Doctors told me I’d die: Athlete reveals what the world’s most extreme endurance feat REALLY did to his body

Doctors told me I’d die: Athlete reveals what the world’s most extreme endurance feat REALLY did to his body

James Lawrence doesn’t hold back when he describes some of the things he’s put his 48-year-old body through over the years. And it’s not for the squeamish.

A record-breaking triathlete, he was the first person to cycle up Kilimanjaro (yes, cycle), he completed 50 full distance triathlons in 50 states in 2015, and biked 3,000 miles across America in 2022.

But the feat that almost broke him – physically and emotionally – was the Conquer 100, a personal challenge to complete 100 full triathlons over 100 consecutive days at the height of the Covid pandemic, swimming, cycling, and running 140.6 miles every single day.

He says it was ‘so incredibly difficult, I wondered at times if I would survive.’

Indeed, before embarking, the Utah-based ‘Iron Cowboy’ consulted several doctors, all of whom told him it was impossible. No human could survive such an endeavor.

‘Not merely that my plan was foolish,’ he recalls. ‘Not merely that they didn’t recommend it. They were actually convinced I would die.’

He didn’t listen to them. And by the time he was half-way through the challenge, he endured such agonizing pain, he actually had several out-of-body experiences.

In his new book, Iron Hope, he recounts the injuries he suffered – from blisters deep beneath the skin to stress fractures that cause him to pass out.

The Utah-based ‘Iron Cowboy’ consulted several doctors before embarking on the challenge, all of whom told him it was impossible

Stress fractures in his legs, caused by excessive and repetitive force - feel like red-hot pokers ¿being hammered up through the soles of my feet into my shinbones

Stress fractures in his legs, caused by excessive and repetitive force – feel like red-hot pokers ‘being hammered up through the soles of my feet into my shinbones

And he says the lessons he learned can be applied to all areas of life, from business to romantic relationships.

His inspiring, emotional, sometimes nauseating, experience kicks off on a chilly Utah day in March 2021. 

But things start to go wrong in the first week, when his left ankle swells up to the size of his knee.

‘I catch a glimpse of my face in the window of a car, and my reflection is pinched with pain…. After I complete the run, I need to be helped off to the car, my left ankle barely able to support my weight.

‘This isn’t in the plan,’ he writes. ‘My body is breaking down far too soon.’

Haydn, his trainer – whose day job is working with NFL players – thinks that blisters could be forming on the inside layers of his heel, not just the surface. But investigating will require too much time out, so James decides to run through the pain.

‘Discomfort can prompt growth if you let it,’ he says. ‘Discomfort develops endurance, and endurance develops strength of character. This leads to growth, and growth is good.’

By day 15, however, things haven’t improved. Stress fractures in his legs, caused by excessive and repetitive force – feel like red-hot pokers ‘being hammered up through the soles of my feet into my shinbones.

‘On a scale of one to ten,’ he says, ‘my pain is at 20, and I have no idea how to make the hurting stop. I’ve experienced pain before, but not like this.’

During that day’s run, it is so bad, he keeps blacking out and has to be supported by his loyal wing men.

In the shower that night, he sobs uncontrollably in the arms of his wife.

This small support network is key to his survival, he says. 

But come day 19, ‘I had so many physical problems to choose from, I didn’t know where to begin.

In the first week, his left ankle swells up to the size of his knee

In the first week, his left ankle swells up to the size of his knee

Other cyclists come out and join James on his rides - even on the coldest Utah days

Other cyclists come out and join James on his rides – even on the coldest Utah days

James's wife Sunny and his longtime friend Rich come out to support James (right) before the run on Day 91

James’s wife Sunny and his longtime friend Rich come out to support James (right) before the run on Day 91 

‘My right shoulder was so messed up I was swimming with only one arm. My calves were frazzled. My thigh was bruised and bloodied from a spill on the bike… and my team worried I had sustained a hip injury from the force of impact.

‘The second toe of my left foot was mangled and badly infected – so blistered that a medical professional had declared the nerves in that digit were dead.

‘My tongue was blood red, covered in a chalky film, an unintended by-product of eating too much fruit. My mind was so exhausted that my memory was slipping – I would talk to someone but an hour later couldn’t recognize the person. More than one medical professional insisted I quit the endeavor.’

