When your time is so precious, you have to be incredibly intentional with how you spend it and also be highly aware of opportunities that you can gain a little time back in your day.

And so on that first one about being intentional with your time, I think in our day and age it's so easy to, I don't know, sit down on the couch and then four hours later you've watched two movies or an entire TV series or I don't know, like you intend on doing one thing and next thing you've been buried in your phone for an hour scrolling through TikToks and Instagram.

And for me, I just try and be very intentional to make sure that time isn't spent that way because I personally don't necessarily get satisfaction and fulfillment out of that.

I feel like I have a much larger purpose and calling in life as being a future physician, as well as using the opportunity that I have now as professional triathlete to inspire other people and to hopefully make an impact on cancer awareness, cancer fundraising, et cetera.

Hello and welcome once again to the Tridoc Podcast.

This is the March 7, 2025 edition and I am your host, Jeff Sankoff, the Tridoc an emergency physician, a multiple Ironman finisher and a triathlon coach.

Coming to you as always from beautiful sunny Denver, Colorado.

That voice you heard at the top of the program was that of Matthew Marquard, my guest on today's show.

Matthew is an incredible individual.

At 27 years of age, he has just taken the triathlon world by storm.

He started as a triathlete in 2021 and by 2022 won the overall age group for men championship at Kona for the Ironman Distance.

He turned professional the next year and has had just a string of successes.

And all of this has come while he's a full time medical student.

He is really an impressive individual, not just athletically but as an all around person and I so enjoyed speaking with him and learning a little bit more about him and I think you'll enjoy that conversation too.

That's coming up in just a short while.

There's been a lot of interesting goings on in the world of triathlon.

You may have heard me discuss it with my friend Matt Sharp on the Tempo Talks episode last week.

But just in case you didn't, there were a couple of very interesting stories that came out in the world both of professional and age group triathlon.

The first of those involves the positive drug test of Imogen Simmons, the Swiss athlete who has twice been on the podium of the 70.3 Worlds last year, finishing in fourth in New Zealand, and has had really a stellar career up to this point.

She unfortunately tested positive for very, very trace amounts of an agent called Ligandrol.

I think we're pronouncing that right, I'm not entirely sure.

But anyways, this particular agent is a selective androgen receptor modulator.

It's the kind of thing that somebody takes if they want to put on a lot of muscle mass.

And if you've ever seen Imogen Simmons, she's not exactly the most sort of heavily muscled kind of female athlete you're going to see.

She's a typical kind of wavy kind of athlete, if anything, and she's had a long track record of success.

So those two things together kind of made the whole positive seem a little bit unusual and kind of mystifying.

There was also the reason she gave for what she thought led to her positive.

And that was her longtime partner had actually been unbeknownst to her taking that substance.

And she contended that possible that he transmitted it to her in his bodily fluids during intimate relations.

And because of that, she tested positive for the very, very trace amounts that she had.

Now, that may kind of come across as a fishy explanation, but in fact there is precedent for that.

An Olympic athlete from Canada in, I believe it was rowing back in the Tokyo Olympics, had the exact same thing happen.

Her boyfriend, unbeknownst to her, was taking this substance.

She tested positive for very, very trace amounts for this agent in her drug screen.

And she was able to successfully have it overturned when medical experts testified that yes, indeed, it is very possible for that amount of this drug to have been transmitted from him to her during intimate relations.

So I think Imogen Simmons is probably going to be successful in her own appeal for all of the reasons I mentioned that this is not somebody who kind of just came onto the scene out of nowhere and had great success and now has a positive doping test similar to what we saw with Thomas Hernandez last year.

But rather, this is somebody with a long track record of success, has had clean drug screens throughout, including as recently as what, a month ago at Worlds, and has a plausible deniability with a story that has precedent.

So don't be surprised if you see Imogen Simmons be overturned or at least her drug test overturned, and she will be back racing without a suspension.

At least that's my suspicion.

The other interesting news has to do with the Iron man related rules changes.

You have likely heard about them at this point.

I think the maiden major ones that are probably garnering the most attention have to do with the change in the allowed bottles or hydration systems that are going to be allowed by rule to be carried on the front and rear of the bike.

No longer will you see these 3D printed contraptions with huge amounts of volume being carried on the front end of the bike, making the bike somewhat unwieldy and potentially dangerous.

The amount of liquid is going to be restricted to 2 liters, although there doesn't seem to be any criteria for how that two liters is stored.

So I won't be surprised if you still see people carrying like four bottles, which still strikes me as too many, but two liters at least is a reasonable amount of fluid.

I know personally my bottles carry about 500, I think about 600cc or so, possibly a little bit more.

And so I wouldn't personally want to have like four of those.

But I guess you never know what people are going to be doing and then on the back end you're only going to be allowed two bottles and it's going to, I don't think dramatically impact too many people.

Although of course we did see a few competitors in Kona last year with a four bottle setup that will no longer be allowed.

The other major rule change has to do with the change in penalties.

No longer will a blue card for drafting or for not falling back or whatever you used to get a blue card for, which would be a five minute penalty.

It's now going to be only a three minute penalty.

So that is a pretty significant change.

I know two minute difference doesn't seem like a lot, but when we're Talking about a 70.3 race, 3 minutes versus 5 minutes is kind of a big deal.

We saw what happened when certain pros have received a blue card penalty and a 70.3.

They kind of just their race as far as they're concerned is over when it's a five minute penalty.

And that I think has led to referees being much less likely to assign penalties.

And the same is probably true for age groupers.

I wouldn't be surprised if age groupers are not getting penalties because the referees don't want to assign such a heavy premium for doing a rules violation.

Well, that and also there's just not enough officials on the course.

But I think with a shorter amount of time being served for penalties, I won't be surprised to see more of them being handed out both to pros and age groupers alike.

But we'll see.

What do you think?

I'd love to hear your thoughts on either of these stories or on whatever else is going on in the triathlon world.

Please do send me a note@tridocloud.com or if you are a member of the Tridark Podcast's private Facebook group, I hope that you will leave a comment and maybe opine on a couple of these things or at least one or two of them of the different stories going around.

And if you're not a member, please do head over there on Facebook, just search for Tridark Podcast, answer the three very easy questions, I will grant you admittance and you can join the conversation and maybe even ask a question that could be considered for a Medical Mailbag segment on an upcoming episode.

