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Mercy Hospital fires shrink and it helps him

Run and Grow Sane... Maybe

Kostrubala admits that he flinched a bit at the picture of Teresa and him in the hot tub. (US magazine, Dec. 1977)
Kostrubala admits that he flinched a bit at the picture of Teresa and him in the hot tub. (US magazine, Dec. 1977)

Thaddeus Kostrubala was jogging when he had the vision. As a long-distance runner he was accustomed to hallucinations, but this one turned out to be rather significant. The psychiatrist was up in the Sierras of northern California when he saw an extra mountain, one not normally there.

After that hot tub debacle, Kostrubala fled to the mountains, where he continued to receive letters from readers of his 1976 book, The Joy of Running.

“Did I really see it?" he asks unemotionally. “Yes.” In a moment, he also saw God, dressed as Moses, descend from the mountain and display a tablet inscribed with the commandment, “Thou shalt have a sense of humor.” Then God went back up the mountain. Time passed. Finally God returned with a second commandment, but before Kostrubala could read it, God started chuckling. Soon Kostrubala was chuckling too, and then the two were belly-laughing, clutching their sides and rolling around on the dirt road. “You see. it was obvious that if you accepted the first commandment, then there couldn't be any others!” says Kostrubala. He becomes convulsed with mirth at the memory. “You couldn’t take any other commandment seriously!”

His cardiologist invited Kostrubala to join a brand-new running program for patients with coronary heart disease.

This, then, is how Kostrubala explains why he has returned to his old jogging grounds in Del Mar to found an international organization of runners. Many San Diegans will recall Kostrubala as the original “running shrink.” touted as a successor to Freud and Jung for his theories that running can cure mental illness; others will doubtless remember the headlines two years ago when Mercy Hospital announced it had fired Kostrubala as director of psychiatry for appearing in an US magazine photograph which showed him hot-tubbing with his fiancee (now his fourth wife).

Tad and Teresa have been getting up at 5:30 a.m. with Tad’s two young children from his marriage with Ann and the four run on the beach.

After that debacle, Kostrubala fled to the mountains, where he continued to receive letters from readers of his 1976 book, The Joy of Running. He says it was one of those letters, from a former mental patient who had read the book and jogged his way to normality, that inspired him to develop an organization that would even more actively encourage novice runners. But he was afraid.

Diann Shipley and her boyfriend, Hans Stewart decided to quit their jobs and devote all their time to developing “the movement.”

And then he had the vision. “That was the thing that released me. I had been holding back, but it was like, okay, now I can go. ” So he returned to San Diego and purchased a modern two-story house on Tenth Street just a block from the beach in Del Mar. It is now home not just to Kostrubala and his entourage, but also to the International Association of Running Therapies.

He touched upon some of the psychological changes reported in “normal” runners: a sense of euphoria about forty minutes into the run.

When he stands in the doorway, dressed in wrinkled yellow satin running shorts, a bulky turtleneck sweater, and thongs, he seems taller than his five foot, eleven inches. Although his face has a pudginess which all the running in the world won’t strip away, his light blue eyes are arresting, powerful. He has a special talent for putting people at ease; they uniformly call him Tad rather than Dr. Kostrubala. He has a quick, self-deprecating sense of humor, and a tendency to swear a lot. It’s from my Marine past,” he says. “I think it’s communicative. ”

Kostrubala’s fifty-year-old body is lean. His legs, furry with blond hair, are muscled, and he retains just a trace of his former slouch. It’s very hard to imagine the body which used to be his; 230 pounds massed in a big belly, a fatty hump between his shoulder blades, and fleshy thighs, all topped by a face hidden behind a thick beard and mustache. That was ten years ago, and his corpulent, sedentary, alcoholic figure was a predictable result of the injurious life he had been leading.

For a model, Kostrubala had his father, a hard-driving, Camel-smoking Pole who immigrated to Chicago at the age of ten and who accumulated degrees first in dentistry. and then in medicine. Finally he settled on a career as one of the early developers of plastic surgery. Young Tad, born on the South Side, had a childhood marked by much movement (he went to eight different grammar schools and four different high schools) but little physical activity — high school tennis was his only sport.

Even that bit of exercise ceased when he entered Northwestern University, where Kostrubala buried himself in anthropological studies. “The whole study of man's origin and past was an obsession with me. I was terribly attracted to anthropology, Egyptology, and so on.” But before he had a chance to develop that fascination into a career, the Korean War intervened. Kostrubala joined the Marines and soon began to think of becoming a career military officer. Pure chance swerved him off that course when Kostrubala’s orders to fight in Korea were suddenly changed. Instead he was sent to Virginia, where he began taking pre-med courses at night and eventually went to medical school at the University of Virginia. Repulsed by what the life of a surgeon had done to his father (who had a heart attack at sixty-five and then died of cancer a year later), Kostrubala chose psychiatry. He returned to Chicago in 1959 at the age of twenty-nine, did his residency work, and by the early Sixties his practice had begun to thrive.

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At one point he maintained five separate offices; then he cut back on his private practice in 1963 when he became director of mental health for the city of Chicago. He set up mental health clinics for ghetto residents, became an outspoken and highly publicized critic of Timothy Leary’s advocacy of hallucinogens, counseled Chicago cops and radicals bent on bashing in each other’s heads. And as his professional reputation gathered weight, so did his body. He also indulged himself materially. He drove a red Jaguar XKE roadster; worked on the fourteenth floor of the building at 8 South Michigan Avenue, in an office overlooking the prestigious Chicago Yacht Club, where he maintained a thirty-four-foot Morgan sloop. “It was big-city time,” he recalls. “I was into leather coats and all that crap.”

Finally, at thirty-nine, newly married to his third wife, Ann, “tired of all the bullshit,” he fled to Portland, Maine, where he established a community psychiatric program. Again his practice flourished, but “there wasn’t any meaning in it,” Kostrubala recalls. With “the express purpose of engineering a change,” the family sailed the sloop to the Bahamas, but the voyage failed to fill Kostrubala’s sense of emptiness. One day, stuck in the snow in his enormous driveway, “I said to myself, ‘I’mcrazy to be here!’ I looked at the fuckin' map and I said I ’m going to get the hell out of here. I put my finger on San Diego, and said, ‘That's where I’m going to go.’”

At a national psychiatric convention in Washington, D.C., a few months later, Kostrubala, who hadn’t yet acted on his impulse to move, met Dr. Stuart Brown, then the director of psychiatry at Mercy Hospital. From him Kostrubala learned that Mercy was looking for someone to expand the hospital’s mental health services. The former Chicagoan secured the position easily and in September of 1971 he and his wife moved into a home on Oribia Road, up the hill from the Coast Highway in Del Mar. Once again he began producing brilliant professional sparks; he established departments of out-patient mental health services and two hospital-sponsored education programs. But all the sparkle in his personal life had dulled. “Somehow I was a failure and I knew it,” he recalls in his book. “Discontent, self-loathing came up from below. Some soulsaving grace, some guardian angel arranged enough vision for me to stir powerful currents of depression. This was an accurate self-appraisal. Alcohol had become my drug of choice. I was tense, fat. ” Finally, fear of a coronary goaded him into seeking a thorough medical exam on his forty-second birthday, eight years ago this past September 22. Cardiologist John Boyer’s opinion was grim: with Kostrubala's high cholesterol, rising blood pressure, and fifty pounds of excess weight, he was a prime candidate for a heart attack. Then Boyer offered an unusual suggestion; he invited Kostrubala to join a brand-new running program for patients with coronary heart disease. Kostrubala records in his book, “If I had any doubt about the seriousness of my condition, it evaporated at that point. I was to be treated along with those men who had survived the dreaded killer. I wasn’t a colleague any longer; I was a patient.... I especially didn’t like the thought of being together with those men whose hearts had already been damaged. I had an odd fear of contamination. Perhaps in some crazy way, I would ‘catch’ having a coronary.” Still, his initial fear proved the stronger emotion, and he submitted to the tests which Boyer required of all the beginning runners, tests which pushed the patients’ cardiovascular systems to their limits. From this, Kostrubala and the cardiac patients learned how to tell (by taking their pulses during exercise) when their hearts were functioning at seventy-five percent of their capacity, the safe limit at which physical conditioning takes place. He submitted further — to the humiliation of puffing around the grassy grounds of the Francis Parker School on Linda Vista Road overlooking Mission Valley — lumpy, sweating, terribly self-conscious. The group met Tuesday and Thursday afternoons and Saturday mornings. About two months into the program the psychiatrist went through a period in which he would stop at a liquor store on the way to the session, buy a pint of vodka, then “sit and furtively gulp the burning white liquid enough to ease my fear before I ran.” But gradually he progressed. Kostrubala says that the research literature of exercise physiology has proven that what happened was inevitable. Almost any human being following the same pattern — spending forty minutes three times a week in exercise which increases the heart rate to a sustained three-quarters of its capacity — will undergo a similar physical conditioning, although it might take some individuals a month and others a year to reach the point where they can safely and comfortably run a mile. It took Kostrubala about two and a half months. Just prior to being retested at three months, he continued to doubt his progress; still more than 200 pounds, he hadn’t changed his eating, drinking, or work patterns. But that second round of electrocardiograms, pulse tracings, and blood pressure readings confirmed that dramatic, almost incredible physical changes were occurring within Kostrubala’s puffy frame.

