What Ironman Louisville Taught Me About Gratitude

This post has been a long time coming.  Back in 2003, I volunteered as a first year medical student at the Blue Devil Ironman.  As exhausted and elated triathletes crossed the finish line, I worked the medical tent and escorted those who were dehydrated, hyponatremic, or obviously suffering from altered mental status into the tent for fluids.  I remember thinking you’d have to suffer from significantly altered mental status at baseline just to sign up for such insanity, much less complete one.  And I was totally right.

For the uninitiated, an Ironman is a very, very, very long race composed of the three classic disciplines in triathlon.  According to triathlon folklore (and Wikipedia), its ridiculous distances descend from combining three 1970’s era Hawaiian races – the 2.4 mile Waikiki Roughwater Swim, a 115 mile Oahu bike race, and the Honolulu Marathon – into one massive race.  When in 1978 the first competitors shaved 3 miles off the original bike race’s course to create an easier Transition Zone from swim to bike and bike to run, the now iconic “Swim 2.4 miles! Bike 112 miles! Run 26.2 miles! Brag for the rest of your life!” ethos of Ironman Triathlon was born.

I had trained for my race – Ironman Louisville on October 14, 2018 – for over a year, having barely finished a half-distance Ironman 70.3 race alive in 2017.  Shortly after crossing the line in Raleigh that summer, profoundly dehydrated and unable to stand up, my wife had to whisk me into the medical tent for intravenous fluids and something called “salted Gatorade.”  It tastes just as bad as it sounds.  Midway through the second liter of intravenous saline I promised her that if I was crazy enough to ever try a full Ironman I’d hire a coach and train hard enough to finish the race and remain on my own two feet.  Turned out that within a month I’d decided I was just that crazy.

Late in the fall of 2017, I hired coach Steve Brandes who started prescribing my daily training sessions. We worked around hospital, travel, and family commitments to build the endurance and power needed to withstand 12-14 hours of racing.  By the summer of 2018 I was up every weekday morning at 4:30AM to train for an hour.  I trained almost every day for 6 months, with weekend sessions reaching out at their longest to over five hours of cycling one day and three hours of running the next.  Throughout the summer, my incredibly supportive family built our weekends around my training and I finished nearly every training session Steve prescribed to the letter.

Finally the day came, and October 14th wound up being ridiculously cold for Kentucky in early fall.  The thermometer registered a balmy 48 degrees as a cold rain fell on the starting line, and I jumped into the Ohio river for a current-shortened swim.

This is what I looked like after getting just a brief taste of the Ohio River during the frigid practice swim the day before the race.

It was just as cold when I finished the swim, waved to my wife and kids in Transition, and hopped on my bike to start the 112 mile journey around northwest Kentucky.  With the rain still falling and the thermometer stalled at 50 degrees, my clothes were soaked through within minutes and I started to shake.  My face shook, my fingers shook, my arms shook, and every time I steered the bicycle down a hill my whole body shook so hard I had a hard time controlling the bike’s aero-style handlebars.  I honestly believed that if I kept going I’d sooner or later lose control of the bike speeding down a hill and crash.  Not willing to risk dying somewhere on a highway outside of La Grange, I knew there was no way I could finish the race without catching some kind of break.

It came just after mile 26, where I stopped at a high school with an aide station.  A volunteer grabbed my bike, pulled me off, and directed my shuddering frame through the school’s front doors.  I walked into the lobby and found fifty other triathletes all quivering from the same hypothermia as me, caused by a combination of cold wind, cold rain, and a total lack of waterproof clothing.  A second volunteer sent me into the men’s restroom under the hot hand-dryer vents, which began to rewarm me from the core out.  It took 20 minutes for the shaking to subside, after which I found a seat in the makeshift field hospital.

I’d spent hundreds of hours in the pool, on my trainer, and pounding the pavement over the last year training for that day.  I had a crew of friends and family rooting for me at home and watching my progress on the Ironman race app, which at that moment just said I had gone “off course.”  And somewhere out on the race course my wife and kids – who had sacrificed just as much as I had to make this day a possibility – were shivering themselves, waiting to root me on and cheer as I crossed the finish line that night.  I desperately needed some kind of break.  It turned out to be Mylar.


Most people only experience Mylar in balloon form, but like generations of endurance athletes before me I’d been wrapped in a Mylar blanket as soon as I entered the school.  Its reflective coating had helped warm me up from the inside-out by preventing heat from escaping my body.  Mylar blankets make for a terrific a field hospital tool, but aren’t particularly practical for riding a bicycle.  That didn’t stop the volunteer at my table though, who said “Well why don’t we just totally wrap you in it mummy-style?”  Why not indeed.