Add to that a bad case of thrush, thanks to his exhausted immune system, and swollen, blistered lips, cracked and bleeding from the icy Utah winds, and he could be forgiven for walking away.

But instead, he says: ‘I go deep into what I call my pain cave, blocking out everything from my concentration except the next step.’

When hard times come, which inevitably they will, the temptation is to give up. What keeps James putting one step in front of the other are his ‘whys’.

‘You must fill a whole bag with “whys.” In your hardest moments, you can reach deep into your bag and pull them out, one by one. You can stack and sort them. Play with them, pile them high. One reason alone won’t cut it. One motivation is not enough. Many help you triumph.’

People often ask him about his reasons for willingly putting his body through such intense pain. Why do it?

‘Inwardly, I have my bag of whys,’ he says. ‘But people don’t want a dozen reasons. They want it boiled down to one they can get their minds around.’

So he simply says: ‘It’s what I do.

‘I have identified my gifts, magnified my strengths, and concluded that the only thing that makes me unique in any way is my ability to withstand suffering. Making that discovery, then exploiting it to the maximum, has allowed me to redefine the impossible.’

He has to pull out that bag of motivations more than once.

Because the next day his pain is so debilitating, he describes a supernatural experience, in which he rises out of his body, like a ghost, and watches himself limp on below – not quite conscious, but not unconscious.

‘The James Lawrence I see on the trail is trembling,’ he writes. ‘His eyes stare straight ahead like a zombie’s, and I notice that this James is doing a really weird thing with his right hand. Reflexively, my thumb touches my index finger, then moves to touch my middle finger, then moves to touch my ring finger, then moves to touch my pinky. A sequence of four. I watch this James repeat the sequence as I try to keep speedwalking.

‘James has never done any of this before. My body is running on autopilot. The weird hand movement is perhaps symptomatic of just how stressed my mind has become. For once, my logical brain isn’t in charge.’

Every night is a battle to stay awake while he tries to finish dinner and consume the required 12,000 calories

Every night is a battle to stay awake while he tries to finish dinner and consume the required 12,000 calories

The punishment triathletes put their feet through can result in crippling blisters and lost toenails

The punishment triathletes put their feet through can result in crippling blisters and lost toenails

Smiling at the end of the swim on day 100, knowing his suffering will soon end

Smiling at the end of the swim on day 100, knowing his suffering will soon end

He sees himself stumble again and almost immediately, he’s back in his own body.

But he reflects: ‘My first ever out-of-body experience – yes, it is real.’

The punishment a triathlete puts their body through is brutal. They can develop everything from crippling blisters and muscle pain to brain fog, nausea, lost toenails, and shoulder bursitis caused by the rotator cuff and shoulder blade rubbing together.

All that bike action can cause wrist, hand, and forearm pain, plus saddle sores and hemorrhoids.

Running can result in hurt knees, ankles, hips, and heels, tibial stress fractures, bleeding nipples, bleeding underarms, and kidney damage due to lack of blood flow around your organs.

‘After one triathlon a body can be destroyed,’ says James. ‘It takes a normal person about a month after a triathlon to return to regular activity.’

And yet he is going for 100, one after the other.

To have enough energy to even get up in the morning, he has to consume 12,000 calories every day – often eating through the face hole in the massage table while a masseur works on his crumpled, aching body.

‘Every night is a battle to stay awake while I try to finish my dinner,’ he says.

And when he does sleep, it comes in twitches and fits, haunted by nightmares and tremors.

On Day 21, he receives custom-made orthotics that finally deliver some relief to his shattered shins.

But the pain returns with a vengeance on Day 49, when his blisters are so bad, his trainer decides to go deep.

‘He hasn’t been able to see anything on the skin surface, which is part of the problem. Essentially he’s done all he can so far, and no textbook exists for what he’s encountering. But tonight I insist. I don’t care what he does… Hayden could cut my foot off. I just want the pain to go away.

‘He goes in with a scalpel and a syringe and begins to debride the thickened area on my heel, removing as much necrotic tissue as he dares. He cuts away the top layer of the skin.

‘Underneath the top layer it looks like the blueprints of a house, with intertwining vesicles, the thin-walled sacs filled with fluid.