After that interview with Matthew that I referenced at the beginning of this monologue, we are going to get to the Medical Mailbag and it's an interesting one.

If you heard last episode, then you heard me voice my dismay about a lot of the pseudoscience that seems to be percolating through our society these days and how it is impacting people in that it is leading them away from the tried and tested things that we know help our health and well being.

Well, today's Medical Mailbag segment deals with yet another one of these things, what I like to refer to as the Bro Peptides.

These are peptides that are being promoted by all kinds of influencers, the likes of Andrew Huberman, for example, who shamelessly, as a scientist, no less, goes on his program and promotes these things that have absolutely zero evidence whatsoever to suggest that they do anything, anything positive for anyone.

And yet he brings on individuals who, he does not clarify, represent a clinic that stands to profit and benefit from selling these things.

And he brings them on as a reputable guest and gives them all the credibility in the world and allows them to espouse all kinds of falsehoods about these things.

So I call them the Bro Peptides.

They are things that have been promoted to improve healing and improve health and improve well being.

And the reality is, I'm afraid, is just not that exciting.

We're going to talk about that when Juliet joins me right in a moment here for the Medical Mailbag.

Thank you so much for being here.

I look forward to chatting with you as the show continues.

Hello again, Juliette.

How are you?

I'm fine.

How are you?

We're only laughing.

The listeners should know we're only laughing because we have just brought our both of our collective heartbeats down from a very dynamic discussion offline.

Dynamic.

Dynamic, yes.

That's one way of putting it we had a little bit of an intense warmup discussion for you as we prepare for a somewhat interesting Medical mailbag segment that we have for you.

If it's the Medical mailbag, then that means Juliet, of course, is my friend and colleague Juliet Hockman, coach at Life Sport Coaching and a dear friend, Juliet, what is the question that we're going to be tackling here and hopefully keeping our heart rates down while we discuss Exactly?

I feel like we've already tackled it, so this question came to us from one of our listeners.

Thank you very much for sending these questions in.

The questions are much more interesting if they come from you rather than if we generate them, so keep them coming.

This question regards the use of peptides for increased performance in endurance sports.

And peptides have become more and more apparent for athletes, particularly athletes and particularly male athletes in the gym as they look for performance gains.

And they are heavily shilled by people on the Internet, YouTube channels, by people we'll talk about this soon, who have some pretty laudable degrees and big names behind them.

But what do we really know about these peptides, particularly BPC157 and TV500 in terms of are they effective for any type of athlete and particularly staying in our lane for endurance athletes?

So what did your team find out?

Jeff?

Oh, we had so much fun.

Cosette Rhodes was the intern assigned to this, and she came to me yesterday with the research that she had done.

She was actually like laughing out loud when we were discussing this because she had not heard of this, just as I had not until it was brought to my attention.

And we were looking at the science behind this, which is very scant and not at all on humans, and we just could not believe that this was as much of a thing that it is.

And I shared with you an article that came from the Lay press a couple years ago, actually produced by my alma mater, someone at McGill University, and I thought it was an excellent little piece on what these things are.

So just just to lead the witness, the article is called the Human Lab Rats Injecting Them with Peptides, which is clickbait.

Even coming from McGill University, I have to say.

Yeah, I like it.

This is.

I alluded to the fact that we were going to have a couple of these topics coming up this episode and next episode.

The next one is a doozy as well.

And we chatted about this last episode where I asked you what?

Why is there so much of this pseudoscience permeating the interwebs and the listener who sent this into me attached a couple of links to a very popular podcast.

Actually, I don't know, does he do a podcast?

Huberman?

And it's.

What is it called?

It's Huberman Podcast.

No, it's absolutely a podcast.

I've listened to it.

Oh, okay.

It came to me as a link to a YouTube.

Oh, no, this is.

It's called Huberman Labs, I think.

Okay, so Huberman Labs, much more popular than the Tridoc podcast.

From what I could tell on YouTube, he's got 7 million subscribers.

The number of likes he had for the linked video that I looked at is like an order of magnitude higher than the number of listens that this show will get.

Which is really unfortunate because Andrew Huberman, as far as I'm concerned, honestly should be ashamed of himself.

Here is a guy, and I don't say that lightly, here's a guy who is apparently, I don't know what his actual bonafides are, but he advertises himself as a neurobiologist and somehow involved with ophthalmology at Stanford University of all places.

And he's clearly, he leads the program with those credentials, so he's advertising himself as someone you should take seriously.

And he then goes on for more than an hour to spew the most unbelievable amounts of garbage on this subject.

And now I can only imagine what else he's talking about because I have not listened to his program and I really don't want to ever have to again because this was painful enough.

He talked about peptides and he brought on what he called a world expert on peptides.

And when I looked into who this world expert was, turned out that he's just a guy who owns a clinic that sells this stuff and injects people with this stuff and makes all these claims about peptides, but who he himself has not done any research on any of it.

And it was just mind blowing to me that this was being pushed on people as cutting edge scientific evidence that backs up the use of these things.

And that if you're not considering using these things, then you're missing the boat somehow.

And this just infuriated me.

Yeah.

So let, let's back up for a second.

And if I understand, peptides are basically short chains of amino acids.

Right.

And they're responsible for stimulating growth hormone.

Is that right?

That's what these ones are supposedly doing.

So we can go back and just look at sort of the history of this.

And there was, there were scientific reasons to try and find ways or find molecules that had activities within the body.

That would result in changing the physiology of what was going on in different kinds of processes.

So, for example, I can give you a really good example of a peptide that was discovered that triggers a whole chain of events in physiology.

That actual.

That has real world results.

And that peptide is GLP1 ozempic.

Is that the one for kids when the kids aren't born?

Oh, Ozemic Ozempic.

Oh, okay, okay, okay.

Yep.

The weight loss drug semaglutide is basically a peptide.

It is a short chain peptide.

It is a small piece of a hormone that was discovered through many years of research that basically exerts its influence within the brain and within the gastrointestinal system to basically make you feel like you're full.

And there are hormones that do this.

Semaglutide.

Not semaglutide, but the semaglutide is based on a hormone that.

I'm trying to remember the name of it.

Anyways, it doesn't matter.