He says it was about that same time that he noticed the phenomenon which was to revolutionize his professional work: he observed that he and his fellow runners not only seemed peppier, but also less depressed, more cheerful. The psychiatrist in him was intrigued; he began quizzing his own wife and the wives of his fellow trainees, and almost all confirmed that their mates were displaying subtle personality changes. About four months into the running, Kostrubala decided to take a small group of nearly hopeless patients from his psychiatric practice at the hospital and run with them. Today he insists that at that point he had no expectations, just a curious hunch.

They must have seemed a strange pack, six crazy people led by their hairy, ungainly leader, stumbling around the track down the hill from the Parker School’s buildings. They assembled late afternoons on Mondays, Wednesdays, and Fridays. After the exercise, they would meet in a classroom for a group discussion. Among them were a severely depressed young women in her thirties who was dependent on antidepressant drugs, and a paranoid schizophrenic young man of about nineteen who “was barely able to function,” Kostrubala recalls. “He would sleep in bed until ten or eleven every morning and his girlfriend took care of him. He went to one class a week. And that’s it. Vegetating. Heavy medication.” The group also included a girl in her late teens suffering from anorexia nervosa, the neurotic refusal to eat. She had been hospitalized and tube-fed twice, had long stopped menstruating. Another woman a year or two older was using “every.drug under the sun.” Another man, a heavy smoker and drinker in his later forties, was chronically depressed and coronary prone. A second paranoid schizophrenic in his early thirties rounded out the group. Within weeks, Kostrubala began seeing results.

By his recollection, all six patients, all of whom had seemed stuck at plateaus in their therapies, began responding in their individual sessions with Kostrubala. They were talking more, sharing with him more significant details of their lives. About two to three months into the program, the group witnessed one frightening setback: the middle-aged schizophrenic went completely psychotic and dropped out of the program, an effect which Kostrubala chalked up to the fact that that individual had undergone electroshock therapy about seven years earlier. In all the other patients, the psychiatrist noted remarkable improvements. At the same time, Kostrubala began hearing accounts of similar experiences.

By that point, he had expanded his own running far beyond the circle of the Boyer group. He began training to run in a marathon and met other runners. Some confided stories which amazed the psychiatrist. “I would listen to a person tell me the story of how they had gotten to where they are now, and they would tell me a complete diagnostic tale of the recovery of a paranoid schizophrenic. ” Gradually and selectively he began running with his patients on an individual basis; he still recalls the first one, a person suffering from depression. “I said. ‘It seems to me that there are two ways we can go. One, we could try the medication (antidepressants) and we can sit and talk, or maybe we can go on out and we’ll walk and jog together and see if that works instead.” The patient chose the second alternative, “and that’s when I discovered that the treatment of depression with this is so fast. ”

Yet he says the clear “aha!” didn’t strike until about a year after the formation of the first group, when Boyer invited him to report on his work to a meeting of cardiologists and exercise physiologists. The psychiatrist delivered a very short paper. He talked about his running patients and touched upon some of the psychological changes reported in “normal” runners: a sense of euphoria about forty minutes into the run, changes in perception. And he says his listeners reacted weirdly. For a long moment after he finished talking, he heard no sound at all. “Then about half the audience started coming toward me. I was startled! Frightened.” Finally, a long-distance runner broke the silence by declaring that all the psychological changes Kostrubala had just described in “normal” runners had also occurred to him, but that he had never seen them reported before. “That proved to me that the experience I had had with my patients was not just limited to me,” Kostrubala says.

He had a choice then, by his recollection. He figured he could continue to test his developing theories scientifically, attempting to report on them in the medical journals, or he could try to take his early findings directly to the public. He says he suspected that his professional peers would react with hostility so he chose the second path; he sent the short paper around to publishers. An editor at Lippincott delighted him by championing the idea and winning for the doctor a book contract. The firm offered him an advance of $3000 and Kostrubala, ever the symbolist, suggested a more meaningful figure — $2638.50 (a marathon is twenty-six miles, 385 yards long). Lippincott didn’t argue.

Kostrubala worked on the manuscript throughout 1975, finishing about late December. Months before publication, the “running shrink” began to garner notoriety — the first stories appeared in the Union and Tribune and in scattered other publications. As his file of publicity clips thickened, Kostrubala settled into a steady pattern with his personal running, logging an average of about ten miles a day. In the spring of 1975 he had started Sunday-morning gatherings at the information booth on Mission Bay, and these “marathon clinics’’ (which continue today) began attracting hundreds of participants. As the last of his excess weight melted away, he shaved off his beard and mustache (later, for a period, he also shaved all the hair on his head). But a tension was building in Kostrubala’s life, an irony was deepening. As his newly sleek figure loped into the spotlight, he began to have cause for doubting the benefit of running on his personal life.

After his conversion to running, Kostrubala had encouraged his wife, Ann, to join him, and she had done so, first tentatively, then with enthusiasm. She had completed five marathons by the fall of 1976 when Kostrubala came home one night and she announced that their marriage was over. He was stunned by Ann’s assertion that she felt the move was essential to the growth of her personality. Today he says gravely, “Running is a very powerful agent of change. ” He cites a study by Dr. Paul Milvy of the Mt. Sinai Medical School in New York City which showed the divorce rate among marathoners to be 300 times higher than that in a comparable, nonrunning population.

Professional clouds had also begun to shadow him. Although Kostrubala in 1976 replaced Stu Brown (who went into private practice) as Mercy’s director of psychiatry, the runner keenly felt the reaction of his colleagues to his outlandish assertions about the impact of running on mental health. As demands upon him from individuals seeking running therapy increased, Kostrubala trained a few assistants. The first was Ozzie Gontang, a graduate student in rehabilitation counseling at San Diego State who’d taken a course with Kostrubala. The second was Teresa Clitsome, a USIU student who had volunteered to work in Mercy’s mental health unit while getting her master’s degree. But Kostrubala’s fellow physicians began avoiding talking to him about his work with an iciness that spooked him. “I heard what other people said other people said. No one ever said it to me. I would have loved to have tangled with someone in some way, but as it was, I was frozen out. If you really want to know, I had absolutely no support at all. Nobody. Nothing at all. The only things were innuendos and criticism.”

That fall (1976) The Joy of Running appeared, and the public response to it somewhat balanced the professional cold shoulder. Lippincott’s timing was perfect; the book hit the shelves just months before public interest in running exploded. (To date the book has sold about a quarter of a million copies, including editions in Japan, Australia, New Zealand, Italy, England, and Mexico, and eight paperback printings here.) Kostrubala began receiving daily mail from fans, but again the increased notoriety wasn’t all positive. He recalls being stopped one day by one of the nuns at the hospital, who announced, “I used to like you. You used to be jolly and fat and stuff like that. Now you’ve started all this running, I don’t know if I like you anymore.” Today the psychiatrist dissolves into pained laughter at the memory. “I was like, ‘Woo-ah. What did I do?’ ” He brings his arms up as if to protect his head, laughing harder, retorting to his reproacher, 'I'm trying to save my ass and you’re pissing on me.’ This was really happening all the time! It was funny. I would hide."

Despite such rejections. Kostrubala felt that his overall relationship with Mercy’s nuns was good. In fact, in 1977 he had intensified his drive to re-establish himself in the Catholic Church’s good graces. Born a Catholic, he had fallen away from the religion, become an agnostic, a Southern Baptist, an Episcopalian. But as he became a runner, he had begun to yearn for the mystery and pageantry of the church of his youth. He and Ann had even been re-married in the chaplain’s office at Mercy Hospital by Monsignor Henry Keane, and Kostrubala had begun receiving the Catholic religious sacraments again. After his divorce from Ann, Kostrubala learned that Keane hadn’t filled out the required papers correctly, rendering the marriage invalid in the eyes of established Catholicism. That was fortunate, because by the fall of 1977 Kostrubala was hoping to have his upcoming marriage to Teresa Clitsome so sanctified. In fact, Teresa was taking religious instruction and Kostrubala was talking to I. Brent Egan, chancellor of the San Diego Catholic diocese, about reentering the church at the time that US magazine approached him for an interview.

