine a number of creative ways to fell Ganesh, he was as usual unfazed by his medicinal dosing of microbes or my foot-stomping feistiness.

"What has happened now, with globalization and human migration, people move to areas that are very, very clean. Within one generation we have moved into a different environment. What we have been finding out is that in the second generation of Asian, Latin American and African children, where the first generation had been exposed to those kinds of parasites and early childhood infections, the second generation that has moved to 'cleaner' countries has not been exposed. The incidence of Crohn's disease, multiple sclerosis, and chronic asthma is as common in the second generation from the third world as in those with European or North American backgrounds, and in some cases even higher," said Dr. Kugathasan and I couldn’t help but wonder what happens when you’re unwise enough to migrate in the other direction.

My mother was a first generation American born of a Sicilian mother and a Swedish father. Before dying at the age of 61, she suffered from rheumatoid arthritis and Type 2 Diabetes in spite of her often below-average bodyweight. My sister, my nephews and I have all had digestive issues throughout our lives. My father is essentially bulletproof and, of the few maladies he complains of, none of them occur from anything other than bad habits completely of his making and often questionable lifestyle choices which make him marginally unhealthy but very entertaining at parties.

While my mother spent most of her childhood in Catholic School, my father spent his youth on farms during extended summer vacations and as a result chose to raise us part of the time on a farm of his own where he grew much of our food. As it turns out, it’s exposure to livestock that helps cultivate the immune system. In fact, Jared Diamond argued that point even within the very title of his book ‘Guns, Germs and Steel’ in explaining what factors lead to the dominance of one society over another.

“The protective effects of a farming environment in childhood provide important evidence in favor of the hypothesis that environmental factors encountered in childhood could have a lifelong protective effect against the development of allergy. Since there are numerous reports of an increase in asthma in a number of settings -- for example, urban African towns and inner cities in the United States, it is not simply a clean vs. dirty environment that may dictate outcome. The farming environments may be creating an immunologic setting, beyond endotoxin exposure, that directs the immune response along a particular pathway,” wrote Gelfand. In the case of my sister and me, our health problems developed later and our time on the farm was limited to weekends and perhaps cancelled out entirely by my mother’s efforts to love us to death with sugar.

Though I now live in a city, I have regular contact with livestock whether I know it or not. The cows and donkey carts that regularly merge with downtown traffic are the more obvious signs of an inner-city animal population but the other morning I saw the spindly legs of goats being carted to market in the same Rikshaws I take to work. Though the two goats sat quietly with their owner as if this was their regular mode of transportation, I’m guessing they make the trip to Russell Market only once. I make the trip to Russell Market more frequently where I mingle with the chickens, cows and goats as I weave between the vegetable stalls in my flip flops. Even the eggs I bring back are never washed and are often smudged with broken egg yolks and what I’ll call ‘dirt’. My belly has never felt better.

It’s the hearty constitution of farmers that had researchers at the University of Iowa in Iowa City pondering parasites. Joel V. Weinstock, David E. Elliott, and Robert W. Summers are examining the possibility that immune imbalances may contribute to the rising incidence of inflammatory bowel disease reported Carpenter for

“Weinstock's group proposes that the Th1 dominance stems from a lack of parasitic worms called helminths. Despite parasites' bad reputation, the researchers contend that helminths are important members of the intestinal community. Throughout evolution, they say, the human immune system has grown to depend on helminths to suppress overly aggressive Th1 responses to bacteria, viruses, and dietary proteins. Because modern sanitation has largely eliminated intestinal parasites, the immune system sometimes begins to attack the lining of the gut.”
The article goes on to say, “The team has also begun treating a few patients suffering from inflammatory bowel disease by giving them a drink spiked with eggs from a harmless whipworm. Of six patients studied so far, all showed substantial improvement in their symptoms, the researchers reported at the May meeting.” I think I’ve had that drink. Here we like to call it ‘tap water’.