But there is this hormone that actually exerts its effect that makes you feel full.

And they were able to figure out that if we just take a short chain of that, it's semaglutide, this small GLP1 receptor agonist.

This peptide will do exactly the same thing, but it doesn't have a lot of these other influences that the hormone itself would have.

And that made it really a desirable kind of thing.

Great, so that's a peptide that works.

And another peptide that was discovered by some of the early people that looked at this were peptides that stimulated the pituitary gland to release growth hormone.

And this was very important for a variety of different diseases.

They used it in kids and it would help kids who had growth hormone problems and allow them to grow taller and things like that.

And this led to a whole array of research.

And one of the things that was found was there is a type of fish called a zebrafish that has the ability to regenerate its heart tissue.

And people started to think, wow, if we could figure out how the zebrafish regenerates its heart tissue, then I bet we would be able to use whatever it is that's doing that in people.

Because after a myocardial infarction, we have death of cardiac tissue, we need to regenerate it.

Right, sure.

And so this led to a whole bunch of research that led to the discovery of these tiny little peptides or these hormones within the gastric juices of the stomach that were then reduced into these like short chains that seem to retain some of the activity and that protein is called BPC157 and BPC157 and TB500 is the other one.

Both of them are felt to do a whole host of things, but one of the big things is it's supposed to help with regenerative capacity, supposed to help regenerate injured tissue and to give you a sense of what malarkey it is, because the research.

There has been no research to actually show any of this works.

But they're calling this the bros out there, the Joe Rogans of the world, the Andrew Hubermans of the world.

They're calling this stuff the Wolverine stack.

Wolverine, like the superhero from the X.

Men who can be shot up.

Yeah.

So you just have to buy these capsules at a hundred bucks for 50 capsules and get the claws inserted somehow and you're ready to go.

The problem is, outside of the zebrafish, there's not like a whole lot of things that have been shown.

So we found a whole bunch of studies, many of them in rodents, that seem to suggest that in preliminary, very preliminary science, if you injure the tendons of a rat, you can see the stimulation by these peptides of some tendon fibroblasts, which are the cells required to cause some tissue repair.

But do you actually see tissue repair?

Who knows?

Because the studies haven't shown it.

They don't get.

Remember, you know how many times we've talked about the mouse, the mice on treadmills?

Yeah, right.

None of these.

They didn't even run them on treadmills.

They haven't done that.

They haven't had the mice swim.

They haven't had them do anything.

Instead, all they've done is in various rodent level studies, they have basically just showed indirect levels that, hey, these peptides might work.

But just might is enough for some of the drug testing agencies of the world to take note, because they see how many people are taking these things.

And so Wada a few years ago said, we don't like this.

Yeah, we don't like either of these things.

Amongst a host of other peptides we don't actually believe.

And this is what they say.

So this is right off the water site.

The experimental peptide BPC157 is prohibited under the World Anti Doping Agency list and category of unapproved substances.

The reason they're blocking it and the reason they're blocking TB500 is because both of them are.

They worry could be the kinds of peptides that stimulate growth hormone.

So the reason you don't want that is because we know that growth hormone is a performance enhancer and we don't want people taking exogenous growth hormone.

We also don't want them taking something that's going to make their own growth hormone come out in more.

So they're thinking that, but they say.

That just because water bans it.

Just because water bans it doesn't mean it works.

Because they go on to say.

Worried about it.

Yeah, they go on to say that all the studies that have ever been done looking at BPC157 appear to have been canceled or stopped without any published conclusions because no positive results were ever found.

Right.

And yet Andrew Huberman, with his 7 million listeners.

So why does.

Why so knowing that these studies are non existent pretty much, or inconclusive at best.

Why.

From what source are these podcasters drawing their conclusions that this stuff is so effective?

It's entirely anecdotal, right?

Oh, I felt better.

It worked for me.

I.

My muscles are bigger around.

I think one said he was like my muscles rounder.

Yeah, that's.

That's the question.

And that's what I was asking you last time.

And I think it's what causes me a lot of angst.

Because I think in this day and age of social media, it's very easy for just any Joe Blow to just stand up there and say, I took this stuff, it did wonders for me.

And oh, by the way, I'm selling it.

Why don't you just pony up and you can sell, you can buy it from me.

And Huberman gives people a huge stage and people are everywhere looking for easy answers.

We've talked in the past, you and I don't take supplements because we just do the hard work and we recognize that the science doesn't bear out most of the claims that these things do.

But most people aren't willing to take the time to read the science or to even care to understand the science.

Because instead you've got Andrew Huberman, or whoever these other influencers are who look great, look a lot better than I do, and they have the time to spend on their social media channels basically saying, I look like this because I take this product, which ends up being complete rubbish.

Because as that article points out, what was his name?

The.

The strength influencer who was pushing this BPC157, saying that he was living clean and the only thing he was doing was his BPC157.

And then lo and behold, it turns out, oh no, actually, he's pumping himself to the gills with the liver king.

Brian Johnson, the Liver king.

Brian Johnson.

Yeah, yeah.

Living clean, but not really living clean.

And then other people pony off.

Not pony, but basically piggyback off of him and do the exact same thing.

And yet the gullible continue to be duped.

And I think it's because as you and I were talking before, everybody wants the quick answer.

Everybody.

It's so easy to just latch onto these things and just, just if I just shill send in some money, I'm going to get this thing.

It's going to make me a better whatever.

And the truth, which is what you and I peddle in, is unfortunately not all that glamorous.

Right.

It's a lot harder to tell people that this stuff doesn't work.

Or when we do tell people that it does work, we don't make promises of enormous gains.

We just say, yeah, it'll give you a marginal gain on top of the hard work that you have to put in.

None of these things are going to come easy.

And I think people don't like to hear that.

But it really is discouraging to me to continue to see this kind of misinformation, disinformation being promoted by people who should know better, who have a huge platform, who, as far as I'm concerned, should feel a responsibility to the truth.

And this is what leads to the hesitancy to believe in what science has laid down in terms of the foundation of what our whole society is based on.

This is why a child dies in Texas, because people latch onto whatever the latest person is going to say on the Internet.

And, oh, never mind that we have 50, 60 years of science that shows that vaccines are safe and effective.

If I see one person, one famous person, tell me that a vaccine is going to kill my kid, I'm not going to go there.

