The presentation above is a recorded version of the same one delivered at the 2018 VR Voice ‘VR in Healthcare Symposium’ held at Harvard Medical School, Boston, USA.
Please follow the link below to access a PDF version of the full paper from the above presentation, including the results of the survey conducted on the experiences and awareness of VR and AR within the veterinary profession.
Click link below to access paper
Anyone who has ever put themselves through an endurance event, such as an Ironman race or a marathon, will recognise the description of the (often) many moments during the event when thoughts inevitably turn a little dark and take the form of “why, oh why, do I do this to myself?! What made me sign up for this hell?! That’s it! This is the last time…. never again!” Then, as one crosses the finish line, how those very thoughts pretty much instantly transform into ones of elated euphoria and a wry smile as you tell anyone who asks if you’ll do another, “well, never say never, eh,” meaning “yes, almost certainly yes.” It is the biological shot in the arm and natural high from endorphins and the incredible sense of achievement that follows completion of a really tough athletic challenge that sees us return to the endurance pantheon and continue to push ourselves on and on, higher and higher, harder and harder. Time and time again.
I’m no exception to this apparent rule and so it seemed almost inevitable that following the completion of two iron distance races, and two solid years of equally relentless training, my thoughts turned once again to event options. I had tried the whole ‘training just to keep fit for fitness sake’ thing and it really didn’t work – I NEED a specific goal and that invariably means an event to train for. One thing I realised from long course triathlon was that I was neither a natural nor an enthusiastic cyclist whereas the running I did enjoy – a fact that really saved both of my iron distance races given that the run came at the end. As such I decided that I wanted to focus more on running as I moved forward and in probably a very cliched way I looked to endurance options, namely ultra-marathons.
I first heard the term ‘ultra-marathon’ whilst at vet school as one of the farm residents, a great guy by the name of Ben, was known for running them. The prospect at that stage of running even a normal marathon seemed extreme and so I considered those who went well beyond that to be, well, a bit mental. Fast forward many years and having become well and truly initiated into the endurance sport world the idea of ‘going long’ was no longer an alien concept. In fact, it sort of felt like the natural progression.
Having made the decision to focus on running, and specifically trail, last season I got involved by joining Dubai’s Desert Trail Runners, headed up by running machine, Lee Harris, and closed out my first winter by taking on the famed Wadi Bih 72km race, which you can read more about here. As with most races, the lingering thought following completion of the event was “I wonder what I could have done were I to train harder?” It was this thought that drove me to look at race options and to find a really special event for which to train. The Eiger 101 was that race.
As soon as I found out about the Eiger I was smitten. For a start I love the mountains, a fact that was a major draw for me doing the Lake Tahoe Ironman in 2015, and the views that runners are blessed with during the Eiger 101 are legendary. Secondly, it is regarded as a tough race. A very tough race. Who wants easy, right? The difficulty factor applies not only to the actual course but also to actually getting a slot, with only 600 starts available for the 101km race, all of which sell out very quickly. I had tried to register last year in 2016, for the 2017 race, but was too late and so this year I was determined to do all I could to maximise my chances of a slot.
With the 31st October firmly penciled into my calendar and my credit card details at the ready, I was sat at my computer as the clock crept towards the 10am (Swiss time) mark. Tick. Tock. Open. Cue the kind of frantic clicking and typing that is normally reserved for efforts to secure Glastonbury tickets, coupled with the intense frustration that came with getting repeatedly booted out of the reservation page and/ or having the page fail as I was headed into the final payment screen. Twenty fruitless minutes later and I was no closer to being registered AND was now expected to actually start some work, having cheekily blocked out my first appointment of the day so as to be able to focus on the race booking. I was convinced that once again my efforts had been thwarted as I was presented with a screen that said something akin to “you’re in a digital queue,” before that became, “sorry but booking is now closed.” Grr! Twenty minutes of my life, nada to show for it and the prospect of the very race I had started training hard for having moved firmly out of reach. Needless to say I was peeved.
That was until an email pinged into my account that seemed to be telling me in no uncertain terms that I had, in fact, secured a place and I was duly invited to pay for it. So I did. How a day can about face and turn 180-degrees in a moment! So that was it….. I was in. I AM in. Awesome! But wait……that means I now have to run it. 101 kilometres. Up and down serious mountains. Holy s*$t! What have I let myself in for?!
