Alpha Rowing

By Amber Wong

/ Nonfiction /      

The April air’s crisp as a Granny Smith, the water smooth as velvet. Shades of coral edge over the eastern horizon, the promise of a sunny spring day. At the top of the University of Washington crew racecourse on the edge of Lake Washington, my eyes sweep the skyline, north to south, hoping for a sweet reward. And there it is. Today, beyond the dark evergreen nests of firs, the blue-gray jags of the distant Cascade Mountains end with an exclamation point. Lenticular clouds that normally shroud Mount Rainier are gone. Rainier’s snowy cap, heavy shadow on the west flank, glistens with an ethereal golden glow. My skin tingles. Magically my spirits lift, like water to sky.

A boat engine roars and I’m back to business. I toss back my ponytail and face forward. I take five deep breaths, exhaling hard after each one. Clad in a bright yellow high-visibility jacket, black spandex tights, and a neon pink ballcap, on the water I’m indistinguishable from my rowing teammates, all lined up in racing singles to my right. 

After winter’s icy rows where my primary goal is to stay upright, today I must push myself to the limit. This spring ritual tests another year’s toll on my aging body. I’m no athlete so I thrill in the irony, mouthing words I’ve never spoken aloud: I’m in training. 

Fingers light on my oars, upper body tilted forward like a Lexus “L,” I slowly slide forward so my knees touch my chest. My single racing scull, twenty-seven feet long and narrower than my hips, wobbles precariously and I almost panic. Don’t tip over! I lift the oar handles just a half-inch, enough to bury the blades and steady myself. For the next ten minutes, a distance of two-thousand meters at race pace, I won’t be thinking about the beautiful view. I’ll be thinking about my sixty-six-year-old lungs and my tiny red blood cells, and the betrayal that is alpha-thalassemia. 

Our coach’s megaphone barks across Union Bay. “Ready all, row!” 

My legs press down hard, I swing my body toward the bow. I draw in with my arms—a subtle right to left offset—and keep both oars evenly buried. After my first five power strokes I’m still flush with my teammates. Water churns around our blades, fantail backsplashes rise beside us. Heads on a swivel, we stay in our lanes and keep a straight course, because crashing oar blades with another rower is very bad form.

Adrenaline’s pumping, and my first twenty strokes are long and strong. My boat surges in a push-glide rhythm. So does my blood, efficiently moving oxygen to muscle. My lungs settle in a measured pace. I’m breathing steady, feeling the balance between inhale and exhale, air in, carbon dioxide out. Legs, body, arms—all sing as musical as a chord.

But a thousand meters in, there’s a twang, a note gone flat. My next breath feels shallow so I try to draw in deeper. Now I’m breathing harder and faster, way out of sync with my body’s cadence. My lungs gulp air, but something’s gone amiss —oxygen’s not feeding muscles fast enough. Thighs burn, then arms. My shoulders slump. My core is tired of doing sit-ups. It’s every rower’s nightmare. I’m flying and dying.

The Montlake Cut engulfs me—a wretched five-hundred more meters to go. Concrete walls splashed with crew slogans and motorboat wakes constrict my vision even further. Rowing is such an alpha dog sport. “Bust a Nut in the Cut” blurs as I churn by.

Suddenly I notice I’m all alone. My teammates have, in rowing parlance, walked away. 

“Paddle!” The call comes from a distant fog, and I know my teammates are done. But I can’t stop. I push even as my lungs scream for air. Twenty strokes later, when I finally pass the finish line, I crumple. Legs and arms fall silent. Air rasps the back of my throat like sand. I gag, start what’s known as “regatta cough.” I can’t get enough wetness in my throat to swallow. 

Is it me, or is it my alpha-thalassemia?

* * *

Most athletes don’t have alpha-thalassemia—most people have never heard of it. One estimate is that alpha-thalassemia affects between five and thirty percent of the Southern Chinese population, so I shouldn’t be surprised I have it. Fairly common among people of African, Southern Chinese, Southeast Asian, Middle Eastern and Mediterranean descent, alpha-thalassemia is a genetic trait that causes a person’s red blood cells to shrivel into tiny misshapen crescents. One theory is that alpha-thalassemia evolved in certain geographic areas because in its milder forms, the mutation offers some protection from malaria. The small, numerous blood cells that are the hallmark of this trait may confer protection because invasive malarial parasites are only able to infect and destroy a smaller percentage of the body’s red blood cells. In the evolutionary ability to protect against malaria, thalassemia carriers are similar to carriers of sickle cell anemia. 

In a blood disorder where gene deletions are measured on a scale of one to four, I’m a two. I have alpha-thalassemia trait, also known as alpha-thalassemia minor. Level-one (alpha-thalassemia silent carrier) imparts no symptoms. Level-three (Hemoglobin H disease) causes severe anemia and may necessitate regular blood transfusions. Level-four (alpha-thalassemia major) is catastrophic; it causes death before or shortly after birth. 