And I don't want to talk about vaccines, but I do want to talk.

About it seems like we have.

There's a couple challenges here, right?

One is that people have less time now than they've ever had in the history of time because everyone's very busy all the time.

So people are looking for shortcuts and quick answers because they just don't have the time to train and train, which is what we know it can take to get performance gains.

People are impatient, so they want to see results now instead of six months, nine months, two years, 10 years.

You gave a great chalk talk last year about the importance of stacking seasons.

Right.

And being consistent.

There is no.

Yeah, there is no off season.

It's all about Training consistently all year round, periodizing it, but not training for six months.

Stopping for six months, training, whatever.

We have to continue to see those performance gains.

And then as you just mentioned with the Internet, it's so easy to become alarmed.

I only have to scroll one or two posts and I'm alarmed all the time.

So it's just, it's.

We have news coming at us at a rate that we have never had before.

You and I are the same age.

When we were kids, it was the morning paper and the 6 o'clock news on three different channels and that was it.

And they all said the same thing.

NBC, abc, CBS and then the morning newspaper.

That was it.

There was no other access to news and it took longer to get information and sources were better vetted.

Yeah, now we can all be newscasters by just putting, throwing up, whatever it is.

Challenge.

It is challenging, I think, for people to, to find the good sources and to find the right answers.

Yeah, let's bring it back from my existential angst and just focus on these peptides for just a second more because I do want to give, I do want to give some.

I want to give place a little more medical context.

Yeah, A little more context to all of the work that Cosette did.

Because while there wasn't a lot of science to be found, there was some.

And again, with respect to this, both of these agents, they're peptides.

And I, I think that the article that we read from Gil basically highlights the fact that most of these things, in order to be effective, have to be injected.

If you go online, a lot of these things are sold in capsule form.

And that's a big problem because there was two issues there.

Number one, these things are not regulated.

Say what you will about regulatory agencies, but when our food and drugs are regulated, it means that somebody is overseeing, watching the shop on the label is actually in the bottle.

And they did a study, let's see, this was a study from 2023 where they looked at TB 500.

They wanted to get a better understanding of what you were getting when you bought these things.

And basically they said that the take home conclusion was no FDA approval leads to a lack of regulation.

And TB500 product tested by researchers was not found to be what it was advertised as.

You're buying this stuff, you generally have no idea what's actually coming in it.

So that's problem number one.

So.

Well, I guess problem number one is this stuff doesn't do anything.

Problem number two is if you think it's doing something you're buying a product that often doesn't contain what you think it does.

And then problem number three is let's say it does.

Let's say it does contain these peptides.

Your stomach and your intestines do a fantastic job of breaking down proteins and their composite component, amino acids.

And so the second that these peptides hit the stomach, they get broken down and then absorbed as into individual amino acids, and they don't get reconstituted into the peptide they once were.

There's a reason Ozempic has to be injected.

Ozempic can't be taken orally because our body won't absorb the peptide as a whole, and therefore it will lose its efficacy.

All of these things exactly the same as you swallow them, they get digested, they get absorbed in building blocks as opposed to as the peptide themselves.

So even if you want to disregard everything I've said and think that, oh, there's.

I'm going to believe Huberman, you can't beat the fact that most of these things don't include what they say they do.

And also, if they did, they wouldn't.

They wouldn't.

They get broken down.

They wouldn't get delivered.

Yeah, they wouldn't get delivered.

So now if you want to inject yourself with this stuff, that's your call.

I wouldn't recommend it given that there have been exactly zero.

And I am not exaggerating here, we looked there and even on Huberman's podcast, they admitted it.

There have been zero studies on humans.

Why they would then say that these things are so effective in that context, I have no idea.

But I am going to tell you, in the absence of any human trials, you can't say that these things do anything in humans.

You are completely making it up if you think that these things are doing anything.

And based on the very limited animal science we have, it just, you know, here we are.

So you're giving us the great tridoc thumbs down, double thumbs.

This is getting double thumbs down.

It's.

This is.

These things are no worse than any of the other things.

The only reason I'm more riled up about it is because of how they're being pushed.

Like, we.

We have talked about a lot of supplements before where the websites make all, like New Zealand currants, I think is a great one.

Right.

There's a fruit that is not dangerous in any way.

Its promoters do have some research that is.

Yeah, it's not the best research.

They're making claims that are maybe outside of what the research supports.

More power to them, it's.

They're not.

They're scratching credulity a little bit, but they're not making things up.

They're basing it on the limited research they have and they're just extrapolating a little bit.

And if people want to buy this natural substance and they want to take it and if it makes them feel good, great.

I don't have a problem with that.

And also, it's not that expensive.

But this is next level garbage, right?

This is like people who should know better, people taking advantage of, people who don't want to take the time to actually look into it, people who are lending their credibility to others to sell this stuff.

And I just.

That.

That is not okay.

I.

We.

All right, so listener note.

If you want to really crank Jeff Sankoff up, have an Ivy League or a Stanford or another really amazing university degree and have a couple million followers and sell them trash.

Send me a question about something that one of those people is promoting.

Exactly.

Oh, no, we love the guy who sent the question in.

Hey, look, we have never accepted sponsors for this program.

And this is why, because we want to be able to say at face value that we don't have any stake in the game, that we're going to tell you about the things based on what the science says and nothing else.

And it's my hope that makes us more trustworthy.

We have no, we have no reason to tell you other anything other than what we find as the truth.

And I will hold.

And the studies are coming from studies that are out there and publicly available from all corners of science and medicine.

And now that we're publishing a newsletter that comes out next week.

That's right.

That will include all of the references.

References that we use.

If you think we missed a reference, then you could compare to what we have there and you could say, hey, Sakoff, you missed this reference.

That includes humans.

Yeah, let us know.

I'll want to know.

Yeah, absolutely.

But yeah, if you want to see those references, then of course please do subscribe to the newsletter.

The link is in the show notes.

The link is on the Tridoc podcast, private Facebook group.

It's at my Instagram as well.

So you could find it all over the place.

I hope that you'll subscribe.

The people who have subscribed have let me know that they have found it to be quite enjoyable and a quick read.

So I want to do a quick.

A double shout out here.

One is that you and Matt Sharp are co hosting a.

