Akbar Lalani ran almost six marathons across the Sahara desert. He tells Karen Hebert about the blisters and stress fractures and the over-riding triumph of finishing the race

The Marathon des Sables--"marathon of the sands"--takes place in the Moroccan desert. Akbar Lalani, a fourth year medical student at Bristol University, completed the race, running for a charity, the Madrasa Preschool Programme. He was one of 661 athletes from 32 countries competing this year, the 18th time the race has run. The race covers 243 km in six stages over seven days. The stages include a dune day (a day that is run entirely in sand dunes) and a non-stop 82 km stage that athletes had to complete within 40 hours. That is a total distance of almost six marathons--run in 40ºC heat. Competitors are self sufficient, carrying everything they need for the duration (apart from water and tents) in rucksacks weighing about 12 kg.

Akbar decided to enter the race after watching a television programme about it. "I told my flatmates about the race, and they said, "You'd have to be mad to do that." But I thought they couldn't all be elite athletes. I thought to myself about the other competitors and why they might be doing it. I thought, I am sure you can train to be mad."

About two years before the race, Akbar started training. "I read people's training diaries and they were doing 25 hours more training a week than me. So I started to gradually build it up. Of course there were big dips when there were exams, or I was ill, or I just couldn't be bothered. Bristol doesn't have amazing weather, but towards the end I forced myself to do it, more for psychological training than anything. My training triumph was running 50 km through the snow covered Brecon Beacons at night in under eight hours."

His training did, however, affect his studies. "I failed my ENT [ear, nose, and throat] and ophthalmology exams, although this was complicated by a family member's illness." In addition the race took place during term time. "I went through a major hassle with the university because the race coincided with my general practice and paediatrics exams. But eventually they let me put it off until the fifth year retake block. So now I am doing half my fourth year exams in the fifth year, which I am not entirely looking forward to. The other proviso is that I can't go abroad to do my elective, which is perhaps the biggest blow."

He spent a lot of time trying to get sponsorship. "I raised £12 000 which was half of what I wanted to raise--although I did have an ambitious target." Nonetheless that gives 8000 children a start in education. Akbar was sponsored by studentBMJ, a sports nutrition company called Maximuscle, and doctors.net, but he found other corporate sponsorship difficult to obtain. "I was going to have Readybrek dissolved in water for my breakfast every day, but when I approached them all I got was six boxes of cereal. I also approached the drug companies--none of whom were interested. Some did not even bother replying."

When he got to the airport to fly out to Morocco his initial thoughts were "What the hell am I doing here?" But the people he sat with on the plane became his best friends, and they ended up sharing a tent throughout the race. "You drop your social boundaries from the moment you start talking. The camaraderie was incredible. You could be sitting on the side of the track, and someone would run past and say something in a completely foreign language and give you the thumbs up."

Aside from a stress fracture he picked up during training, Akbar's main problem during the race was with his feet. "I made the big mistake of taking Gore-tex trainers. Sand blew into the vents and at one point my shoes had two big handfuls of sand actually trapped within the fabric of the shoe. Although we cut the Gore-tex out, the damage was already done. All that sand stuck in the shoe had crushed my feet." He would treat his infected blisters at night with iodine and said that this was so painful that "you could hear grown men screaming."

Akbar came in the top half of the competitors on day one but then describes the middle three days as his darkest hours. "By the second last day I was only walking with the aid of walking poles. You get given an emergency flare--if you take the lid off and pull the string you have ended your race and you will be rescued. I almost pulled it twice. But I kept reading the strips of paper with messages of support and I thought "I can't give up now, I only have a marathon and a half to go."

Nonetheless it took Akbar 12 hours to cover a marathon that day, in 50ºC heat, with only 4 litres of water. "The thing that made that day for me was that other competitors had heard about all the trouble I was having with my feet and that I was doing it with a stress fracture. When I got to the end it was dark and there were about 250 people standing there shouting and clapping. My tent mates helped me back to the tent and forced me to eat when all I wanted to do was sleep. That really was my moment of triumph--it was an even better feeling than crossing the finish line. Because the last 20 km was a mere formality I was going to finish it no matter what. That night was the big win for me."

So, what does the future hold for Akbar? "Once my stress fracture is completely healed I am going back into full training. My next goal is the Yukon arctic ultra race in 2005 (the Yukon Territories are a part of Canada); 300 miles from North Canada through snow and glaciers to the North Pole."

I asked Akbar how he plans to fit racing in while being a doctor. "People keep saying that adventure racing is something I will grow out of. But I see 60 year olds doing it, and if I enjoyed it so much even through the hell, then I am sure I will want to keep on doing it. So I have started to consider career options that will allow me to train and to compete. I have just been given a cadetship with the Royal Army Medical Corps, and I will be working for them for six years. By becoming an army medic, I will be able to indulge in my newfound passion with considerably greater ease than as an NHS doctor."

Akbar's advice based on his experience is, "Don't ever rule something out just because of what other people say or by the way it sounds. You don't know what you can do until you do it. At the end of the day, as much as some people would like you to think of medicine as a life, it is a career, and if you have got other things that you enjoy then you should strive to keep doing them. Maybe not at the expense of medicine, but there is space to do other things if you are willing to make a few sacrifices."

As Akbar was leaving he told me, "I lost ten pounds and ten toenails during the race." Pretty good value for money for those who sponsored him. Karen Hebert intercalating medical student, University of Bristol
Email: kh9694@bristol.ac.uk