A recurrence of her cancer made Pennsylvania dentist Dr. Caroline Hsu determined to bounce back—big. When she told her Benco Territory Representative, Jason Sturm, that one of her goals post-chemo was to complete a grueling Half Ironman, his response was swift and succinct: When do we start?

 By Elizabeth Dilts

WHEN DR. CAROLINE HSU was diagnosed with breast cancer for the second time at age 42, she knew she had to be strong. She had been in remission for a decade and told there was almost no chance her cancer would return. As she gazed that day at her toddler son, Mason, she thought, “I’m looking at someone who needs a mom.” So she steadied her nerves, bought a very good wig and prepared herself to work straight through her incipient chemotherapy regimen.

What she never expected was a major boost from what at first might have seemed an unlikely quarter: One day she got to work to find a delectable smoothie loaded with fruits and vegetables, homemade and hand-delivered by Jason Sturm, Dr. Hsu’s Benco Dental Territory Representative.

The benefits of those chemo-cure concoctions—usually a combination of kale, banana, pineapple, berries and coconut milk—were twofold: One, they helped Dr. Hsu maintain her energy during a debilitating time, and two, they cemented her burgeoning friendship with Sturm, who has worked with the doctor since his first days at Benco as a service technician, beginning in 1999.

Their relationship has been varied: Sturm helped Dr. Hsu update the practice she had purchased from an older dentist in Lansdale, Pennsylvania, some 30 miles north of Philadelphia, in 2006, and transformed into All Smiles Family Dentistry. She in turn had hired Sturm’s wife, Megan, to work in her front office. And Sturm cheered her when she landed a spot on Incisal Edge’s 40 Under 40 in 2012. (In her 40 Under 40 profile that year, she described running her dental practice according to the “Your Mama” rule: that is, treating all patients the way you’d treat your dear old mother.)

Now it was September 2017, around the time Dr. Hsu began chemo anew, and here came Sturm to her practice, armed with inspirational messages, videos and those smoothies. One day, mid-conversation with him, Dr. Hsu mentioned one of her ambitions for after this new bout of treatment was done.

“I knew I was about to get really sick, and I needed to know what I was going to do to get better,” she recalls. “What works for me is having a goal, usually a slightly ridiculous one. I said, ‘I’m going to finish chemo . . . and start training for a half-Ironman.”

Sturm—presumably exceeding the job requirements for a Benco Territory Rep by a good margin—immediately responded, “Let’s do it.”

Dr. Hsu was taken aback. “I was like, ‘What?’ ” she says. “ ‘I’m doing it.’ ”

Sturm, 44, recalls Dr. Hsu asking him if he was joking—and in fact she didn’t quite allow herself to believe that he would really go through with it until he emailed her a screen shot of his registration page for the Old Orchard Beach Half Ironman, which will be held this August 25 in the eponymous Maine town, just south of Portland.

Even in a half-portion, an Ironman is not for the faint of heart—or body. The half will consist of a 1.2-mile swim, a 56-mile bike ride and a 13.1-mile run. In other words: One must swim roughly the length of the Brooklyn Bridge, bicycle from Baltimore to south of Washington, D.C. . . . and then run a half-marathon.

“We’re going to get through this together,” Sturm, who had lost his father to cancer seven years earlier, told Dr. Hsu. “Not only your cancer struggles, but the race, too.”

01: MAKE SURE CANCER CAN’T

During one of her pre-chemo appointments, Dr. Hsu’s oncologist asked her about Mason, her only child. At the time, he was 2 and a half years old. Hearing that, the doctor told her gravely that she needed to be prepared for the possibility of Mason’s being afraid of her when she began to lose her hair.

“I was envisioning needing a hug and Mason running away,” Dr. Hsu says, speaking from the front seat of her family’s car en route to their weekend cottage in the forests of New Jersey. Throughout the early stages of her illness, Dr. Hsu and her husband, Michael O’Connell—a nuclear-medicine technologist—had managed to deflect Mason’s attention from the damaging effects the ailment was having on his mother. If he caught her crying, she says, they were usually able to “make some shenanigans up” to reassure him that everything was OK.

Losing her hair, though, would be a visual manifestation of the toll cancer was taking on her—one she wouldn’t casually or easily be able to explain away. So Dr. Hsu devised a creative solution: a shave party.

Surrounded by balloons, snacks and a dozen of her male friends and neighbors, she threw a haircut bash. One guest shaved his head first, followed by another and another. Dr. Hsu turned to Mason: “Do you want to shave Mommy’s hair?” The boy, she says, “mowed” tracks into her ink-black hair, footlong fistfuls falling to the floor of her home.

“It made a horrible thing tolerable,” she recalls. “I was just trying to figure out how you make this fun, and the only way you make this fun for a 2-year-old is to tell him it’s a party. If you show how [a situation] got from here to there, then they’re OK with it. If you show them here and there, but not how they’re connected, it scares them.”