Another podcast, Tempo Talks, which I've listened to.

I think you've done three episodes so far, is that right?

We have done three, yeah.

Fourth comes up.

Okay.

I've listened to all of them this episode.

Yep, I've listened to all of them.

I think they're great.

That is a mostly impartial review.

So go and check that out wherever you can find your podcast.

And then the other shout out is in a Couple weeks time, March 15 I think it is.

You are doing a chalk talk which Everybody's invited to summarizing 166.

This is episode 166, so.

Right, okay.

So exactly.

So summarizing what really works.

And Jeff did a similar chalk talk two years ago and it's probably one of the most popular chalk talks that we've.

That Life Sport Coaching has ever done and we've reproduced it a number of times.

Really?

And of course now we have two years more information.

So if you would like an invitation to that chalk talk, all we need to do is send you the zoom link.

So please be in contact with either Jeff on one of his many platforms or you can also reach out to me.

I'm on Instagram at Juliet Hockman or julietsportcoaching.com we'd love you to come.

And it's a very entertaining chalk talk.

So yeah, ever since we mentioned that we were gonna do another Review at episode 200, I've been getting a lot of emails.

People are like, oh, I wanna know when is the summary coming out?

For those of you.

And Tim is one of the person who emailed me last.

I actually sent Tim an email back where I listed a bunch of the episodes.

But I think it would be great to have Tim and anybody else who's interested to come to that jock talk.

We'd love to have you there.

So.

Yes, please do.

Actually, we can put the zoom link in the show notes, right?

If I send it to you, put.

It in the show notes.

But definitely drop Juliet a line or me because I know people often don't go to the show notes.

So give your email again.

Juliet.

Juliet.

Like Romeo and Juliet.

J U L I e t@lifesportcoaching.com I'm happy to send you the zoom link.

We hope you come.

March 15th, 5:00 Pacific.

All right, awesome.

That wraps it up for another medical mailbag segment.

We have another kind of crazy one for the next episode.

Oh, I can't wait.

Yeah, it's going to be a good one.

I'm going to put my heart rate.

Monitor on next time.

We hope you enjoyed it.

As always, if you have questions, if you have comments about this subject, then please do let us know.

You could email us at the email that we just gave you.

Or you can of course leave your comments your questions in the private Facebook group on that platform.

Just look for Tridoc podcast and answer the three easy questions.

I'll gain you admittance and we'd love to hear from you.

We'd love to have you as part of the conversation.

Juliette, thanks so much for being here.

I look forward to chatting with you again in a couple of weeks.

And I'll look forward to that chalk talk as well.

Thank you Jeff.

Well, if you've been listening to this podcast for any amount of time, then you've heard me say numerous times how I struggle with so many balls in the air between my day job, my family trying to get my training and coaching in, and of course just doing my own stuff.

But my guest today makes me feel like an incredible slacker.

Matthew Marquardt is a professional Ironman triathlete and a third year medical student at the Ohio State University College of Medicine where he is aspiring to become a head and neck surgeon.

A cancer surgeon specifically.

He graduated from Princeton University in 2021 in chemistry with a minor in entrepreneurship and he's passionate about using 3D printing to improve cancer surgery and applying athletic insights to enhance surgeon performance.

He discovered triathlon in 2021 when he began medical school.

I did not discover triathlon in medical school.

I was discovering a lot of other things.

It wasn't triathlon.

In 2022 in medical school, he won the overall age group title at the Ironman World Championship in Kona, where he first came onto the radar of a lot of triathletes, including myself, and he went on to Turn Pro in 2023 again while still in medical school, earning three podiums and the fastest swim split en route to 11th place at the Ironman World Championships in N.

In 2024 he finished fourth in the Ironman Pro Series with three more podiums, a sub eight hour performance and a new bike course record at Ironman Lake Placid.

Through racing, he is driven by mission to use sport as a platform for cancer advocacy, to honor the people in his life who have battled cancer, and to inspire others to redefine what is possible.

It is my absolute pleasure to welcome Matthew Marquardt to the Tridock Podcast today.

Matthew, thank you so much for taking what I can only imagine is a tiny amount of your free time, or I should say A tiny amount of what you have as free time.

Come and speak with me here today.

Thank you so much for being here.

Of course, I'm more than happy to.

And it's a privilege to be on any sort of podcast and be able to tell my story.

More than happy to spend some time.

All right.

I have a lot of questions, as you might imagine, and one of them is, for most of us, we come to triathlon at some point and we.

We don't win the overall age group in Kona, So clearly you weren't coming from de novo.

You obviously have some kind of athletic background.

So tell us, what was your athletic background?

How did you find triathlon and when did you figure out, hey, I might actually be pretty good at this?

Yeah.

Growing up, my main sport of focus was swimming.

I swam in college, and around the age of 14 or 15 was when it became clear that swimming was my sport.

But throughout, really, as long as I can remember through high school, I.

I always played multiple sports.

So in high school, I did track, cross country, soccer, lacrosse, and swimming.

Went to a very small high school, so we were able to play basically any sport that we wanted.

And so really, I never truly specialized in one sport until I got to college.

And so that's really where the foundation was laid.

And would also ride a bike on weekends and go mountain biking or road biking from, I don't know, probably since the time I was 10 or so with my parents and.

But never competed was always just for fun.

And yeah, so really the.

That foundation was by doing a bunch of different sports throughout high school.

And then swimming's obviously an incredible aerobic base and just built on that in college.

And so that's really why I think that my success has been so rapid, is because it's not like the fundamentals were there, and it's more just been about fine tuning it and translating it over to triathlon rather than starting completely from scratch.

Yeah.

You're dashing the hopes of so many because it's much more fun to talk to someone who says, oh, yeah, I was a terrible swimmer and I had to figure that out.

You're reinforcing this notion that a lot of us have that if you can't come to this as a really good swimmer to start, it's, you're already way behind the eight ball.

But, yeah, you obviously establish yourself very early in these RA races with an incredible swim, and obviously you came up with biking and running, too, so.

Or do you consider any of them to be a weakness?

I think it depends on the race.

And I think also, what do you define as a weakness?

The weakness.

Something that's truly like a weakness or is it just like there you could be better at it.

And I think there's really areas where swimming.

I don't really feel like it could necessarily be better at it because there's just such marginal gain being better at it at this point.