The Eiger 101 – What Exactly Is It?
A run. A very, very long run. Up and down some of the most majestic mountains in the world. The first event was held in 2013 so it is still a relatively young race, with options for shorter distances on offer alongside the 101 km event. The route takes runners on a roughly – very roughly – circular route starting in the Swiss village of Grindelwald, high up in the Alps, returning after taking in the best of the surrounding mountains, meadows and forests.
From what I can glean from the various blogs (see below) I have scoured since securing my slot in 2018’s race, the fastest times for the full distance come in at about 12 hours, with the cutoff being 26 hours. It would seem from what I have read that a fit amateur could be very happy with a time of around 20 hours. That’s a long time out on your feet and up in the mountains – certainly a lot longer than anything I would expect to face in an Ironman race. As such, I look forward to a very different approach to training for this event – this will be as much a cerebral challenge as a physical one. Bring it on!
Click here to visit the Eiger Ultra website & learn more about this epic event.
Some of the great blog posts I have had the pleasure to find & read since signing up to the Eiger 101, with some of the key take-aways summarised:
- Felt long – closer to 120km based on his watch
- Very vertical!
- Use poles
- Don’t go in with any mental baggage
- Did it in about 18 hours
- Views are just breathtaking!
- Tough race – a full THIRD of the 600 runners who started DNF’d!
- Lots & lots of mental toughness required!
- Injinji socks – NO BLISTERS
- Take a camera
- A real sense of ‘togetherness’
- Lots of concentration required – high alpine trails & not well groomed
- Electrolytes important
- Harder than the UTMB!
Mixed Reality & Virtual Reality
In 2016 I was fortunate enough to be at one of the conference parties where someone happened to have two Microsoft HoloLens headsets and was demonstrating them to the small crowd of curious nerds that had gathered around him. Well, I was one of those nerds and before long had the pleasure of donning one of the sets and so was introduced to the wonders of true mixed reality.
Much like a small welding mask, in both look and feel, the HoloLens is essentially a set of transparent screens that sit in one’s field of view by means of the headstraps that keep the device in place. Whilst not especially comfortable and certainly not something anyone is going to ever be in a rush to wear out in public on account of looking, frankly, ridiculous, the experience that it delivered was compelling. With the use of a simple gesture, specifically an upward ‘throwing’ movement, a menu popped into view suspended perfectly in mid-air and crystal clear as if it were right there in the real world in plain sight of everyone around me. Of course it wasn’t and the only person able to see this hologram was me. Selecting from the menu was as simple as reaching out and ‘touching’ the desired option and within seconds a holographic representation of the Earth was spinning languidly before me. I could ‘pick up’, ‘move’ and otherwise manipulate the item in front of me as though it were a physical object, and if I did move it, for example off to the right, out of my field of view, that is precisely where it remained and where I found it again when I turned back round. The human body application was similarly cool, as I was able to explore the various layers of anatomy through interaction with a highly rendered hologram. Whilst comical for onlookers not wearing a HoloLens, as I appeared to apparently be pawing away at thin air like someone suffering a particularly lucid acid hallucination, the thrill of what I was actually seeing and engaging with myself allowed me to ignore my daft appearance.
What are the medical education applications for such mixed reality technology? Whilst holographic visual representations of anatomy are, at first, a magical phenomemon to experience and a pretty cool party piece, it is the fact that mixed reality sees realistic holograms merged, or so it appears to the user, onto the real world, in contrast to virtual reality, which replaces the real world experience with an entirely digital one, that lends itself to unique educational applications. Anatomy instruction by being able to accurately overlay and track in real-time deeper layers onto a real-world physical specimen, enabling students to understand the wider context in which various anatomical structures sit is a far more compelling and useful application of MR than a simple floating graphic. Similarly, surgical training involving holographic overlays onto a real-world, physical object or combined with haptic technology to elicit tactile feedback, offers the potential to deliver programmable, repeatable, easily accessible practical training with minimal expense and zero waste on account of there being no need to have physical biological specimens.
