The first time I beat Mike in a race, I tucked behind other runners for two miles. I was surprised to see Mike ahead, shirtless, crew-cut hair, running as he always did: hard from the gun, no mercy, pure Prefontaine. I couldn’t believe I had him in my sights. I stayed behind him, biding my time.

At three miles, I saw my opening. I was feeling good, heart rate where I wanted. I caught Mike on the last stretch, and took him. He didn’t hide his disappointment. I was happy, but a part of me felt a little bad at beating a legend well past his prime.

When I first started doing triathlons, Mike was everything I wasn’t. Fifteen-minute 5Ks in high school; he made running look effortless. An Ironman finisher—that’s where the name ‘Iron Mike’ came from. The kind of athlete who made suffering look like floating. I was the cardiologist who’d just crawled through an Ironman—slow, stubborn, undignified. But Mike noticed. Something about finishing earned his respect, even if I’d done it badly. That was the beginning of our unlikely rivalry and friendship – years before I finally beat him.

The patient

Mike had already beaten prostate cancer by the time he became my patient. Then came the call from my partner. Mike hadn’t been feeling right during training. The angiogram showed why—a heavily calcified LAD that needed a second opinion. I scrubbed in. Together, we placed two stents into an artery that had likely been building plaque for decades.

Afterward, I showed Mike the data—the studies on lifelong endurance athletes showing increased coronary artery calcification, higher plaque burden despite their fitness: even Iron is not immune to rust. The paradox that troubled researchers: men and women like him, who’d spent decades running and racing, sometimes had more calcified arteries than sedentary patients. We talked about inflammation, about chronic stress on the arterial wall, about how the very thing that made him Iron Mike might also be what brought him to our catheterization lab.

He listened carefully. Nodded at the right moments. Then asked when he could start training again.

He still raced just as hard, maybe harder if that was possible, a medical enigma.

What went wrong?

A few days after that first 5K win over Mike—after years of chasing his pace—he came to see me. Something was wrong, he said. He didn’t feel right.

I ordered a stress nuclear test. He aced it. Perfect perfusion, not a blip on the EKG. His heart was fine—better than fine for a 67-year-old man with two stents in a calcified LAD. I sat him down in my office.

“You’re overtraining,” I said. “Back off a bit. Let your body recover.”

He nodded. Agreed completely.

Then he trained harder.

Paradoxically, when he did—when he came back stronger, when he raced well—I felt relieved. My diagnosis had been correct. It wasn’t his heart. It was just overtraining. Which meant the stents were holding. Which meant he was safe to keep doing exactly what I’d told him not to do.

Mike arrived differently for the next race—focused, quiet, in the morning light. As we moved through the crowd, he leaned close: “Back in the day, when I showed up for a race, the crowd used to part for me.”

When the gun went off for the rematch, he took off.

I stayed with him through the first mile. I let him go during the second, trying to get my racing heart under control, but I had to push to reel him back as we came to mile three. Somewhere in all the confusion, my hypoxic brain worried about his heart rate, the stents, and what his monitor was saying. But I wasn’t racing as his doctor. I was racing as his rival.

Running behind him felt like running behind a celebrity. The whole town knew him. They called his name from sidewalks and porches. And the crowd—Mike didn’t realise it, but the crowd still parted for him. Iron Mike he had been since he’d finished his first Ironman, and would be until the day he couldn’t race anymore.

At the bridge in mile three, he turned around. “You want to lead?” I knew it wasn’t an innocent question. Mike was gauging how I was feeling for the final push.

I played the game. Gave him my best smile and said I would love to, but my shoelaces had come undone. But in truth, it was me coming undone. I was maxed out. I had taken my body to its maximal limit. Mike had pulled me into his world- a hellish place full of lactic acid percolating through my body, my heart screaming for me to stop. My heart rate was pinned at 192 bpm. I had followed Mike into deep water, and now I was drowning.

I watched helplessly as he accelerated and pulled away.

Watching him go, I shifted mental gears the way I do in the catheterization lab when a case isn’t going according to plan. The goal was no longer perfection—no longer catching Mike, no longer winning. It was damage control. Don’t trip over the shoelace. Don’t pull up injured. Just finish the race intact.

He beat me fair and square.

Prevailing

Sometimes the greatest gift you can give a competitor isn’t victory. It’s the acknowledgment that they can still pull you into deep water—that after everything, the cancer and the stents and the cardiologist’s orders, they’re still the athlete the crowd parts for.

Mike didn’t need me to lead. He didn’t need to back off and recover. He needed to prove he could still make me drown. And at mile three, with my heart screaming and my shoelace undone, watching him pull away across that bridge—he did.​​​​​​​​​​​​​​​​

(Dr. Dinesh Arab is director, interventional and structural cardiology, AdventHealth Daytona Beach and clinical assistant professor of medicine, Florida State University. dinarab@yahoo.com)