But there's always room for improvement in both the, the bike and the run.

And I guess it depends on the day, which is the weakness.

Now, at the risk of sounding very much like a bitter old man and sounding like I'm gonna say in my day, but I am gonna say a little bit in my day because when I went to medical school, I could barely get dressed in the morning to get out the door and be ready for my rotations and everything else.

Now, I went to school in Canada where we did call as a third year student and we had pretty demanding rotations all the way through third and fourth year.

I know from working in Denver that it's not quite the same, but it is still medical school.

It is very difficult.

And here we are, it's Saturday morning when we're recording this at 9am Denver time.

I think it's 11 where you are.

Right.

And I asked Matt what had he done already this morning?

And he says, oh, five hours on the bike and cleaning the house a little bit.

And so he's got his whole day ahead of him.

How do you do it?

How do you balance it all?

I mean, you've got probably a 60 to 70 hour work week that you're not getting paid.

You are paying for the luxury of doing that work week.

And then you're training an additional probably 20 to 30 hours.

How, how do you.

And then sleep.

How do you.

Seriously, how do you do it?

What are your tips for people who, like me, have a pretty busy work week?

I've got kids, I've got everything else and I don't complain.

But I definitely do feel like it's a struggle to get in the training I'm trying to do.

Well, what's your tips for the peons like us age groupers who, who, who feel like we can't get it all done?

How are you doing it?

Yes, it's a great question and it's, it has many different layers of an answer.

And I think one of the most important things is I have my priorities for the day and I stick to them.

And those come first pretty much no matter what.

And so those are like, obviously training in school.

And then the eating, sleeping and all that stuff as well is super important.

But I think when your time is so precious, you have to be incredibly intentional with how you spend it.

And with that said, also be highly aware of opportunities that you can gain a little time back in your day.

And so on.

That first one about being intentional with your time, I think in our day and age, it's so easy to, I don't know, sit down on the couch, and then four hours later, you've watched two movies or an entire TV series or, I don't know, like, you intend on doing one thing, and next thing that you've been buried in your phone for an hour scrolling through TikToks and Instagram.

And, like, I'm not saying that's bad.

There's no judgment on that.

Like, that's a very typical part of life now.

But for me, I just try and be very intentional to make sure that time isn't spent that way, because I personally don't necessarily get satisfaction and fulfillment out of that.

I feel like I have a much larger purpose and calling in life as being a future physician, as well as using the opportunity that I have now as professional triathlete to inspire other people and to hopefully make an impact on cancer awareness, cancer fundraising, et cetera.

And so really, it's what are the things that drive me throughout the day?

And it's these bigger missions of learning everything that I can so that I can become the best physician in the future, as well as wanting to be one of the top triathletes in the world.

And that really provides the lens through which I view pretty much everything.

And so, with that being said, like, some of the practical aspects of that is depending on the day, I have to leave for rotation, somewhere between 6, 10, and teen in the morning, depending on what I have that day, is it clinic, is it the operating room, et cetera.

And so really go from there.

And then I figure, okay, these are the workout.

This is the workout or the workout that I want to get done before that time.

And so then that sets, okay, this is what I need to wake up so that I do those things and that I then make it to my rotation ahead of 10 to 15 minutes early.

Big day.

On time is obviously really important.

And then throughout the day, it's okay.

I'm focused on being the best student that I can be and, like, really trying to be fully engaged in that.

We all have to do different rotations.

Last month I was on family medicine last week, and actually next week I'm on ent.

So that's obviously an interest of mine, but we have to do everything.

And I will probably never spend another day or so in a family medicine practice for the rest of my career, but this is the month that I have, and I personally view that as an incredibly important time to learn as much as I can and to get as much done, exposure, et cetera, during that time as possible.

Because again, the goal is to become the best physician possible.

And so during the day it's focused on that.

And with that being said, though, that there are moments throughout the day like where you can fit in some other things.

It's an operating day, maybe there's four or five cases in between cases the residents are running around doing stuff and.

But sometimes a medical student can't necessarily help, so we're just stuck in the corner and you've got 10 minutes between cases or whatever it is where you're not really doing anything.

That's a great opportunity to send some emails or do a little bit of studying.

And you piece that together throughout the day, you can find a shocking amount of time to do stuff.

So that's definitely part of it.

And then the other thing too is like you get home and then, I don't know, I.

I've got like my routine.

And so I think that's a really important part, is I have the priorities of these are the things that have to get done in a given day and trying to find those literal opportunities wherever I can.

And then also just having that larger purpose in sport and also in life to provide some motivation during the times where it's 6:30 or 7 at night and I would really love to not do anything or watch TV or just sit down or whatnot, but I have a workout to do and so I need to go do that.

That's the hard part, right?

That's the hard part.

Because I think that a lot of us bring the same kind of intentionality and dedication.

But the really hard part is making sure that you follow through exactly as you just described.

Because it is really difficult.

I know personally, I start work at 6am every day.

I finish at 3.

Immediately I head out to do whatever workout I have.

I often have things that I need to do around my podcast or writing for triathlete or whatever it is.

And then I've got my kids to get to an activity or something.

And when I get home, I have that small window before I hit the sack at around 10.

And often I'm tired and the idea of doing a workout later at night when you're fatigued is difficult and clearly you're younger.

You obviously very driven, very mature.

I have to say for a 27 year old to be as dedicated and driven to make use of every moment like that is I don't think, I don't think you'll find that in a lot of 30 or 40 year olds.

So it's a testament to who you are and I think that's a very special characteristic that you have.

So kudos to you.

People ask me frequently and again, I do not want to compare myself because I am nowhere close to as dedicated as you are.

But people ask me frequently, how do you get it all done?

And I have frequently said it involves a certain amount of sacrifice.

I have to give up things that I generally would otherwise like to do.

The only time I watch TV is when I'm on the trainer.

I watch Netflix on the trainer.

I don't do Zwift.

I do Trainer Road so that I can watch TV on the trainer.

I love to read and I don't read because reading is time that I just don't have.

So what sacrifices have you made?

I know when I was in medical school, my way of decompressing was social.

I, I had a huge friend group.

It was a lot more partying than there probably should have been.

I'm guessing that's something you've had to choose to forego.

Yeah, no, that's a great question.