Kostrubala recalls routinely clearing the magazine’s request with the hospital’s chief executive. Sister Joanne, as well as with the director of personnel and the public relations department. The psychiatrist says none of them balked, so he spent several hours with the US writer and local free-lance photographer Ted Lau. He thought little further of it until early in December of 1977, when one morning’s mail brought him both the most recent Annals of the New York Academy of Sciences and the December 13 issue of US. The highly prestigious scientific publication included two psychological studies produced by Kostrubala, Clitsome, and Gontang, focusing on marathoners. The copy of US featured on its cover a huge photo of Jaclyn Smith. One of the headlines next to it blared, “Doctor’s RX; Run Your Way to Mental Health,” a promotion for the story on page forty-six about “San Diego’s jogging shrink.”

Kostrubala admits that he flinched a bit at the picture of Teresa and him in the hot tub. He hadn’t previewed the breezy content, so he read for the first time such tidbits as Teresa (“heir to a $3.5 million real estate fortune”) describing the “Kostrubala jogging clan” as “more than a circle of close friends," and his own assertion that he and ex-wife Ann were planning a “divorce ritual.” Today Kostrubala assesses the overall tone as “really positive — but it was within the framework of how US writes its stuff. ” He showed both publications to Sister Joanne. Her immediately negative reaction distressed him, but he and Teresa nonetheless headed for Hawaii and the annual Honolulu marathon.

Upon his return, the executive nun summoned Kostrubala to her office and gave him an ultimatum — either quit or be fired from the $60,000-a-year position. The order dumbfounded him. both by its unfairness and its swiftness; the hospital had already prepared his final paychecks. He chose being fired, packed up, and moved out of his office December 15. It took nearly two months for the hospital to announce its decision to the press, and then the assistant administrator insisted Kostrubala’s competence wasn’t in question. Instead the administrator said the implication that the doctor and his fiancee were nude in the tub together “does not reflect favorably on a Catholic institution.” (Kostrubala has always insisted they were clothed.) The administrator continued, “What was in the magazine was not in concert with the Sisters of Mercy and conduct that we would like from a leader in our institution.”

“My first reaction was, ‘Well, they must have a good reason for what they did. I must be wrong.’ I really had the feeling, ‘Jesus, I’ve made a terrible mistake,’ ” Kostrubala says today. He and Teresa fled to a home she owned up in Mammoth, and he says, “I literally withdrew. I didn’t want to do anything.” He kept expecting the phone to ring, for it to be the nuns, declaring (hat they had erred, asking him back. As the months wore on he halfheartedly investigated the possibility of taking legal action but was told that any battle against nuns would be doomed to failure. Finally, he found a lawyer who disagreed, and the day before statute of limitations would have prohibited litigation, Kostrubala sued the hospital for “breach of oral permanent career contract and intentional infliction of emotional distress.” He asked for $4.75 million — an amount calculated to include the loss of his salary and to compensate him for the “shame and humiliation” he suffered. The action continues today to plod through the legal system. “It’s terrible. I dislike it intensely,” Kostrubala says. “But I have no alternative. It’s a matter of it must be cleared out; it can’t stay there. I'm not built that way. It’s not my nature.”

He says it took another full year for him to recover from the shock of the firing. Only toward the end of last year did he again begin to focus on the subject dearest to his heart: the psychological impact of running, what explains it, what it means.

He had long before concluded that running does more to the mentally ill than simply make them feel fitter. He cites the example of one man who walked up to him at a marathon in September of 1978. The stranger introduced himself and reminded Kostrubala how they had chatted briefly in the Mercy Hospital cafeteria a year earlier, at a time when the man had been seeing another psychiatrist. In his thirties, the man had been diagnosed as a manic-depressive; he’d been hospitalized repeatedly and he was dependent on drugs when he decided to read The Joy of Running. Yet here was the same man at the marathon, radiating health, testifying how he had gotten off the medication, freed himself of the need for counseling. ‘‘Now what do you do with somebody like that?” Kostrubala asks. ‘‘That’s not just feeling better. This guy found something for himself that changed his life, that in a specific diagnostic sense altered it.” The psychiatrist plucks out yet another anecdote about the schizophrenic young man who had been vegetating when Kostrubala formed that first group. After becoming a runner, he finished undergraduate school, then acquired a master’s degree and had an A-minus average. Now he holds a steady job. “Total switch,” Kostrubala says. “That’s not just feeling better.” Furthermore, independent researchers had quickly begun to confirm Kostrubala‘s clinical observations. Two major studies from the Universities of Wisconsin and Virginia concluded that running alleviates depression. Others reported general personality improvements. Kostrubala says as yet no one has scientifically studied the effect of running on schizophrenia, but he claims that he personally has seen fifteen to twenty schizophrenics markedly improve — to the point of the symptoms totally disappearing.

Kostrubala says it was the weight of such accumulated evidence that forced him finally to come up with “a whole new interpretation of how we are put together.” He still remembers the night his thoughts coalesced. He was sitting in his Oribia Road home, writing The Joy of Running, sifting through all that he’d seen, when suddenly he understood that nothing in Freudian or Jungian or any other established psychological theory could explain why taking people out and making them put one foot in front of the other could dramatically change their hearts and minds. And then all Kostrubala’s passion for anthropology surged to the fore. It struck him that he’d never get the answer from modem man, tied and suited and ensnared in the perverse zoos of modem cities. One had to consider the whole of human history, to engage in what he later called “paleoanalytic thinking. ” When he looked back, he beheld four million years of evolutionary history which not only sculpted the form of the present human body but which, he concluded, also left its powerful residue on the human mind, the human soul.

It is critical to remember, Kostrubala stresses, that for the roughly four million years during which genus Homo has existed — during that ocean of time — humans lived in running, hunting, gathering, mobile tribes, the demands of which made them the best long-distance runners on the face of the earth. Does that seem strange? Kostrubala answers that many cats and antelope can sprint faster for short periods of time, but no creature can endure sustained long distances as can the human (and his friend, the dog, who learned long-distance running from its human masters, Kostrubala asserts). He offers examples of primitive tribes that still demonstrate the ability: the Tarahumara Indians of Chihuahua (Mexico), who run daily through their rugged, mountainous homeland and occasionally hold 150-mile races for pleasure; the lone aborigine who jogs after his kangaroo target all day and into the night, then sleeps when the kangaroo sleeps; in the morning, he kills his prey, which is too stiff to resist or escape. He tells how North American Indians used to catch turkeys by literally running them down. But the psychiatrist asserts that even the urban executive, who has lived all his life in the city/zoo, bears some part of man’s running heritage; it lies in a deeply submerged section of the mind which Kostrubala calls the “paleoanalytic consciousness” (he says this is the foundation for Jung's “collective unconscious” and all other layers of the mind). And when that executive dons running shorts and takes to the road, the slow, sustained movements strike a chord which resonates through the individual’s primordial soul, and those vibrations often jar the person’s entire way of life.

Thus, in Kostrubala’s eyes, running began to shape up as not merely one among ten or twenty possible vehicles for becoming physically Fit. Instead, he says, evolution has woven it into the very fabric of human nature; biology has ordained that man should run. When man doesn’t, biology takes vengeance — by distorting bodies and warping personalities, and it warps a few into severe derangement. When the trained therapist runs with the deranged individual, he can assist as the physical activity alone causes changes in the subject’s personality; he can help steer the subject, who will be driven by the running itself back to normality.

“Freud invented the couch and psychoanalysis. I invented the use of running as a tool in paleoanalytic psychology!” Kostrubala says triumphantly. At first it seemed clear to him that the role of the “running therapist” shouldn’t differ that drastically from the traditional psychoanalyst. The former had to be a runner and also had to share far more of himself than the traditional Freudian- or even Jungian-style counselor, but the running therapist should come from a traditional mental health field and have intense exposure to psychiatric therapy, Kostrubala believed initially.

In the Sierras, however, he began to re-evaluate the necessity of using a trained psychotherapist to reflect on some of the cases he had seen. “Heh, heh, heh,” he chuckles today. “Give you a story. Heh, heh, heh.” He describes the nineteen-year-old schizophrenic who came to his office at Mercy Hospital one day. Kostrubala says, “Once you recognize what a ‘process schizophrenic’ looks like, you never forget them. He stood there, staring vacantly. He knocked on the door of my office, didn’t even walk in. Just stood there like a zombie. Couldn’t keep one thought together. Said [mimicking the kid’s dulled tone], ‘Can I be your patient?’ I said ‘No. You’re somebody else’s patient. Go away. Get him out of here.’So he goes and asks his doctor, ‘Can I become Dr. Kostrubala’s patient?’ And the doctor says, 'Sure! Oh yeah! That’s wonderful!’ ”

Kostrubala says when the youth returned and asked what to do, Kostrubala brushed him off by telling him to read The Joy of Running and to run by himself, warning he could only spare a half hour a week to talk. That was in May. “Kid came in in June. Every half hour he saw me, he got worse; I thought. ’Oh God. This is really great therapy. This kid is crazy as a bed bug. He’s crazier! I mean he just looks really nuts.’ It’d almost be funny if it weren’t so pitiful.” But at the end of July, the youth began claiming that he felt “normal” when he was running. “I said, ‘Yeah, sure.' August, he starts getting better daily. So finally he asks about running therapy. By then I felt guilty, so I agreed. So we go running and at the end of it he says, is this what you call running therapy? I don’t need you.’ ”

Kostrubala tentatively agreed, but asked the boy to join the marathon clinic. He says every month the young man appeared less discemibly different from the rest of the crowd. He finally ran a marathon in January “and that kid didn’t look any different from any other marathoner finishing. He looked identical. He was finished. He was done."