Imagine: a fully-functional and resourced dissection and surgical training lab right there in your clinic or home and all at the press of a digital button. Imagine how confident you would become at that new, nerve-wracking surgical procedure if you had the ability to practice again and again and again, physically making the required cuts and placing the necessary implant, being able to make the inevitable mistakes that come with learning anything new but at zero risk to your patient. Being able to step up to the surgical plate for real and carry out that same procedure that you have rehearsed and developed refined muscle memory for, feeling the confidence that a board-certified specialist with years of experience has, and all without having had to put a single animal at risk – that’s powerful. That’s true action-based education at it’s most compelling and it is a future that both VR and MR promises.
I predict that the wide adoption of graphically rich, immersive and realistic digital CPD programmes, through both VR and MR, will result in a renewed engagement of professionals with CPD training and ultimately lead to more confident, skilled, professionally satisfied and happier clinicians. I, for one, know that were I able to complete practical CPD by simply donning a headset and loading up a Vive or HoloLens experience from the comfort and convenience of my clinic or home, all whilst still being able to interact in real-time with colleagues both physically present and remote, my CPD record would be bursting at the seams. That has to be a great thing for the profession, our clients and society in general.
Following on from my recent post regarding Augmented Reality, Virtual Reality and their potential impact on our sporting lives, specifically skydiving, I thought I would take a look at how AR & VR might add to the other big sport in my life: triathlon.
Triathlon involves training and racing in three separate disciplines, with races ranging in total distance from super-sprint to Ironman and beyond. Data does play a role in both training and competing, whether it be keeping track of 100m splits in the pool, or sticking to a pre-defined power zone whilst on the bike. I think it would be safe to say that pretty much all of us rely, to some degree, on a sports watch, or athletic tracker of some description, with the required data available for monitoring live or analysing after the event.
AR offers the chance to have the most important and relevant data visible without breaking the rhythm of a workout, adding to the quality of the experience and value of the training or outcome of the effort.
SWIM – AR may not be the most obvious technology for use in an aquatic environment but I see AR offering some real advantages to those training both in the pool and open water. As far as I am aware there are no currently available AR systems for use with goggles, but with the advances being seen in the field, especially by companies specialising in athletic applications of AR, such as Recon Instruments (www.reconinstruments.com), I do not imagine it will be long before AR reaches the water.
- Training data – the usual information that one might glance at a watch for, such as lap count, 100m lap times, heart rate and other such swim metrics could be easily projected into view, thus making such data available without having to break the flow of a swim workout.
- Sighting & ‘staying on course’ – any open water swimmer will admit that sighting and staying truly on course can prove troublesome, during both training and especially races. Swimming further than is necessary is both a waste of energy and impacts on race time, and having to frequently sight disrupts smooth swimming action, again, impacting energy efficiency and swim time. Imagine having a virtual course line to follow, much like a pool line, projected into view both when you look down (as if looking at the pool floor) and when you do look up to sight, such that staying on course is as simple as ensuring you follow the line? Less ‘open swim wobble’ and a faster, more efficient swim.
BIKE & RUN – systems do already exist that provide AR for both cyclists and runners, with the Jet, from Recon Instruments, being one such system. A range of metrics, including the usual – speed, average speed, heart rate, power, distance – could all easily be projected in AR. With GPS technology and mapping one could have a new cycle or run route virtually projected in order to follow a new course or how about having a virtual running partner/ pacemaker running alongside or just in front of you, pushing you that little bit harder than you may otherwise train? The limits to the uses of AR in both bike and run settings are really only limited by imagination, with the technology rapidly catching up with the former.
It’s gone midnight, it’s pitch black apart from the small slits of light emitted in front by our respective bike lights and the twinkling lights of the highway off in the distance, and we still have another two hours to go. Ordinarily I would be found out on the Al Qudra desert cycle track – all 50km of this tarmac loop stretching off into the desert before spinning back towards civilisation again – most Friday mornings, when it seems most of the cycling and triathlon community of Dubai drag themselves up early, don their lycra and venture out in pairs or packs (rarely solo) for one, two, maybe more loops of this wonderful training resource we have. Not this week though.