And yeah, certainly there's a lot of sacrifices that I think we make.

Not just myself but my girlfriend as well.

Like on a day to day basis where there are like more times than you'd expect where both of us are, oh man, I wish we were just living a normal life.

Like I wish we could just be normal medical students and like that's.

But then like when you think about it and everything, like when you actually really think about it, you're like, no, this is the preferable option.

Um, but yeah, no, sacrifices are, are a huge thing.

Certainly not nearly as much socializing as probably I would have otherwise.

I get a lot of socializing through the people that I work with on a day to day basis and, or just really trying to be intentional with how I socialize.

So instead of going out and partying for six hours, it's spending one or two hours at a dinner with someone and having a really high quality interaction with someone versus going out to a bar and, and having a really late night.

And there are ways that I think you can balance quality and quality quantity versus some Things and obviously socializing is definitely the biggest thing that has to be sacrificed.

And then I don't know, there's just a lot of little things as well on a day to day basis that I honestly can't really think about necessarily right now off the top of my head.

But sure, sure that you end up sacrificing or at least doing different.

Like whenever we go on vacation the bike comes with.

There's things like that I.

My parents don't live too far away and her parents don't live too far away either.

But it's, it's hard to be able to even just go home on a weekend sometimes because that's time spent in the car and not spent studying or training.

And it sounds like a psychopath.

And I would agree with that to an extent.

But like overall, like I'm.

I still try and be very intentional and make sure that the things that I'm doing in my life are the things that I enjoy and that the people that are the most important to me still get the time and whatnot that I want.

So for example, I'll still call my parents on FaceTime and talk to them on FaceTime, but maybe I don't necessarily go drive home for the weekend to see them.

So there's like different ways around it that you can.

Some of these things.

Yeah, maybe it's not ideal, but also this is the, it's the kind of light of a medical student.

I've talked a lot, I've talked a lot about the importance of having, even though triathlon is a individual sport, the importance of your team and you have really just, I think sketch that out very nicely.

Is your girlfriend an athlete as well?

No, not anymore.

Okay.

She.

What did she do?

She, she did like some running in high school and college and a little bit of rowing as well.

You can always get back to that later.

I'm curious if you have given thought to what your future is for professional multi sport.

You're getting to the point now where you're going to start applying for residencies.

Have you considered.

I've spoken to a lot of other professionals who were like, Tamara Jewett was a lawyer, Laura Siddal worked as an engineer.

Several professionals were actually in the world of working as high level professionals, realized they were really good at this, decided to take a break from what they were doing and then leave the possibility open to return someday.

Have you given consideration to maybe taking a gap year or two before residency?

Or are you just.

Is this just as long as it goes?

You're Going to have fun with it and then move on to residency because let's face it, an ENT resident is probably not going to be able to do this.

Exactly.

Yeah, there's.

I don't know, there's a lot of.

I've taken some research time which has given me some additional research time which has given me a little bit more flexibility in terms of being able to travel and do things.

And so that's definitely an option and can certainly do more of that.

But we'll never like fully step away.

I think as crazy as it sounds, being a medical student actually helps provide a lot of balance in triathlon because like I do my workout.

Take this morning for example.

I did my workout immediately, finished and basically got on this call.

And then after this I'll study and then this afternoon I'll do my workout.

Like there's no perseverating on a workout or overanalyzing it because like there's just no time.

And I think that can be a real strength because otherwise you're like going back over the file for an hour or two each day and you're just overanalyzing things.

And I think having that larger purpose as well is also really valuable.

And I think that's something that people can take away no matter what they do is like, why are you doing this?

And I think like being.

I personally feel like if I was only a pro, I wouldn't find that very fulfilling.

There's a reason I've decided to go into medicine.

As I like to tell like other pre meds, like there's a lot of much easier, quicker ways to make 400, $500,000 a year than becoming a doctor because it's a really long hard road and if it's not something that you want to do, like you shouldn't do it because like you have.

We always say that the journey matters as much as the destination.

And that's certainly true like with medicine.

And so I don't know, it's a long winded way to answer your question, but I think like for the most part it's.

I've just taken triathlon six months at a time, six to 12 months at a time, and kind of throughout my entire career.

And that's what I intend on continuing to do because there are certain things that you just can't really plan for.

I think that's one of the main lessons that I think the pandemic really taught a lot of us is that medical students in particular have like their next 10 year plan mapped out.

That's just not realistic in this day and age anymore.

I feel especially with how my trajectory in triathlon has been like that also.

I just don't think that it's worth it to try and do those mental gymnastics to yeah, make a five year plan or whatever and.

Are you working with a coach?

I do work with a coach and I've worked with a coach pretty much, I don't know, since like week four that I've been in the sport.

And I'm a huge proponent of working with a coach because especially in my case, I don't have time to think about training.

And I also am a huge advocate of delegating things to experts.

I have my area of expertise as a medical student and research or whatnot, but the amount of time and energy that it would take for me to really become an expert in terms of coaching is just way too long and way too much time.

And I'd much rather have someone else handle that for me who has those prior years of experience, et cetera.

And, and I think that's super applicable to many areas of life.

There's a reason why when you're not, when you're in a surgery, the anesthesiologist handles the anesthesia and you handle the surgery because there's just so much information, so much stuff out there that you really can't be an expert in more than like a few areas of life.

And so for me, coaching is not one of those areas that I want to be an expert in.

I want to be given something to do.

I will execute it, give a little feedback and then move on with my life and then do the next thing.

You're preaching to the choir.

As somebody who coaches, I've been saying that for a long time that investing in yourself and taking the time and to search for a coach that lines up with you and, and making that investment in a coach is probably the best thing you can do for yourself as a triathlete.

Are you just a regular med student on campus?

I know triathlon is not exactly a high profile sport, but you have accomplished some pretty amazing things.

Do you know?

It depends.

So yes and no.

There's certainly a cohort of people that know me as the iron man guy, for better or for worse.

And then, but then there's also a lot of people that like, don't know who I am.

And honestly I love that.

Like I've swum at the same pool here at O2 for, I don't know what, almost four years now.

And I think during that time maybe only, like, less than a handful of people have recognized who I am and, like, stopped me and said hi.

And obviously, those interactions are super cool, and I love it when that happens.

And I think it's always great to talk to people that.