Combined with cases like that was Kostrubala’s growing conviction that people trained in traditional psychological theories often found it harder to overcome their prejudices and accept this new mode of therapy. So Kostrubala began to envision training a radically expanded group of running therapists to spearhead a “mental health movement.” It was only this past spring that he saw his vision in the mountains, got the psychic go-ahead. By then he had acquired two disciples willing to commit themselves to forging the movement with him and Teresa.

One was Diann Shipley, a thirty-five-year-old checker at the Safeway store in Bishop, who had turned to Kostrubala for counseling after her seventeen-year marriage broke up last fall. When her depression dissipated after just two months of learning to run with the psychiatrist, Shipley felt a calling to help Kostrubala spread the good word. She assisted at the February conference organized by Kostrubala to launch his fledgling organization. The gathering so inspired her and her boyfriend, Hans Stewart, that they decided to quit their jobs (he was the assistant manager at the grocery store where Shipley worked) and devote all their time to developing “the movement.” In late March, the pair moved to an apartment in Del Mar just a few blocks from the home on Tenth Street in which the Kostrubalas had settled a month earlier. Shipley and Stewart’s combined savings began to run out in the middle of June. They began living on credit cards. Shipley sold her horse and corral in Bishop; Stewart borrowed money from relatives in Germany. “We’ve just been begging, borrowing, and stealing,” Shipley says cheerfully. Finally, in August she and Hans began camping on the floor of the Kostrubala home, anticipating the day when organizational funds will begin to flow in from membership fees.

In the interim, they and the Kostrubalas have been working to develop a grandiose structure for IART (they pronounce the abbreviation for the International Association of Running Therapies “eye-art”). “It will be very much like est, except that we don’t have that hokey bullshit,” Kostrubala says. Shipley, who has assumed the title of IART public relations and membership director, hauls out beautiful, hand-drawn charts, showing the organization’s two distinct components. One will include the actual “running therapists,” whom Kostrubala will train for a $400 fee; the only requirements for becoming one are the completion of two marathons a year and the possession of any societally recognized “people-handling” certificate; anyone from a barber to a masseuse to a psychotherapist is eligible, Kostrubala declares.

IART’s second component is aimed at the general public; here Shipley wields a chart abloom with colors. Members pay eighty dollars a year. For that they get an IART T-shirt (red), nine weeks of training in how to run (with the nine two-hour lessons patterned after the nine chapters in Kostrubala’s book), and additional benefits such as a newsletter. Teaching them will be ‘‘Kostrubala trainers” (”K-trainers” for short, in orange T-shirts), who will guide up to thirty students at a time. (“Thirty is the largest possible number with which significant interpersonal communication can take place,” the psychiatrist notes.) For every four K-trainers, there will be a supervisor (yellow T-shirt). For every four of them, a green, on up through blue, indigo, and violet (by which time 153,000 members would be involved). The whole plan reeks of symbolism, and Kostrubala loves it. "Thirty is the tribe. Seven is the extended family,” he bubbles. “The duo is the triad ...” The first class for members is now set to begin October 18 — at the Kostrubala home. The pace is building. Recently, Tad and Teresa have been getting up at 5:30 a.m. with Tad’s two young children from his marriage with Ann. Mondays, Wednesdays, and Fridays the four run on the beach; Tuesdays and Thursdays they go belly-boarding in the dim light of dawn. This particular day at their home the phone begins ringing early; it’s a woman whom Kostrubala has never met. A former probation officer who read The Joy of Running, she wants to become a running therapist. Shipley schedules an appointment for her to meet with Kostrubala that noon. The psychiatrist relaxes on the long sofa in his living room, with its dramatic sky-and-sea panorama, and he returns to explaining the point of all this IART hullabaloo,

He thinks there’s a need for organized efforts to attract and support runners because humans need to be nudged into running. Although the activity may be inseparable from human history, it doesn’t come naturally. “Even runner-hunters don’t like to run or move,” he lectures. ‘ They will do everything they can to avoid that. The favorite activity of runner-hunters is to have great big orgies. They like to eat a lot and sit around. That is heaven.’’ So, paradoxically, longdistance runners “are going against our running, hunting nature,’’ he says. “They’re exercising an increase in consciousness. You have to make yourself do that.” IART will help by leading neophytes step by step.

The phone rings again. It’s a call from Florida, from a physician/runner who has just read Kostrubala’s book and is concerned about the statement that running stimulates the thyroid. The caller says he is taking thyroid medicine and worries that the running might interfere with it. Kostrubala has known runners who’ve “burned out their thyroids,’’ so he advises the doctor to consult a running endocrinologist. He returns to the living room just as the mail is arriving. It contains a letter from a rabbi in Rochester, New York, who volunteers to speak on “Running and Religion’’ at an upcoming IART conference.

When asked about his expectations for IART, Kostrubala is self-effacing; he says he hasn’t the faintest idea how the enterprise will fare. It’s as if he knows that the elaborate plans verge on sounding pretentious, and, cagily, he wants to be the first to mock himself.

In fact, the planning for IART only consumes part of his time. He’s also writing a play, completing a children's book, polishing a mystical account of his third annual marathon, which he organized in Mammoth on August 15 to celebrate the feast of the Assumption of the Virgin Mary into heaven. He’s also planning a sequel to The Joy of Running, which will focus, at least in part, on long-term changes which Kostrubala now believes long-distance running can stimulate.

Some people develop parapsychological abilities, he claims. Some begin seeing angels and having other mystical experiences. “I’m talking about straightforward, uncrazy people who don’t begin running because they’re seeking these types of experiences.” Like some storyteller sitting around the campfire, he spins out another long, complex theory to account for such startling phenomena. Thinking paleoanalytically. he asserts, leads him to suspect that ten percent of the human population has always consisted of “genetic throwaways,’’ a group which has always contained the world’s schizophrenics, its artists, its priests. He postulates that humans in this group have the heaviest genetic load of imagination and thus are most susceptible to the dramatic breakthroughs in consciousness that long-distance running can induce. But he warns that any runner may be touched by these and other amazing changes, both psychological and physical. Longdistance runners tend to become more and a more individualistic, more religious, more apolitical, according to Kostrubala. Physical indices of aging seem to stop. It may cure cancer, he says. And it seems to be leading to the development of a “third sex” — women who stop menstruating (because their percentage of body fat drops to such a low level). “They look like what nuns should look like,” he adds. “I know of one woman who stopped menstruating five years ago. I’m enthralled by her.”

But Kostrubala says the public should be warned about such strange side effects, and he really means it as a warning. Paradoxically, it seems that he has come full circle, from saying that running makes you sane to running makes you crazy. He mentions that the University of Nebraska will soon publish a paper of his in which he points out that definitions of mental illness have been historically and culturally relative. He says, “If you are defined as ‘mentally healthy’ or ‘mentally ill’ within a cultural context, it’s quite clear that many people see the changes that are undergone by people in running as crazy, disturbing. Using that basis, it’s very clear that running may be dangerous for your mental health.”

He recalls his first awareness that people might perceive it that way; it was years ago when he was speaking at Loma Linda University. “I described some of the changes and a woman in the audience asked, ‘How can I run and not have these emotional changes? I don’t want them.’

“I was startled! I said, ‘You don’t want to feel better? You don’t want to be happy?’ And she said, ‘No. I don’t.’ And I didn’t know how to answer her. But I knew what she meant. She did not want to disturb her life.” He imagines many people may shrink all the more from long-distance running when they realize it could lead them to mystical visions, divorce, membership in a third sex.

He won’t drop the point. “Doggone it! It happened to me! I experienced effects from running that weren’t necessarily what I wanted in my life. It would be morally incorrect and very derelict for me to say, ‘Hey, do this. Everything’s going to be just wonderful. You’re going to feel better and you ’re going to be healthier and all this stuff.’ Instead, I’ve got to say, ‘You may be feeling better, but your personality may change and other people may say you’re crazy. And you may run into things that are not going to make you feel wonderful. They may disturb the living hell out of you. They may change and switch a lot of things that are going on inside of you. And it may not be comfortable.”

He says he himself never would have started running had he known all that would happen to him — if he had known that he would lose a beloved wife, that he would “almost die” as a result of being fired from Mercy Hospital, that he would be prevented from seeing three of his daughters as a result of not being able to pay child support. “I think people should be forewarned,” he says evenly. He also sounds as if, at this moment, he has never been happier in all his life.