With the daytime temperatures now reaching the mid to high forties, and the humidity knocking on uncomfortable, training in the daylight is simply becoming a silly thing to attempt to do. The value derived from braving the fierce heat is, in my opinion, negligible whilst the risk of simply getting sunburnt and succumbing to heat exhaustion makes it not worth attempting. So….. training simply ceases, right? No. Training continues. In fact, training is increasing in volume and intensity as I find myself a mere 12 weeks away from standing at the start line of Ironman Lake Tahoe. What has to happen then is to either train indoors, which I find impossibly dull, or to become nocturnal. Hence why we find ourselves peddling around in the desert in the first hours of Friday morning.
My programme prescribed a 5 hour bike ride with a run off the back of it for this week and so I pitched the idea of a Thursday night cycle marathon to the triathlon community here in Dubai. A few people got back to me and so it was arranged that we would meet at 9pm at the start of the AQ loop. I would have preferred an earlier start to be honest, especially given that 5 hours would lead to a finish after 2am, but such is the nature of working as a vet that even getting away from the clinic at 7pm was a blessing. So a quick turnaround at home, including shoveling some food down, loading up the ice vest system which I had planned to test out (didn’t need to in the end as the temperatures experienced made it redundant), and water and nutrition for the bike, it was back in the car and heading straight out to the desert.
For anyone who doesn’t know where the AQ track is, one drives past Arabian Ranches, out towards Bab Al Shams desert resort and just keep going for what feels like a long, long time. The stick (an extension of the cycle track) runs alongside the road for the last 18km of this approach before reaching a roundabout and the main parking area with amenities such as a cafe (closed at that time of night sadly) and toilets which are mercifully open all the time.
Loop one saw four of us band together for the ride: good friend and fellow Dubai Tri Pirate, Jan; Ironman Zurich preparee, Stephen; another Ironman, Matt; and myself, yet to join the ranks of the men of metal. A fast first loop was had and we came home in good time and spirits, with Matt ending his session, which had started much earlier in the evening, and Jan, Stephen and I heading straight out for the second loop. By the end of the second legs were certainly starting to be felt and water refills were in order, as was a quick top up of the fuel tanks, although in hindsight the choice of chocolate and a can of Red Bull (I still don’t know why I touched it?!), was less than optimal, as I didn’t feel wonderful heading out on the third and final loop. Stephen spun back round at the 15km mark, as he was on track for a total distance that evening of 180km, having also started earlier, and so Jan and I forged on for the remaining 35km towards home and a total distance of 150km in a little over the target 5 hours.
One of the rather interesting features of cycling in the dead of night is that all that can be seen is what is immediately around you. As such, one cannot see the horizon, which means that the impression of it not getting any closer on those impossibly long stretches of track does not occur. Which is probably just as well given how uncomfortable I was finding the third loop. By now my legs were well and truly complaining and I unfortunately cramped up on at least two occasions, one such requiring a gritting of the teeth and some real willpower to move through. I am still in the process of figuring out my optimal nutrition plan for the bike, and suspect that it may have had a role to play. Although I had taken electrolyte in the bottles, I wonder whether I should have added additional at the water bottle refill after our second loop and looked at something more quick release, energy wise, than the nuts and dried fruit that I had with me. The process of experimentation continues therefore.
Wildlife experiences were a little closer than usual in the day, with at least two episodes when we nearly had impact with an Oryx, as they suddenly dart out across the track. Hitting one of them would not be fun and a few bruises and some road rash would, I daresay, be the best case scenario of such an accident. We also saw several smaller species on the track, all doing their best to try and get run over, thwarted in their efforts by some quick and deft swerving on our part. A desert rat was the coolest thing I remember seeing, with its long, kangaroo-esque back feet and lengthy tail that made it look like a Stretch Armstrong version of a gerbil.
However, even the interesting nocturnal activities of the desert wildlife could do little to distract me by the end of the third, and thankfully final, loop as my legs were screaming at me to stop. If I hadn’t fully appreciated the enormity of the challenge that I face in September before then I do so now, as I simply felt unable to even contemplate any further time on the bike. Unfortunately I found myself feeling a little dizzy (again, inadequate nutrition? Or maybe pure fatigue, as it was afterall gone 2am?). Anyway, it did mean that venturing out solo for my run felt like a poor idea and so I made the executive decision to forgo that element of the session and head home. The drive itself was a challenge as I had to stop at one point back towards Arabian Ranches to deal with a sudden onset of cramp in my driving leg, and then there was the very real risk of actually falling asleep at the wheel that I had to contend with. Scary stuff indeed and I was ecstatic at arriving back, dumping my stuff in the house, grabbing a much needed protein shake and a shower before collapsing into bed for what ended up being an epic and well deserved period of sleep. All in all, a big session but nothing compared to what is to come. Thank you sincerely to both Stephen and Jan for accompanying me out and if it were not for Jan and his encouragement that third and final loop would have been sheer and utter torture.