I always find it weird, honestly, to find it when someone says that I'm an inspiration to them.

But it's also, I think, very cool and a huge privilege.

And for the most part, I feel like I'm pretty anonymous, which is pretty cool, honestly, just another guy.

But then there's certainly, you know, the cohort that kind of knows me in who I am and what I've done.

And so that's also fun to jump between those two realities.

Yeah, that's great.

I was just thinking back to my question about the gap year between med school and residency.

You wouldn't be the first.

There was a medical student at my alma mater, Laurent.

I can't remember his last name, but he was a defensive lineman for the Kansas City Chiefs, and He graduated from McGill Medical School.

He played for the Kansas City Chiefs.

He actually graduated while playing for the Chiefs because he played football at McGill as an undergraduate, did medical school while he was playing, and then finally, after his playing career ended, he went and started a residency in emergency medicine, of all things.

So it wouldn't be unprecedented.

Yeah.

What is your personal story with respect to cancer of the head and neck?

Because I know that you've spoken about that and you've referred to it a couple of times in this conversation.

So what is it that motivates you to become a head and neck cancer surgeon?

Yeah, the.

How someone chooses what specialty they go into is obviously like a long, evolving process.

And everyone has their different reasons.

And I will withhold judgment because some reasons are better than others, I think.

But everyone kind of has this process that occurs over, generally speaking, over months as to how they choose it.

But my story really started back when I was, I guess, 14, 15 years old, and that was like, really the first time that I had experienced cancer, when one of my childhood friends was diagnosed with acute lymphoblastic leukemia, which otherwise known as pediatric blood cancer.

And during that time, that was really the first time that I had experienced anyone that had cancer.

And so obviously, watch her go through her treatments and whatnot, and she ended up beating the disease, and.

And that was the first time.

And then over the subsequent years, there's been a variety of close and extended family, as well as some friends that have had different cancers.

One had a head and neck cancer, bladder Cancer, pancreatic cancer, like kind of the lung cancer, this whole spectrum.

And so my life in general has been really touched by.

And so coming into medical school, I knew that I wanted to be a surgeon because I'm really three dimensional, as I think some people know.

I really like playing with Legos, like loved playing with Legos growing up.

And I love building things with my hands.

And so being a surgeon was like a no brainer.

And then it was figuring out, okay, what area within surgery did I want to go to.

And really the head and neck cancers, I think are this perfect balance for me of complexity.

You're tackling different tissue types.

Like you have some bony aspect to it, you have some soft tissue aspect to it, there's like a nervous system aspect to it.

So it's this very like, I guess we'll call it like a multi system surgery that I find really cool.

And then the surgeons have a significant role in that, the cancer's patient's care too, which I really like.

Whereas in some other areas the, the surgeon like just does the surgery and that's it, and then they send them off.

Whereas in head and neck cancer surgery, the surgeon is involved throughout the whole process.

Even in some head and neck cancers where you don't necessarily treat surgically, you treat them with chemo, radiation, the surgeon is still very much involved.

And so I really like that and I like the variety of not only the cancer pathologies, but also the types of cases.

So like, you could have a really short case that's an hour long, and then you can also have 8 to 12 hour cases as well in that variation.

And the challenge that comes with needing to do a really complex, like removal of a tumor and then also reconstruction of that body part so that someone hopefully looks and functions just like they used to, I just find really awesome and really fascinating.

So that's, I don't know, that's a long story of it.

But yeah, I've had a lot of people in my life that have had cancer.

And I've seen over the years how cancer research has made an impact in their quality of life while being treated as well as the outcomes that people have.

And so that's, I guess the larger guiding light is I like hard problems and I want to be a part of like, change.

And I think cancer is a great way within medicine to be a part of innovation and pushing the field forward.

As an emergency physician, there are few patients that terrify us more than the head and neck surgery patient who comes in with an airway problem because it's never straightforward.

So what's next?

What's next for Matthew Marquardt?

What?

I know you.

You were hinting on your Instagram about six races this year, which is pretty amazing given what you're doing.

But.

And you don't have to name them because I think you had a contest going.

So I don't want to.

You don't have to divulge those if you haven't already.

But what's the plan for the short, medium, and maybe long term?

Yeah, so I.

Through kind of the end of April, I'm in clinical rotations, and so we'll be training and doing rotations.

And then the summer time, I go back onto some research time for a couple of months, which will give me some more flexibility in terms of being able to race.

And then in the fall, we'll continue to race.

And there's some rearrangement of my schedule that work.

And I'm working through with Ohio State so that I can do a couple races in the fall.

And during that time, I'll be back on rotations and doing internal medicine, which here encompasses internal medicine, just kind of hospital medicine, as well as neurology and psych, like psychiatry.

And then right now the plan is to then go on a surgery rotation and then fourth year, and we'll go from there.

So that's the, that's the broad bucket, as I said.

Like, there's always, I think, some contingency plan or some.

Some potential other paths that I don't really want to talk about if this happens.

Okay, maybe we would consider going this way or if this happens this way and figuring it out as we go along and continuing to.

But I think, like, the great thing is that I have a really awesome team around me and so I know that we can make it work whichever direction, like, I end up going.

That's amazing.

Matthew, just can't thank you enough for making time to speak with me this morning.

It really was a pleasure to get to know you a little bit and to hear your story.

I just consider you an inspiration to me, a doctor towards the end of their career.

Just watching you at the beginning of yours and seeing what you've accomplished already and just knowing with great certainty that you're going to accomplish a lot more.

Congratulations for everything so far and the best of luck on what's to come.

Matthew Marquardt is a age group champion in Kona.

Who knows, maybe he'll be a professional champion this year.

The men are in Kona, right?

The men are in nice this year.

The men are in nice this year.

That's a great place to go, Ray.

So who knows, maybe he'll be a champion there.

And he is of course a medical student at the Ohio State Medical School where he is pursuing a career, he hopes in head and neck surgery, specifically to be a head and neck oncologist.

Matt Maricar, thanks again for joining me on the Tridoc Podcast.

It was a real pleasure.

Thank you so much.

Have a wonderful rest of your day singing all the songs that no one knows.

I wanna broadcast it.

Hi, my name is Rebecca Adamson and I am a proud Patreon supporter of the Tridock Podcast.

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