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Kostrubala admits that he flinched a bit at the picture of Teresa and him in the hot tub. (US magazine, Dec. 1977)
Kostrubala admits that he flinched a bit at the picture of Teresa and him in the hot tub. (US magazine, Dec. 1977)

Thaddeus Kostrubala was jogging when he had the vision. As a long-distance runner he was accustomed to hallucinations, but this one turned out to be rather significant. The psychiatrist was up in the Sierras of northern California when he saw an extra mountain, one not normally there.

After that hot tub debacle, Kostrubala fled to the mountains, where he continued to receive letters from readers of his 1976 book, The Joy of Running.

“Did I really see it?" he asks unemotionally. “Yes.” In a moment, he also saw God, dressed as Moses, descend from the mountain and display a tablet inscribed with the commandment, “Thou shalt have a sense of humor.” Then God went back up the mountain. Time passed. Finally God returned with a second commandment, but before Kostrubala could read it, God started chuckling. Soon Kostrubala was chuckling too, and then the two were belly-laughing, clutching their sides and rolling around on the dirt road. “You see. it was obvious that if you accepted the first commandment, then there couldn't be any others!” says Kostrubala. He becomes convulsed with mirth at the memory. “You couldn’t take any other commandment seriously!”

His cardiologist invited Kostrubala to join a brand-new running program for patients with coronary heart disease.

This, then, is how Kostrubala explains why he has returned to his old jogging grounds in Del Mar to found an international organization of runners. Many San Diegans will recall Kostrubala as the original “running shrink.” touted as a successor to Freud and Jung for his theories that running can cure mental illness; others will doubtless remember the headlines two years ago when Mercy Hospital announced it had fired Kostrubala as director of psychiatry for appearing in an US magazine photograph which showed him hot-tubbing with his fiancee (now his fourth wife).

Tad and Teresa have been getting up at 5:30 a.m. with Tad’s two young children from his marriage with Ann and the four run on the beach.

After that debacle, Kostrubala fled to the mountains, where he continued to receive letters from readers of his 1976 book, The Joy of Running. He says it was one of those letters, from a former mental patient who had read the book and jogged his way to normality, that inspired him to develop an organization that would even more actively encourage novice runners. But he was afraid.

Diann Shipley and her boyfriend, Hans Stewart decided to quit their jobs and devote all their time to developing “the movement.”

And then he had the vision. “That was the thing that released me. I had been holding back, but it was like, okay, now I can go. ” So he returned to San Diego and purchased a modern two-story house on Tenth Street just a block from the beach in Del Mar. It is now home not just to Kostrubala and his entourage, but also to the International Association of Running Therapies.

He touched upon some of the psychological changes reported in “normal” runners: a sense of euphoria about forty minutes into the run.

When he stands in the doorway, dressed in wrinkled yellow satin running shorts, a bulky turtleneck sweater, and thongs, he seems taller than his five foot, eleven inches. Although his face has a pudginess which all the running in the world won’t strip away, his light blue eyes are arresting, powerful. He has a special talent for putting people at ease; they uniformly call him Tad rather than Dr. Kostrubala. He has a quick, self-deprecating sense of humor, and a tendency to swear a lot. It’s from my Marine past,” he says. “I think it’s communicative. ”

Kostrubala’s fifty-year-old body is lean. His legs, furry with blond hair, are muscled, and he retains just a trace of his former slouch. It’s very hard to imagine the body which used to be his; 230 pounds massed in a big belly, a fatty hump between his shoulder blades, and fleshy thighs, all topped by a face hidden behind a thick beard and mustache. That was ten years ago, and his corpulent, sedentary, alcoholic figure was a predictable result of the injurious life he had been leading.

For a model, Kostrubala had his father, a hard-driving, Camel-smoking Pole who immigrated to Chicago at the age of ten and who accumulated degrees first in dentistry. and then in medicine. Finally he settled on a career as one of the early developers of plastic surgery. Young Tad, born on the South Side, had a childhood marked by much movement (he went to eight different grammar schools and four different high schools) but little physical activity — high school tennis was his only sport.

Even that bit of exercise ceased when he entered Northwestern University, where Kostrubala buried himself in anthropological studies. “The whole study of man's origin and past was an obsession with me. I was terribly attracted to anthropology, Egyptology, and so on.” But before he had a chance to develop that fascination into a career, the Korean War intervened. Kostrubala joined the Marines and soon began to think of becoming a career military officer. Pure chance swerved him off that course when Kostrubala’s orders to fight in Korea were suddenly changed. Instead he was sent to Virginia, where he began taking pre-med courses at night and eventually went to medical school at the University of Virginia. Repulsed by what the life of a surgeon had done to his father (who had a heart attack at sixty-five and then died of cancer a year later), Kostrubala chose psychiatry. He returned to Chicago in 1959 at the age of twenty-nine, did his residency work, and by the early Sixties his practice had begun to thrive.

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At one point he maintained five separate offices; then he cut back on his private practice in 1963 when he became director of mental health for the city of Chicago. He set up mental health clinics for ghetto residents, became an outspoken and highly publicized critic of Timothy Leary’s advocacy of hallucinogens, counseled Chicago cops and radicals bent on bashing in each other’s heads. And as his professional reputation gathered weight, so did his body. He also indulged himself materially. He drove a red Jaguar XKE roadster; worked on the fourteenth floor of the building at 8 South Michigan Avenue, in an office overlooking the prestigious Chicago Yacht Club, where he maintained a thirty-four-foot Morgan sloop. “It was big-city time,” he recalls. “I was into leather coats and all that crap.”

Finally, at thirty-nine, newly married to his third wife, Ann, “tired of all the bullshit,” he fled to Portland, Maine, where he established a community psychiatric program. Again his practice flourished, but “there wasn’t any meaning in it,” Kostrubala recalls. With “the express purpose of engineering a change,” the family sailed the sloop to the Bahamas, but the voyage failed to fill Kostrubala’s sense of emptiness. One day, stuck in the snow in his enormous driveway, “I said to myself, ‘I’mcrazy to be here!’ I looked at the fuckin' map and I said I ’m going to get the hell out of here. I put my finger on San Diego, and said, ‘That's where I’m going to go.’”

At a national psychiatric convention in Washington, D.C., a few months later, Kostrubala, who hadn’t yet acted on his impulse to move, met Dr. Stuart Brown, then the director of psychiatry at Mercy Hospital. From him Kostrubala learned that Mercy was looking for someone to expand the hospital’s mental health services. The former Chicagoan secured the position easily and in September of 1971 he and his wife moved into a home on Oribia Road, up the hill from the Coast Highway in Del Mar. Once again he began producing brilliant professional sparks; he established departments of out-patient mental health services and two hospital-sponsored education programs. But all the sparkle in his personal life had dulled. “Somehow I was a failure and I knew it,” he recalls in his book. “Discontent, self-loathing came up from below. Some soulsaving grace, some guardian angel arranged enough vision for me to stir powerful currents of depression. This was an accurate self-appraisal. Alcohol had become my drug of choice. I was tense, fat. ” Finally, fear of a coronary goaded him into seeking a thorough medical exam on his forty-second birthday, eight years ago this past September 22. Cardiologist John Boyer’s opinion was grim: with Kostrubala's high cholesterol, rising blood pressure, and fifty pounds of excess weight, he was a prime candidate for a heart attack. Then Boyer offered an unusual suggestion; he invited Kostrubala to join a brand-new running program for patients with coronary heart disease. Kostrubala records in his book, “If I had any doubt about the seriousness of my condition, it evaporated at that point. I was to be treated along with those men who had survived the dreaded killer. I wasn’t a colleague any longer; I was a patient.... I especially didn’t like the thought of being together with those men whose hearts had already been damaged. I had an odd fear of contamination. Perhaps in some crazy way, I would ‘catch’ having a coronary.” Still, his initial fear proved the stronger emotion, and he submitted to the tests which Boyer required of all the beginning runners, tests which pushed the patients’ cardiovascular systems to their limits. From this, Kostrubala and the cardiac patients learned how to tell (by taking their pulses during exercise) when their hearts were functioning at seventy-five percent of their capacity, the safe limit at which physical conditioning takes place. He submitted further — to the humiliation of puffing around the grassy grounds of the Francis Parker School on Linda Vista Road overlooking Mission Valley — lumpy, sweating, terribly self-conscious. The group met Tuesday and Thursday afternoons and Saturday mornings. About two months into the program the psychiatrist went through a period in which he would stop at a liquor store on the way to the session, buy a pint of vodka, then “sit and furtively gulp the burning white liquid enough to ease my fear before I ran.” But gradually he progressed. Kostrubala says that the research literature of exercise physiology has proven that what happened was inevitable. Almost any human being following the same pattern — spending forty minutes three times a week in exercise which increases the heart rate to a sustained three-quarters of its capacity — will undergo a similar physical conditioning, although it might take some individuals a month and others a year to reach the point where they can safely and comfortably run a mile. It took Kostrubala about two and a half months. Just prior to being retested at three months, he continued to doubt his progress; still more than 200 pounds, he hadn’t changed his eating, drinking, or work patterns. But that second round of electrocardiograms, pulse tracings, and blood pressure readings confirmed that dramatic, almost incredible physical changes were occurring within Kostrubala’s puffy frame.