Lost toenails come with the territory

The blisters on his heel are so bad, his trainer decides to go deep

Lost toenails come with the territory (left); he blisters on his heel are so bad, his trainer decides to go deep (right)

‘He keeps going with a small scalpel, and underneath the upper epidermis is another layer of blisters. He goes even farther, and underneath that is another lawyer. There are probably four layers of blisters on my heel, stacked, intertwined with the various layers of my skin.

‘At last he hits what he believes is bottom. Something explodes down there, squirting liquid upward. He extracts syringe after syringe of pus. All this is done without anesthesia or painkillers. I have to keep my mind clear. Somewhere in the middle of the procedure I pass out.’

Bandaged up, he gets a few days of reprieve. But he’s still barely half way through his challenge  when he begins to fall apart again.

‘My hip causes my entire leg to feel it’s being pushed through a meat grinder. After a few miles of intense pain, I slow to a snail’s pace, then stop… my muscles seem to be failing simultaneously. The pain is brutal.’

On day 59, he’s involved in a nasty collision with another rider on the cycle leg, which sees him somersault over his handlebars.

‘For one horrible flicker of a moment, I realize I am directly upside down, diving into a pool of solid asphalt.

‘The first part of my body to strike the highway is the top of my head.

‘Darkness.’

Astonishingly, no bones are broken.

But every part of his body is cut and bleeding. ‘My hands, fingers, knees, and one side of my nose are scraped and raw. My shoulder hurts. My hip is ripped. My right knee is banged up.’

Driven by adrenaline, he completes that day’s triathlon, but emotionally he’s a wreck. More out-of-body experiences help him rise above the agony. But there’s a new searing pain in his lower back that is unfamiliar and worrying.

‘I have reached the most fragile point I’ve ever experienced,’ he writes, adding: ‘Sometimes rock bottom is the exact place you need to hit. When you hit rock bottom, you discover the courage and power to rise.’

James completed his 100th triathlon on June 8, 2021 – then did an extra one the following day. No pressure. Just for fun.

‘One more hour of study can be the breakthrough to the honor roll,’ he says. ‘One more phone call can be the tipping point in your business that secures a huge, life-changing client.

‘One more hard, forgiving conversation can flip around a troubled marriage… one more intense session of active listening with your teenager can reverse a bad attitude and change your teen’s entire life trajectory.’

That night, Forrest Gump’s words sum up how he feels: ‘I’m pretty tired. I think I’ll go home now.’

But the punishment to his body isn’t over.

About a month after the endeavor, his lower back is still killing him, and he discovers a tiny hairline separating his L5 vertebrae.

‘Almost certainly it had happened during the bike crash on Day 59.’

His doctor tells him: ‘You understand what this means, James? You completed 42 full-distance triathlons with a broken back.’

Hundreds of riders come out to support him on the bike section on day 100 - but the added cyclists are a concern for safety after his tumble on day 59

Hundreds of riders come out to support him on the bike section on day 100 – but the added cyclists are a concern for safety after his tumble on day 59

Tears of joy and relief, as James is joined by his family at the finish line

Tears of joy and relief, as James is joined by his family at the finish line

There is yet more bad news to come. Eighteen months on, he’s still desperately fatigued. Tests at a brain rehab clinic reveal that, even though his back has healed, it’s still sending pain signals through his body, forcing him to relive the trauma of the crash every day.

‘Neurological tests showed that my eyes were twitching 12 times every five seconds. A normal person shouldn’t twitch at all… moving the eyes takes a surprising amount of energy, and the twitches were a marker of my brain’s inability to calm myself.’

Four weeks of intensive brain repair exercises recalibrate the receptors in his inner ear and vision and, finally, he is able to rest.

‘Recovery is serious work,’ he writes. ‘If you’re struggling right now, if you’re tired, exhausted, or depleted, your job is to recover. Do whatever is necessary to heal.’

Conquer 100 raised $1m for Operation Underground Railroad, which works to end human trafficking.

More than 1,000 people joined James on his daily swims, rides, and runs – and others from all over the world got in touch with their own stories of hope and inspiration.

James’s final lesson is this: ‘Surround yourself with supportive people. Keep doing the hard work. Refuse to quit. Learn to appreciate the grind. Keep going.

‘Keep showing up and be the best version of yourself. One day soon, you will cross your finish line. You will triumph. Because you, my friend, are far stronger than you think.’

Iron Hope: Lessons Learned from Conquering the Impossible by James Lawrence is published by St Martin’s Press

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