- Cycling at night is certainly much more comfortable in terms of the heat, with the temperatures a perfect mid to late twenties for most of the time, and at times even a little on the noticeably chilly side. This certainly translated into faster speeds at the same effort than would be possible at higher temperatures.
- The track was very, very quiet, as one would expect at those insane times. In fact, the only other people we saw were two cyclists going in the opposite direction on both of the first two loops. There were then a couple of crazy morning warriors clearly starting when we finished at gone 2am, otherwise the track and desert belonged solely to us.
- In spite of the challenges and discomfort associated with heading out overnight, the fact that I was able to simply sleep on through Friday morning did make it all worthwhile.
- Nutrition is still something I need to figure out. I should not have cramped up and I suspect that I need to examine my electrolyte intake more closely. I shall not be taking Red Bull out again and some more natural quick release energy sources, such as bananas, may have been of more use during the actual cycling.
It was a year ago that I decided to sign up online to do my PADI Rescue Diver course, the natural progression after Advanced Open Water and a qualification that I had heard was well worth doing. A year whizzed by, with the occasional dive thrown in but nothing much done about the course owing in large part to the sudden draw on the majority of my spare time that has come with training for my Ironvet race in September.
With the online course about to time out it was time to knuckle down, do some studying and get the course finished, which I duly did, and then booked my practical training with Freestyle Divers in Dibba. The course covers everything from how to recognise potential risks whilst diving, to managing situations involving tired, panicked and unconscious divers, including those who have gone missing. With the theory firmly established in my brain I was looking forward to getting stuck into the water-based practicals.
The first thing we had to do before starting the Rescue Diver practical training was complete the Emergency First Response course, a one day training programme that equipped both myself and my buddy for the course, Sabah, with the skills to manage an emergency as a first responder, focusing on essential CPR and first aid. I now have the right to be able to utter the words “My name is Chris. I am an emergency first responder. May I help you?” if ever I find myself in a situation during which to actually say them.
With day 1 spent getting our EFR training out of the way, day 2 was all about starting the Rescue Diver practical training, with 10 distinct sections to get through, including how to respond to a tired diver in the water, approaching and, if necessary, controlling a panicked diver, and rescues from the boat. We also ran through how to surface an unconscious diver from underwater, and how to get said victim to safety, including the various techniques for getting them out of the water and either into a boat or the beach. One thing that became very evident is just how tough it is to lift and otherwise move around someone who is unconscious – no where near as effortless as they seem to make it out to be on films!
We didn’t quite manage to get through everything on day 2 so Sabah and I arranged to return to Dibba on our next mutual day off to complete the course and claim our titles of Rescue Divers. Day 3 was more involved, with the most important exercise being learning how to manage an unconscious, non-breathing diver in the water, including towing them to safety whilst providing rescue breaths and removing their diving gear – again, not an easy task and well worth practicing! The final part of the course, apart from the written exam at the end of the day, was a scenario whereby our instructors staged a real rescue situation in which one of them had gone missing, with their buddy reaching out to us for help. As such, we had to gather essential information from the missing diver’s buddy, formulate a search plan and pattern, locate the missing diver and surface them after confirming unconsciousness, and then tow them back to the safety of the beach before removing them from the water and instituting essential first aid, including CPR.
It is true what they say about the PADI Rescue course being the most fun of the PADI courses, and the skills developed are defintely ones that will help expand my enjoyment of diving, in addition to feeling as though I can now be useful if an emergency situation ever does present itself.
Many thanks to the team down at Freestyle Divers in Dibba, and especially our instructor for the course Amir El-kader, who did a sterling job of taking two enthusiastic open water divers and morphing us into bona fida Rescue Divers. Also thanks to both Rhys and Andy, both of whom played diving victims amiably, putting up with our efforts to ‘save’ them, including dragging them from the water somewhat unceremoniously, in the true good-natured spirit of the course.