Seen under a microscope, the difference in my level-two blood cells is obvious. Normal red blood cells are big, plump, and round, but my level-two cells are small and curved. Blame faulty hemoglobin. Normal, well-balanced hemoglobin is made up of two alpha and two beta globin chains. I don’t produce enough alpha globin. The imbalance between alpha and beta globin results in smaller red blood cells and less functional hemoglobin. The upshot is that my compromised red blood cells can’t efficiently transport oxygen to other parts of my body. In a valiant attempt to adapt, my body makes a lot more red blood cells and, to a greater extent, it works. Aside from being mildly anemic, I’ll lead a normal life. I can jog, kayak, play volleyball, and even swim, should I ever want to. But my Achilles heel is endurance. My muscles burn, my blood pounds, and I’m left gasping way too long after a race piece is over.

But that’s minor compared to the grimmest consequence of having alpha-thalassemia trait: the risk to one’s children. If both partners have the trait, they run a higher risk of having a baby with level-three or level-four. Because the outcome can be dire, affected populations should be aware of the condition, test before they have children, and spread the word to their families. Why? Because if you don’t specifically ask to be tested for alpha-thalassemia, most doctors will miss it. 

It took me ten years to get a definitive diagnosis. My first clue came when I signed up for my company’s annual blood drive. I was twenty-two, fit and able, bicycling to work, hiking on weekends. The jolly nurse with the clipboard pulled me aside. “First time? We need to check your hematocrit first.” She jabbed me with a needle and took a tube of blood. “I’ll spin this down and be right back.” When she returned, she looked grave. 

“Do you feel weak? Do you need to lie down?” she asked. 

Why would I feel weak before donating? I leaned forward and tried to see her notes on the clipboard. “I feel fine,” I said. “What’s wrong?”

“Your hematocrit doesn’t look right. But if you feel okay…” She lifted my arm and poked the plump, welcoming vein in the crook of my arm. Her frown disappeared. “We can just use your plasma then!” she crowed. Later realizing that they were going to throw away my precious red blood cells, that was the first and last time I gave blood.

My second clue came four years later when I saw a new doctor. Something was terribly wrong with my iron level. He shrugged and put me on iron supplements.

Six years later, married and ready to start a family, I got serious about my health care. I went straight to the University of Washington Medical Center and made a pre-pregnancy appointment with one of their chief OB/GYN doctors, a distinguished middle-aged Caucasian man with an impressive resume. Experience mattered, and he didn’t disappoint. He flipped through my lab tests, glanced at my Asian face, and his voice grew stern. “Who put you on iron supplements? That’s the worst thing you could do! You’re not iron-deficient, you have alpha-thalassemia.”

“I have what?” That sounded so much worse than iron-deficiency anemia.

He explained the blood disorder, then apologized. “Oh, I meant alpha-thalassemia trait, not full-blown alpha-thalassemia. It’s not dangerous,” he hastily added, “and won’t shorten your life expectancy. But because it’s a genetic condition, one or both of your parents must have it too.”

I shrugged. “That’s the first I’ve heard of it.” 

“Well, here’s what’s important. Your husband needs to be tested. Is he of Asian or Mediterranean descent?” I shook my head and he nodded. “Then there’s a better chance he doesn’t have the gene deletion. If he doesn’t have it, your children’s worst outcome would be level-two, like you.”

“And if he does?”

“Then we’ll talk more.”

* * *

Turns out, it’s not easy to deduce who has the alpha-thalassemia trait. When I called my parents, I was hot to accuse my mom, who had a peculiar habit of falling asleep at the dinner table. She even fell asleep at a live Las Vegas show! If she had the trait, somehow that might explain her odd lethargy. But my athletic dad—a Boston University trained physician who biked to work, skied every winter, climbed mountains to hunt big game, and had regular gung-fu workouts—sheepishly admitted it was him. 

I was stunned. “Why didn’t you tell me?” Surely he, a doctor, would think the information relevant. 

“I didn’t want you to worry.” A bite in his tone meant, don’t ask. Taken at face value, I’d have to admit he was right. Why worry about something that might not even be an issue? But given my new diagnosis and focus on family, I was aghast: Is our family tree strewn with sad little endpoints, newborns dying from an undiagnosed disease? 

Dad’s response nagged me; there was something to that bite. Much later I recognized that it arose from a pain my family still resists talking about. My American-born parents and their friends, second- and third-generation Chinese Americans who came of age in the 1940s, struggled with an America that marginalized and humiliated them, stereotyped them as weak and illiterate, refused to hire them or allow them to live in white communities, even as they served in the military, went to college, became professionals. Perhaps Dad’s omission was strategic, consistent with our family mantra: Show no weakness. I was seven when I’d come home crying after three boys on bicycles cornered me with taunts of “Ching Chong Chinaman.” Dad had been furious. “Look them in the eye. Never back down,” he’d growled. “You’re not just as good as they are. You’re better.” This claim to power, repeated over the years, fueled me to engage with the outside world, to be academically competitive and socially adept. So if Dad saw alpha-thalassemia as a potential weakness—or even a true physical weakness —I understand why he wouldn’t want me to know. He wouldn’t allow me any excuse to limit myself.