The effort paid off. Mason was reassured—and, Sturm adds with evident surprise, Dr. Hsu’s preemptive strike made her staff and patients feel more at ease regarding their doctor’s serious illness. “I really respect the way she did it,” he says. “Eliminating the surprise was valuable. Why not do it and ease people in?” (At his next smoothie delivery, he adds, “I told her she looked adorable.”)

Adorable, yes—but still desirous of longer tresses now and again. So as the days passed, Dr. Hsu would don what Sturm deems “the most incredible wig ever” and went on with her work.

After four rounds of chemotherapy three weeks apart, she finished treatment right around Christmastime.

02: LET’S GET PHYSICAL

A week or so later, on New Year’s Day 2018, “I started a new boot-camp class,” Dr. Hsu says. “It about killed me.”

She had signed up for that old health-club standby—the New Year’s special that caters to holiday laggards who swear that this will finally be the year they get in shape. She got unlimited classes of high-intensity interval training for just $29. A friend accompanied her to that January 1 class. It was grueling, she says, but so much the better—because it marked, for her, “a mental reset date.

“It was like, ‘I’m done with that year,’ ” she says. “ ‘I’m done with treatment. I’m going forward.’ ”

Sheer will and determination carried her at first. She’d walk into the gym minus her wig, looking like “a monk. I wore a baseball cap, but I had that chemo look,” she jokes. “ ‘Don’t judge me! I just had chemo!’ ”

Her trainers modified the courses to her momentarily lessened capabilities, but even so she quickly came to recognize the limits of her post-cancer body. A lifelong runner, Dr. Hsu had completed nine half-marathons in the decade between her two bouts with the disease. (She quickly ticked off seven of them from her car—Philadelphia, New York, Chicago, Baltimore, Long Branch [New Jersey], Disney twice!—but was unable to place the other two.) Now, though, in her current condition, she could do just four jumping jacks before she was breathing heavily and forced to take a break.

“The hardest part of training was I felt like I was two different people,” she observes. “The person I remember is the one who could do an hour or two hours of exercise anytime. But I hadn’t exercised in over six months, because I was just too busy trying to survive. I was just trying to go to work, trying to go home, trying to raise my kid.”

Her mantra during this time: Challenge your body, then let yourself rest for two days. After six weeks of being so sore she could hardly stand, she finally began to feel stronger. She could jump in place. She could squat. After another month, she went for her first post-chemo run, a three-mile jog though her neighborhood’s flat sidewalks and streets.

03: TRAINING TEAMWORK

Dr. HSU’s PACE IS SLOWER than Sturm’s, and their schedules are just about opposite, meaning they do most of their training separately. But the Territory Rep has been keeping up his end of the pact.

He wakes most days at 4:30 A.M. and is at the gym by 5. He kicks things off with one of the three Ironman elements: a short swim, bike ride or run. Then weight training. Then home by 7 to help with breakfast and getting his 5-year-old son and 8-year-old daughter off to school. “I have no problem falling asleep by 10 P.M. at the latest,” he says with a laugh.

For her part, Dr. Hsu is now up to six-mile jogs twice a week with O’Connell, who runs alongside her pushing their son in a jogging stroller. They hit the streets together as part of a jogging club, and spend other days swimming or weight training at their local YMCA. O’Connell, as it happens, is training for his own half-marathon, scheduled for a few weekends after Dr. Hsu and Sturm will compete at Old Orchard Beach.

Meanwhile, back at All Smiles Family Dentistry, tongue planted firmly in cheek, Dr. Hsu faux-gripes that Sturm’s smoothie delivery has largely ceased. “Apparently when you’re not going through chemo anymore,” she says with a laugh, “you don’t get a smoothie.”

Sturm and Dr. Hsu keep track of each other’s training progress over social media and texts, sharing their programs and tips they’ve picked up. They’re both lifelong athletes, but she has more experience with open-ocean swimming of the sort the half-Ironman entails. Given that all swimmers are in close proximity to the other contestants, that’s the one portion of the competition that gives Sturm—an experienced indoor swimmer—some pause: “There aren’t a lot of elbows and knees kicking around close to your head when you’re swimming in the pool.”

Megan Sturm, the TR’s wife who has worked at Dr. Hsu’s practice, has some concerns about the extreme physicality of the Ironman competition, but her husband’s motivation to support Dr. Hsu and commemorate his father’s battle with cancer have helped bring her around.

“I’m chomping at the bit at this point,” Sturm says. “I’ve been training for a while, and I feel like I’m in the condition now to really just go for it. My motivation is trumping all those fears.”

Happily, Dr. Hsu’s locks are starting to come back in, too. “Our hair is about the same length,” Sturm says. “I told her, ‘You look great. Keep moving forward.’ ” •

ELIZABETH DILTS is a staff writer for Incisal Edge.