Editor's Note

When I am rudely yanked out of velvety blackness, it's all I can do to remember what that rhythmic shrieking is. An alarm clock. Slowly, painfully, I remember how to reconnect mind to body and what to hit to turn off that horrid noise. Still woozy with sleep, I force the question by rolling toward the edge of the bed until I have a choice -- get feet on ground or fall face first on floor.

I still can't stand, but I know that within minutes I will be pumping my legs on an elliptical trainer, my breath coming in huffing gasps as the seconds ooze glacially by. Then comes 45 minutes of nausea-inducing effort at a gantlet of sadistic weight machines. I sit there, head wobbling in dizzy circles, and think, "How does anybody do this?" How do people actually go through with a morning workout, instead of slipping back into the soul-sucking seduction of sleep?

What I mean to say is, how do other people do it? I know how I do it. Abject terror.

My fear dates from a single moment five years ago. I was consulting an orthopedist about what I thought would be simple arthroscopic surgery to smooth out a few ragged pieces of cartilage. But the doc slapped some X-rays on the light board, tapped the shadowy structures with his finger and said: You have advanced arthritis in that knee. It's bone on bone in there. I have patients with pictures that look just like this who can't even walk.

A real charmer, but he'd made his point. After surgery, my physical therapist convinced me that my best shot would be to build up the muscles surrounding my knee, creating a first-class suspension system to keep naked, uncushioned bones from crashing together. So I have kept at it long after rehab ended. First I could limp, then walk, then run, then sprint again. Still, every time I feel a twinge, or worse, like when I missed a step on a ladder putting up holiday lights, I wonder if I've run out of luck. But then I go back to the gym, grunt and sweat, and the pain recedes. Another reprieve. It seems more than obvious what would happen if I stopped. So the alarm shrieks, and I roll.

I was kind of proud of myself until I read freelancer Tom Dunkel's story that begins on Page 8. Pat Rummerfield didn't just defy a scary X-ray, he turned medical science on its head. And, to do it, he didn't just get up in the dark and work out, he made his life into an unending Ironman competition. It's hard to say what's more miraculous -- that he found some unknown way to circumvent the damaged tissue in his spinal cord or the sheer willpower he generated to get there.

Tom Shroder can be reached at shrodert@washpost.com.