Luckily, my fifth-generation American biracial sons don’t carry that cultural baggage; for them alpha-thalassemia is a straightforward health issue. One son rowed in high school. I panicked when I found out that he had a nasty habit of vomiting during extreme workouts, which in rowing circles earns you a badge of honor, but to a mom sounds horrifying. He got tested. Vomiting may be a normal sign of overexertion, but I wonder whether his alpha-thalassemia trait made him more susceptible.

Another son who has never had symptoms hopes to start a family. He’ll be tested soon. 

* * *

Part of me, the part that denies that I’m any different from my white friends, resists the thought that my blood makes me different. Would I be a faster rower if I had a full complement of cushiony red blood cells? Would I be able to row a standard two-thousand-meter race with ease? There’s no way of knowing. Information on athletes with alpha-thalassemia is virtually nonexistent, not surprising given that the condition’s not debilitating and strikes mostly minorities. But other lay athletes like me have similar questions. Why do we tire before our colleagues? Could we ever be competitive?

One exception of note: Pete Sampras, one of the greatest tennis players of all time, winning fourteen singles Grand Slam titles over his fourteen-year career, had beta-thalassemia minor, a condition he didn’t reveal until he quit the circuit. He likely kept his mild anemia a secret so his opponents wouldn’t gain any psychological advantage. He must have found a way to recuperate between the explosive power bursts of each tennis rally.   

But professional tennis rallies are relatively short, points won in under thirty seconds. Rowing requires sustained intensity. At thirty strokes per minute, a two-thousand-meter race is more like an eight-minute sprint, recovery time between strokes measured in mere fractions of a second. Most racers can—and do—go anaerobic in their final sprint, still finishing strong. They know they’ll be fully recovered five minutes after the race. I tried it once. Twenty minutes later my chest was still heaving and I felt like I was suffocating. Not going there again.

* * *

It’s September. Pale morning light seeps through the clouds for Seattle’s Pink Ribbon Row, our rowing community’s equivalent to a 5K fun run. This regatta, a costumed fund-raiser to benefit breast cancer research, is what I’ve been training for. I will be 3-seat in a quadruple scull. Like previous years, I’ve lined up my donors. I’ve honed my pacing, my breathing, my balance and technique. I’ve attuned myself to my body’s internal alarms, learned to ease up before my crucial “fly and die” tipping point. I’ve practiced saving just enough for the last sprint to the finish. I’ll wear pink.

Today I’m rowing in honor of my friends Martha and Diane, who survived breast cancer, and my friend Chris, who did not.

My rowing partners know about my alpha-thalassemia, but they still want me. They tell me, we love to hear you laugh. Fifteen years ago we found ourselves—four middle-aged women of middling height—in a learn-to-row class comprised mostly of men. We dubbed ourselves the Magic Quad and began rowing together. We became fast friends. In the annual Pink Ribbon Row, then known as the Row for the Cure, we gradually rose in the standings: seventh, third, third, second, and then, the year we thought we could win it all, the regatta was cancelled due to high winds. No matter. After all the other rowing clubs derigged their boats and left, our coaches ignored the whitecaps and launched us onto the course. The wind whipped the pink tulle we’d tied to our hats and our arms got an extra workout from constantly correcting our point. Errant waves threatened to flip us into the water. Our finish time was terrible. But when we powered past the finish line, we were laughing. We’d finally come in first! First in a field of one, but victory over the elements felt so sweet. 

This year we are sporting tiaras. We’re such an unlikely group of princesses—a doctor, a lawyer, a counselor, an engineer—that we collectively joked that if we’ve ever had that fantasy, now’s our chance to indulge it. In the cramp of boat racks eight tiers high, we reach up for our boat. “Up an inch and out!” calls our bow person, and as I squirrel around the protruding riggers I see a new hazard. “Duck, or the boat’s going to hit your tiaras!” I yell. As rowers, everyone immediately obeys without question. As we rest the gunnels on our shoulders and walk carefully down the slippery dock, I can’t stop beaming. This is why I’ve been in training. This is why I’ve been braving the wind, the cold, the dark predawn hours all year. Magic is brewing. 

A light Seattle mist fills the air. It’s a good omen, good rowing weather, neither hot nor cold. 

Graceful as dancers, our arms arc over our heads as we roll the quadruple scull into the water. Together, we step into the boat. Together, we match our strokes. My right oar is misbehaving, stuttering across the water surface. A deep exhale relaxes my shoulders, and suddenly both oars suspend perfectly, an inch above the glinting water. As we shift from easy paddle to seventy-five percent pressure, my whole body welcomes the transition as ragged breaths yield to flow. I’m breathing easy at a higher, steady rate. My tiny red blood cells smoothly grab and disperse oxygen. My hemoglobin is in the zone. 

As we head to the start line, we increase our stroke rate, pick up pace. The landscape blurs. Crowds packing the railing at Gas Works Park cheer as we sweep by. I gasp in delight. We are so much speedier as four than one, our eight oars dipping, pushing, rising together. Each whoosh thrills me, tells me I belong. Water, cool, unhurried, will soon ripple fast beneath our seats. I feel our power, throw my head back, and laugh.