He says it was about that same time that he noticed the phenomenon which was to revolutionize his professional work: he observed that he and his fellow runners not only seemed peppier, but also less depressed, more cheerful. The psychiatrist in him was intrigued; he began quizzing his own wife and the wives of his fellow trainees, and almost all confirmed that their mates were displaying subtle personality changes. About four months into the running, Kostrubala decided to take a small group of nearly hopeless patients from his psychiatric practice at the hospital and run with them. Today he insists that at that point he had no expectations, just a curious hunch.

They must have seemed a strange pack, six crazy people led by their hairy, ungainly leader, stumbling around the track down the hill from the Parker School’s buildings. They assembled late afternoons on Mondays, Wednesdays, and Fridays. After the exercise, they would meet in a classroom for a group discussion. Among them were a severely depressed young women in her thirties who was dependent on antidepressant drugs, and a paranoid schizophrenic young man of about nineteen who “was barely able to function,” Kostrubala recalls. “He would sleep in bed until ten or eleven every morning and his girlfriend took care of him. He went to one class a week. And that’s it. Vegetating. Heavy medication.” The group also included a girl in her late teens suffering from anorexia nervosa, the neurotic refusal to eat. She had been hospitalized and tube-fed twice, had long stopped menstruating. Another woman a year or two older was using “every.drug under the sun.” Another man, a heavy smoker and drinker in his later forties, was chronically depressed and coronary prone. A second paranoid schizophrenic in his early thirties rounded out the group. Within weeks, Kostrubala began seeing results.

By his recollection, all six patients, all of whom had seemed stuck at plateaus in their therapies, began responding in their individual sessions with Kostrubala. They were talking more, sharing with him more significant details of their lives. About two to three months into the program, the group witnessed one frightening setback: the middle-aged schizophrenic went completely psychotic and dropped out of the program, an effect which Kostrubala chalked up to the fact that that individual had undergone electroshock therapy about seven years earlier. In all the other patients, the psychiatrist noted remarkable improvements. At the same time, Kostrubala began hearing accounts of similar experiences.

By that point, he had expanded his own running far beyond the circle of the Boyer group. He began training to run in a marathon and met other runners. Some confided stories which amazed the psychiatrist. “I would listen to a person tell me the story of how they had gotten to where they are now, and they would tell me a complete diagnostic tale of the recovery of a paranoid schizophrenic. ” Gradually and selectively he began running with his patients on an individual basis; he still recalls the first one, a person suffering from depression. “I said. ‘It seems to me that there are two ways we can go. One, we could try the medication (antidepressants) and we can sit and talk, or maybe we can go on out and we’ll walk and jog together and see if that works instead.” The patient chose the second alternative, “and that’s when I discovered that the treatment of depression with this is so fast. ”

Yet he says the clear “aha!” didn’t strike until about a year after the formation of the first group, when Boyer invited him to report on his work to a meeting of cardiologists and exercise physiologists. The psychiatrist delivered a very short paper. He talked about his running patients and touched upon some of the psychological changes reported in “normal” runners: a sense of euphoria about forty minutes into the run, changes in perception. And he says his listeners reacted weirdly. For a long moment after he finished talking, he heard no sound at all. “Then about half the audience started coming toward me. I was startled! Frightened.” Finally, a long-distance runner broke the silence by declaring that all the psychological changes Kostrubala had just described in “normal” runners had also occurred to him, but that he had never seen them reported before. “That proved to me that the experience I had had with my patients was not just limited to me,” Kostrubala says.

He had a choice then, by his recollection. He figured he could continue to test his developing theories scientifically, attempting to report on them in the medical journals, or he could try to take his early findings directly to the public. He says he suspected that his professional peers would react with hostility so he chose the second path; he sent the short paper around to publishers. An editor at Lippincott delighted him by championing the idea and winning for the doctor a book contract. The firm offered him an advance of $3000 and Kostrubala, ever the symbolist, suggested a more meaningful figure — $2638.50 (a marathon is twenty-six miles, 385 yards long). Lippincott didn’t argue.

Kostrubala worked on the manuscript throughout 1975, finishing about late December. Months before publication, the “running shrink” began to garner notoriety — the first stories appeared in the Union and Tribune and in scattered other publications. As his file of publicity clips thickened, Kostrubala settled into a steady pattern with his personal running, logging an average of about ten miles a day. In the spring of 1975 he had started Sunday-morning gatherings at the information booth on Mission Bay, and these “marathon clinics’’ (which continue today) began attracting hundreds of participants. As the last of his excess weight melted away, he shaved off his beard and mustache (later, for a period, he also shaved all the hair on his head). But a tension was building in Kostrubala’s life, an irony was deepening. As his newly sleek figure loped into the spotlight, he began to have cause for doubting the benefit of running on his personal life.

After his conversion to running, Kostrubala had encouraged his wife, Ann, to join him, and she had done so, first tentatively, then with enthusiasm. She had completed five marathons by the fall of 1976 when Kostrubala came home one night and she announced that their marriage was over. He was stunned by Ann’s assertion that she felt the move was essential to the growth of her personality. Today he says gravely, “Running is a very powerful agent of change. ” He cites a study by Dr. Paul Milvy of the Mt. Sinai Medical School in New York City which showed the divorce rate among marathoners to be 300 times higher than that in a comparable, nonrunning population.

Professional clouds had also begun to shadow him. Although Kostrubala in 1976 replaced Stu Brown (who went into private practice) as Mercy’s director of psychiatry, the runner keenly felt the reaction of his colleagues to his outlandish assertions about the impact of running on mental health. As demands upon him from individuals seeking running therapy increased, Kostrubala trained a few assistants. The first was Ozzie Gontang, a graduate student in rehabilitation counseling at San Diego State who’d taken a course with Kostrubala. The second was Teresa Clitsome, a USIU student who had volunteered to work in Mercy’s mental health unit while getting her master’s degree. But Kostrubala’s fellow physicians began avoiding talking to him about his work with an iciness that spooked him. “I heard what other people said other people said. No one ever said it to me. I would have loved to have tangled with someone in some way, but as it was, I was frozen out. If you really want to know, I had absolutely no support at all. Nobody. Nothing at all. The only things were innuendos and criticism.”

That fall (1976) The Joy of Running appeared, and the public response to it somewhat balanced the professional cold shoulder. Lippincott’s timing was perfect; the book hit the shelves just months before public interest in running exploded. (To date the book has sold about a quarter of a million copies, including editions in Japan, Australia, New Zealand, Italy, England, and Mexico, and eight paperback printings here.) Kostrubala began receiving daily mail from fans, but again the increased notoriety wasn’t all positive. He recalls being stopped one day by one of the nuns at the hospital, who announced, “I used to like you. You used to be jolly and fat and stuff like that. Now you’ve started all this running, I don’t know if I like you anymore.” Today the psychiatrist dissolves into pained laughter at the memory. “I was like, ‘Woo-ah. What did I do?’ ” He brings his arms up as if to protect his head, laughing harder, retorting to his reproacher, 'I'm trying to save my ass and you’re pissing on me.’ This was really happening all the time! It was funny. I would hide."

Despite such rejections. Kostrubala felt that his overall relationship with Mercy’s nuns was good. In fact, in 1977 he had intensified his drive to re-establish himself in the Catholic Church’s good graces. Born a Catholic, he had fallen away from the religion, become an agnostic, a Southern Baptist, an Episcopalian. But as he became a runner, he had begun to yearn for the mystery and pageantry of the church of his youth. He and Ann had even been re-married in the chaplain’s office at Mercy Hospital by Monsignor Henry Keane, and Kostrubala had begun receiving the Catholic religious sacraments again. After his divorce from Ann, Kostrubala learned that Keane hadn’t filled out the required papers correctly, rendering the marriage invalid in the eyes of established Catholicism. That was fortunate, because by the fall of 1977 Kostrubala was hoping to have his upcoming marriage to Teresa Clitsome so sanctified. In fact, Teresa was taking religious instruction and Kostrubala was talking to I. Brent Egan, chancellor of the San Diego Catholic diocese, about reentering the church at the time that US magazine approached him for an interview.