She left for a moment and returned with more Mylar, a pair of scissors and some tape.  I unzipped my race jersey, and we wrapped the Mylar completely around my skin from chin to belly button, over each shoulder, and down each arm to my fingers.  She then taped up all the seams and I zipped back up my jersey.  I looked like the Tin Man and sounded like Jiffy Pop every time I moved, but it worked.  Once I hit the course again I found could ride the downhills without shivering – my face, fingers, and feet were numb, but my core was warm and that’s all the mattered.

As you’d expect, the rest of the race brought a few additional obstacles.  Around mile 80 I face-planted outside of an aide station when my bike ran over a Gatorade bottle.  Mercifully I was going close to zero MPH, and with the small laceration on my leg just as numb as the rest of me it didn’t take much extra resolve to push on.  Seven hours after leaving Transition to start the bike leg I finally rolled back in, high-fived my kids again and hit the run course.

With a little more luck, a lot of perseverance, and more Mylar than the Macy’s Day parade, I ultimately crossed the finish line after finishing the marathon another four and a half hours later at 4th Street Live in Downtown Louisville.  I was so deliriously overcome with emotion that I didn’t even hear the iconic “Chris DeRienzo – You Are an Ironman!” announcer’s call until my friend Shannon sent me the video below that she’d recorded live on her phone.  I crossed the finish line on my own two feet, and walked with my wife and barely-awake kids back to the hotel to celebrate.




I learned several lessons in the 12 hours, 32 minutes, and 2 seconds I spent swimming, cycling, and running around the Greater Louisville metro area – here are five of the most meaningful:

1. You race the race you get.  I’d trained for a full 2.4 mile swim and sweltering heat.  I got a current-shortened swim, 48 degrees and rain.  The universe didn’t care, so that’s what I raced.  More often than not life works the same way.

2. Never clip into your pedal when there’s a Gatorade bottle standing between you and the road.  Self-explanatory.

3. Runner’s GI distress is a real thing – it’s unstoppable, and like most unwelcome and unstoppable things in life it’s best to deal with it and move onNo further comment.

4. Just stay in the game long enough to catch a break.  No amount of grit, determination, and perseverance is more valuable than a little bit of luck at exactly the right time.  That said, it sometimes takes a ridiculous amount of grit, determination, and perseverance to not just give up until you happen to get lucky.  I got incredibly lucky to find a volunteer at the field hospital who thought Mylar-wrapping my entire body might be a good idea, and I’m convinced there’s no way I would have finished the race without her help.  I’m also convinced that it took an enormous amount of motivation to stay in the race long enough to make it to that aide station alive, not throw in the towel while shaking like a maraca on a high school bathroom floor, and remain open to finding an unexpected opportunity.  Which brings us to number 5…

5. Having a lot of people counting on you is an absolutely incredible motivation.  Some say triathlon is a lonely sport.   It’s true that no one else can swim, bike or run for a triathlete, and riding 5+ hour training sessions on your own is monotonous at best and torture at worst.  That said, it’s not possible to finish an Ironman without an enormous universe of other people’s help.  From the legions of volunteers, to my friends and family cheering me on in-person and back home, to the thousands of other triathletes supporting, comforting, and cajoling each other ever forward towards the finish line – it may be possible to feel lonely on an Ironman race course, but it’s impossible to ever really be alone.

Before the weekend of October 14th, I didn’t even know Ironman had an app that lets you track athletes during a race.  But my friends did.  As a result, throughout the day I knew I had people from all four corners of the country watching my progress.  I also had my wife and three kids braving the elements and twelve-plus hours of total boredom in the wilds of Kentucky just to be there for me and with me.  Knowing they were all watching me, counting on me, and believing in me meant I just could not let them down.  It’s hard to explain, but the fire that lit felt just like the lines from the song Jim Henson’s Muppeteers sang at his memorial service:

And when all those people believe in you, deep enough and strong enough, believe in you, hard enough and long enough, it stands to reason you yourself will start to see what everybody sees in you… and maybe even you… can believe in you too.

I am deeply grateful for the chance to have trained, traveled, raced, and finished my first Ironman.  I am grateful for the volunteers, the police, the organizers, and the other triathletes who all helped make October 14, 2018 a special day in my personal history.  But more than anything else, I am now and forever grateful for having so many people believe in me that failure was simply not an option.  It was at once the most humbling and most exhilarating experience of my life.

Dr. Chris DeRienzo is a physician leader from North Carolina and author of the book Tiny Medicine – One Doctor’s Biggest Lessons from His Smallest Patients.  All views expressed here are his alone and are not attributable to any entity with which he may be affiliated.  Follow him on Twitter at @ChrisDeRienzoMD and on LinkedIn.



  1. Congratulations Chris – a wonderful and gritty accomplishment! Great commentary on the need and power of family and community!! I’d like to say you inspired me to do it but I’m not quite there yet.

  2. Chris,

    This is a great post about this adventure and accomplishment.

    I admire the hell out of you for all the training and grit it took to do this.

    You Are an Ironman! Forever.


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