There is nothing quite as refreshing and enjoyable as the rush of cool, clean air flowing over you, zapping away the heat and sweat of a steady, concerted effort, especially when accompanied by the heady aroma of exotic herbs and the sound of nothing more than your own breath, the rush of the breeze and the whizz of a freewheeling bike. A little piece of paradise right here on Earth!
With September’s Ironman race in California set to be a hilly one on account of Lake Tahoe being an alpine setting, hill training of some form or another is a pre-requisite of my preparation for the big day. Compared to Europe, however, the selection of truly big hills on which to cycle here in the UAE is a little more limited. Hatta, sitting about 10km from the Oman border, is one of the options we UAE cyclists have and the route from the Hatta Fort Hotel, a beautiful oasis of tranquility, up and over towards the Kalba side of the range is a fantastic workout.
I first experienced these same hills almost exactly a year ago when I arrived in Dubai. On that occasion I was a fresh-faced young Tri Pirate and barely made it a third of the way up what felt at the time like the steepest, highest, longest mountains I had ever had the misfortune to try and pedal a bike up. As it turned out I ended up having to bow out and jump in the support car such was my level of sheer fatigue on attempting to conquer the Hatta Hills. Fast forward twelve months and the difference that training makes is clear to see.
Trace and Barbara had arranged for SuperTri to base ourselves at the Hatta Fort Hotel on Thursday evening in preparation for an early 5am start and a full on hill session, with some running thrown in for good measure. The plan was to start at the hotel, cycle the twenty odd kilometers to the small shop by the roundabout the other side of the Hatta range, before returning, parking our bikes back at the hotel and setting off on a short 2km run, making for a good brick session. And to do this three times!
In spite of not feeling in tip top state right at the start, as soon as I was up and away on the bike something just clicked and I was away, leading the charge as we started our first ascent. In spite of cycling with guys who I would normally expect to royally thrash me on the bike I found myself in the rather satisfying position of remaining out at the front for the entire session, eventually finishing a full 2km ahead of the next triathlete, both us being the only ones to push on through for the full three repeats, a tough undertaking given how quickly and precipitously the desert heat ratcheted up once it hit 8am. A super session indeed!
There is something quite magical about the hill rides, whether it be the knowledge that you’re going to have to really dig deep and hard for the push to the top, cresting just as you imagine your heart is about to explode out of your chest, to then have the blissful ecstasy of a long, cool, exhilarating coast down the other side, providing the legs with a well-earned rest and serving up the excitement of a rapid descent which saw me at times whooping and hollering like a six year old who had just been out on his first bike ride.
There is a variety, in terms of the terrain, scenery, including wildlife, smells, sounds and people encountered that we just don’t get cycling on the big desert loop of Al Qudra, and it is one of the factors that I think leads to me finding cycling here so much more enjoyable and as a result why I seem to be performing well on the hills.
I am under no illusion that there need to be many more visits to Hatta before September and the truth is that the same sessions are going to have to a) start earlier, and b) will end up being hotter, sweatier and generally a little bit more uncomfortable than they have to date, what with summer very much upon us. Even in the face of these facts I still know they will be some of my favourites.
The Hatta Fort Hotel is the perfect starting point for anyone looking to explore the Hatta Hills on two wheels and I arrived on Thursday afternoon, having booked a chalet-style room for only 375 AED for the night. This did not include dinner or the famous ‘Biker Breakfast’ the following morning, although the additional expense was reasonable. The rooms resemble what one might expect from a small game lodge, with all of the usual trimmings and a bathroom almost as big as the room itself.
On arrival, it was a pleasure to be able to amble down to the beautiful outdoor pool, one of two, with views out over the surrounding countryside, across the expanse of lawn that runs down the hill towards the main gate and the town of Hatta itself. Completing my 2km training swim before sunset and then dinner was easy when in such blissful surroundings – if only one could train with such views all of the time. One thing is for sure: when given the choice of staying the night at the hotel, rising at a more sensible and less brutal 4am, or a 2.30am start from Dubai, I know which I now prefer!