Kostrubala recalls routinely clearing the magazine’s request with the hospital’s chief executive. Sister Joanne, as well as with the director of personnel and the public relations department. The psychiatrist says none of them balked, so he spent several hours with the US writer and local free-lance photographer Ted Lau. He thought little further of it until early in December of 1977, when one morning’s mail brought him both the most recent Annals of the New York Academy of Sciences and the December 13 issue of US. The highly prestigious scientific publication included two psychological studies produced by Kostrubala, Clitsome, and Gontang, focusing on marathoners. The copy of US featured on its cover a huge photo of Jaclyn Smith. One of the headlines next to it blared, “Doctor’s RX; Run Your Way to Mental Health,” a promotion for the story on page forty-six about “San Diego’s jogging shrink.”

Kostrubala admits that he flinched a bit at the picture of Teresa and him in the hot tub. He hadn’t previewed the breezy content, so he read for the first time such tidbits as Teresa (“heir to a $3.5 million real estate fortune”) describing the “Kostrubala jogging clan” as “more than a circle of close friends," and his own assertion that he and ex-wife Ann were planning a “divorce ritual.” Today Kostrubala assesses the overall tone as “really positive — but it was within the framework of how US writes its stuff. ” He showed both publications to Sister Joanne. Her immediately negative reaction distressed him, but he and Teresa nonetheless headed for Hawaii and the annual Honolulu marathon.

Upon his return, the executive nun summoned Kostrubala to her office and gave him an ultimatum — either quit or be fired from the $60,000-a-year position. The order dumbfounded him. both by its unfairness and its swiftness; the hospital had already prepared his final paychecks. He chose being fired, packed up, and moved out of his office December 15. It took nearly two months for the hospital to announce its decision to the press, and then the assistant administrator insisted Kostrubala’s competence wasn’t in question. Instead the administrator said the implication that the doctor and his fiancee were nude in the tub together “does not reflect favorably on a Catholic institution.” (Kostrubala has always insisted they were clothed.) The administrator continued, “What was in the magazine was not in concert with the Sisters of Mercy and conduct that we would like from a leader in our institution.”

“My first reaction was, ‘Well, they must have a good reason for what they did. I must be wrong.’ I really had the feeling, ‘Jesus, I’ve made a terrible mistake,’ ” Kostrubala says today. He and Teresa fled to a home she owned up in Mammoth, and he says, “I literally withdrew. I didn’t want to do anything.” He kept expecting the phone to ring, for it to be the nuns, declaring (hat they had erred, asking him back. As the months wore on he halfheartedly investigated the possibility of taking legal action but was told that any battle against nuns would be doomed to failure. Finally, he found a lawyer who disagreed, and the day before statute of limitations would have prohibited litigation, Kostrubala sued the hospital for “breach of oral permanent career contract and intentional infliction of emotional distress.” He asked for $4.75 million — an amount calculated to include the loss of his salary and to compensate him for the “shame and humiliation” he suffered. The action continues today to plod through the legal system. “It’s terrible. I dislike it intensely,” Kostrubala says. “But I have no alternative. It’s a matter of it must be cleared out; it can’t stay there. I'm not built that way. It’s not my nature.”

He says it took another full year for him to recover from the shock of the firing. Only toward the end of last year did he again begin to focus on the subject dearest to his heart: the psychological impact of running, what explains it, what it means.

He had long before concluded that running does more to the mentally ill than simply make them feel fitter. He cites the example of one man who walked up to him at a marathon in September of 1978. The stranger introduced himself and reminded Kostrubala how they had chatted briefly in the Mercy Hospital cafeteria a year earlier, at a time when the man had been seeing another psychiatrist. In his thirties, the man had been diagnosed as a manic-depressive; he’d been hospitalized repeatedly and he was dependent on drugs when he decided to read The Joy of Running. Yet here was the same man at the marathon, radiating health, testifying how he had gotten off the medication, freed himself of the need for counseling. ‘‘Now what do you do with somebody like that?” Kostrubala asks. ‘‘That’s not just feeling better. This guy found something for himself that changed his life, that in a specific diagnostic sense altered it.” The psychiatrist plucks out yet another anecdote about the schizophrenic young man who had been vegetating when Kostrubala formed that first group. After becoming a runner, he finished undergraduate school, then acquired a master’s degree and had an A-minus average. Now he holds a steady job. “Total switch,” Kostrubala says. “That’s not just feeling better.” Furthermore, independent researchers had quickly begun to confirm Kostrubala‘s clinical observations. Two major studies from the Universities of Wisconsin and Virginia concluded that running alleviates depression. Others reported general personality improvements. Kostrubala says as yet no one has scientifically studied the effect of running on schizophrenia, but he claims that he personally has seen fifteen to twenty schizophrenics markedly improve — to the point of the symptoms totally disappearing.

Kostrubala says it was the weight of such accumulated evidence that forced him finally to come up with “a whole new interpretation of how we are put together.” He still remembers the night his thoughts coalesced. He was sitting in his Oribia Road home, writing The Joy of Running, sifting through all that he’d seen, when suddenly he understood that nothing in Freudian or Jungian or any other established psychological theory could explain why taking people out and making them put one foot in front of the other could dramatically change their hearts and minds. And then all Kostrubala’s passion for anthropology surged to the fore. It struck him that he’d never get the answer from modem man, tied and suited and ensnared in the perverse zoos of modem cities. One had to consider the whole of human history, to engage in what he later called “paleoanalytic thinking. ” When he looked back, he beheld four million years of evolutionary history which not only sculpted the form of the present human body but which, he concluded, also left its powerful residue on the human mind, the human soul.

It is critical to remember, Kostrubala stresses, that for the roughly four million years during which genus Homo has existed — during that ocean of time — humans lived in running, hunting, gathering, mobile tribes, the demands of which made them the best long-distance runners on the face of the earth. Does that seem strange? Kostrubala answers that many cats and antelope can sprint faster for short periods of time, but no creature can endure sustained long distances as can the human (and his friend, the dog, who learned long-distance running from its human masters, Kostrubala asserts). He offers examples of primitive tribes that still demonstrate the ability: the Tarahumara Indians of Chihuahua (Mexico), who run daily through their rugged, mountainous homeland and occasionally hold 150-mile races for pleasure; the lone aborigine who jogs after his kangaroo target all day and into the night, then sleeps when the kangaroo sleeps; in the morning, he kills his prey, which is too stiff to resist or escape. He tells how North American Indians used to catch turkeys by literally running them down. But the psychiatrist asserts that even the urban executive, who has lived all his life in the city/zoo, bears some part of man’s running heritage; it lies in a deeply submerged section of the mind which Kostrubala calls the “paleoanalytic consciousness” (he says this is the foundation for Jung's “collective unconscious” and all other layers of the mind). And when that executive dons running shorts and takes to the road, the slow, sustained movements strike a chord which resonates through the individual’s primordial soul, and those vibrations often jar the person’s entire way of life.

Thus, in Kostrubala’s eyes, running began to shape up as not merely one among ten or twenty possible vehicles for becoming physically Fit. Instead, he says, evolution has woven it into the very fabric of human nature; biology has ordained that man should run. When man doesn’t, biology takes vengeance — by distorting bodies and warping personalities, and it warps a few into severe derangement. When the trained therapist runs with the deranged individual, he can assist as the physical activity alone causes changes in the subject’s personality; he can help steer the subject, who will be driven by the running itself back to normality.

“Freud invented the couch and psychoanalysis. I invented the use of running as a tool in paleoanalytic psychology!” Kostrubala says triumphantly. At first it seemed clear to him that the role of the “running therapist” shouldn’t differ that drastically from the traditional psychoanalyst. The former had to be a runner and also had to share far more of himself than the traditional Freudian- or even Jungian-style counselor, but the running therapist should come from a traditional mental health field and have intense exposure to psychiatric therapy, Kostrubala believed initially.

In the Sierras, however, he began to re-evaluate the necessity of using a trained psychotherapist to reflect on some of the cases he had seen. “Heh, heh, heh,” he chuckles today. “Give you a story. Heh, heh, heh.” He describes the nineteen-year-old schizophrenic who came to his office at Mercy Hospital one day. Kostrubala says, “Once you recognize what a ‘process schizophrenic’ looks like, you never forget them. He stood there, staring vacantly. He knocked on the door of my office, didn’t even walk in. Just stood there like a zombie. Couldn’t keep one thought together. Said [mimicking the kid’s dulled tone], ‘Can I be your patient?’ I said ‘No. You’re somebody else’s patient. Go away. Get him out of here.’So he goes and asks his doctor, ‘Can I become Dr. Kostrubala’s patient?’ And the doctor says, 'Sure! Oh yeah! That’s wonderful!’ ”

Kostrubala says when the youth returned and asked what to do, Kostrubala brushed him off by telling him to read The Joy of Running and to run by himself, warning he could only spare a half hour a week to talk. That was in May. “Kid came in in June. Every half hour he saw me, he got worse; I thought. ’Oh God. This is really great therapy. This kid is crazy as a bed bug. He’s crazier! I mean he just looks really nuts.’ It’d almost be funny if it weren’t so pitiful.” But at the end of July, the youth began claiming that he felt “normal” when he was running. “I said, ‘Yeah, sure.' August, he starts getting better daily. So finally he asks about running therapy. By then I felt guilty, so I agreed. So we go running and at the end of it he says, is this what you call running therapy? I don’t need you.’ ”

Kostrubala tentatively agreed, but asked the boy to join the marathon clinic. He says every month the young man appeared less discemibly different from the rest of the crowd. He finally ran a marathon in January “and that kid didn’t look any different from any other marathoner finishing. He looked identical. He was finished. He was done."

Combined with cases like that was Kostrubala’s growing conviction that people trained in traditional psychological theories often found it harder to overcome their prejudices and accept this new mode of therapy. So Kostrubala began to envision training a radically expanded group of running therapists to spearhead a “mental health movement.” It was only this past spring that he saw his vision in the mountains, got the psychic go-ahead. By then he had acquired two disciples willing to commit themselves to forging the movement with him and Teresa.

One was Diann Shipley, a thirty-five-year-old checker at the Safeway store in Bishop, who had turned to Kostrubala for counseling after her seventeen-year marriage broke up last fall. When her depression dissipated after just two months of learning to run with the psychiatrist, Shipley felt a calling to help Kostrubala spread the good word. She assisted at the February conference organized by Kostrubala to launch his fledgling organization. The gathering so inspired her and her boyfriend, Hans Stewart, that they decided to quit their jobs (he was the assistant manager at the grocery store where Shipley worked) and devote all their time to developing “the movement.” In late March, the pair moved to an apartment in Del Mar just a few blocks from the home on Tenth Street in which the Kostrubalas had settled a month earlier. Shipley and Stewart’s combined savings began to run out in the middle of June. They began living on credit cards. Shipley sold her horse and corral in Bishop; Stewart borrowed money from relatives in Germany. “We’ve just been begging, borrowing, and stealing,” Shipley says cheerfully. Finally, in August she and Hans began camping on the floor of the Kostrubala home, anticipating the day when organizational funds will begin to flow in from membership fees.

In the interim, they and the Kostrubalas have been working to develop a grandiose structure for IART (they pronounce the abbreviation for the International Association of Running Therapies “eye-art”). “It will be very much like est, except that we don’t have that hokey bullshit,” Kostrubala says. Shipley, who has assumed the title of IART public relations and membership director, hauls out beautiful, hand-drawn charts, showing the organization’s two distinct components. One will include the actual “running therapists,” whom Kostrubala will train for a $400 fee; the only requirements for becoming one are the completion of two marathons a year and the possession of any societally recognized “people-handling” certificate; anyone from a barber to a masseuse to a psychotherapist is eligible, Kostrubala declares.

IART’s second component is aimed at the general public; here Shipley wields a chart abloom with colors. Members pay eighty dollars a year. For that they get an IART T-shirt (red), nine weeks of training in how to run (with the nine two-hour lessons patterned after the nine chapters in Kostrubala’s book), and additional benefits such as a newsletter. Teaching them will be ‘‘Kostrubala trainers” (”K-trainers” for short, in orange T-shirts), who will guide up to thirty students at a time. (“Thirty is the largest possible number with which significant interpersonal communication can take place,” the psychiatrist notes.) For every four K-trainers, there will be a supervisor (yellow T-shirt). For every four of them, a green, on up through blue, indigo, and violet (by which time 153,000 members would be involved). The whole plan reeks of symbolism, and Kostrubala loves it. "Thirty is the tribe. Seven is the extended family,” he bubbles. “The duo is the triad ...” The first class for members is now set to begin October 18 — at the Kostrubala home. The pace is building. Recently, Tad and Teresa have been getting up at 5:30 a.m. with Tad’s two young children from his marriage with Ann. Mondays, Wednesdays, and Fridays the four run on the beach; Tuesdays and Thursdays they go belly-boarding in the dim light of dawn. This particular day at their home the phone begins ringing early; it’s a woman whom Kostrubala has never met. A former probation officer who read The Joy of Running, she wants to become a running therapist. Shipley schedules an appointment for her to meet with Kostrubala that noon. The psychiatrist relaxes on the long sofa in his living room, with its dramatic sky-and-sea panorama, and he returns to explaining the point of all this IART hullabaloo,

He thinks there’s a need for organized efforts to attract and support runners because humans need to be nudged into running. Although the activity may be inseparable from human history, it doesn’t come naturally. “Even runner-hunters don’t like to run or move,” he lectures. ‘ They will do everything they can to avoid that. The favorite activity of runner-hunters is to have great big orgies. They like to eat a lot and sit around. That is heaven.’’ So, paradoxically, longdistance runners “are going against our running, hunting nature,’’ he says. “They’re exercising an increase in consciousness. You have to make yourself do that.” IART will help by leading neophytes step by step.

The phone rings again. It’s a call from Florida, from a physician/runner who has just read Kostrubala’s book and is concerned about the statement that running stimulates the thyroid. The caller says he is taking thyroid medicine and worries that the running might interfere with it. Kostrubala has known runners who’ve “burned out their thyroids,’’ so he advises the doctor to consult a running endocrinologist. He returns to the living room just as the mail is arriving. It contains a letter from a rabbi in Rochester, New York, who volunteers to speak on “Running and Religion’’ at an upcoming IART conference.

When asked about his expectations for IART, Kostrubala is self-effacing; he says he hasn’t the faintest idea how the enterprise will fare. It’s as if he knows that the elaborate plans verge on sounding pretentious, and, cagily, he wants to be the first to mock himself.

In fact, the planning for IART only consumes part of his time. He’s also writing a play, completing a children's book, polishing a mystical account of his third annual marathon, which he organized in Mammoth on August 15 to celebrate the feast of the Assumption of the Virgin Mary into heaven. He’s also planning a sequel to The Joy of Running, which will focus, at least in part, on long-term changes which Kostrubala now believes long-distance running can stimulate.

Some people develop parapsychological abilities, he claims. Some begin seeing angels and having other mystical experiences. “I’m talking about straightforward, uncrazy people who don’t begin running because they’re seeking these types of experiences.” Like some storyteller sitting around the campfire, he spins out another long, complex theory to account for such startling phenomena. Thinking paleoanalytically. he asserts, leads him to suspect that ten percent of the human population has always consisted of “genetic throwaways,’’ a group which has always contained the world’s schizophrenics, its artists, its priests. He postulates that humans in this group have the heaviest genetic load of imagination and thus are most susceptible to the dramatic breakthroughs in consciousness that long-distance running can induce. But he warns that any runner may be touched by these and other amazing changes, both psychological and physical. Longdistance runners tend to become more and a more individualistic, more religious, more apolitical, according to Kostrubala. Physical indices of aging seem to stop. It may cure cancer, he says. And it seems to be leading to the development of a “third sex” — women who stop menstruating (because their percentage of body fat drops to such a low level). “They look like what nuns should look like,” he adds. “I know of one woman who stopped menstruating five years ago. I’m enthralled by her.”

But Kostrubala says the public should be warned about such strange side effects, and he really means it as a warning. Paradoxically, it seems that he has come full circle, from saying that running makes you sane to running makes you crazy. He mentions that the University of Nebraska will soon publish a paper of his in which he points out that definitions of mental illness have been historically and culturally relative. He says, “If you are defined as ‘mentally healthy’ or ‘mentally ill’ within a cultural context, it’s quite clear that many people see the changes that are undergone by people in running as crazy, disturbing. Using that basis, it’s very clear that running may be dangerous for your mental health.”

He recalls his first awareness that people might perceive it that way; it was years ago when he was speaking at Loma Linda University. “I described some of the changes and a woman in the audience asked, ‘How can I run and not have these emotional changes? I don’t want them.’

“I was startled! I said, ‘You don’t want to feel better? You don’t want to be happy?’ And she said, ‘No. I don’t.’ And I didn’t know how to answer her. But I knew what she meant. She did not want to disturb her life.” He imagines many people may shrink all the more from long-distance running when they realize it could lead them to mystical visions, divorce, membership in a third sex.

He won’t drop the point. “Doggone it! It happened to me! I experienced effects from running that weren’t necessarily what I wanted in my life. It would be morally incorrect and very derelict for me to say, ‘Hey, do this. Everything’s going to be just wonderful. You’re going to feel better and you ’re going to be healthier and all this stuff.’ Instead, I’ve got to say, ‘You may be feeling better, but your personality may change and other people may say you’re crazy. And you may run into things that are not going to make you feel wonderful. They may disturb the living hell out of you. They may change and switch a lot of things that are going on inside of you. And it may not be comfortable.”

He says he himself never would have started running had he known all that would happen to him — if he had known that he would lose a beloved wife, that he would “almost die” as a result of being fired from Mercy Hospital, that he would be prevented from seeing three of his daughters as a result of not being able to pay child support. “I think people should be forewarned,” he says evenly. He also sounds as if, at this moment, he has never been happier in all his life.

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