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A Doctor’s Advice on Living a Long, Healthy Life: “No idea!”
Hilton Head is an odd place to practice medicine. No one is from here. They all spend their lives somewhere else (usually Midwest or Northeast) working hard enough to make enough money to retire in a place like Hilton Head. Then they move down here and begin their long-anticipated life of leisure. They sleep until they’re hungry and they eat until they’re sleepy and after a few years of this they notice that they don’t feel very well, their pants don’t fit, and they’re on more BP meds now than they were when they were stressed out and working so they decide to get in shape.
My patient Jim followed this path and reached the point where he decided to rededicate himself to his health. I tell him that’s a great idea. He says he’s going to buy a bicycle; I tell him that’s a bad idea. I tell him that bicycles make you healthier but they don’t make you live longer. I’ve seen horrible accidents over the years. I mean horrible stuff. I have four close friends who either died or were crippled by bicycle accidents. Jim figures that I’m just being a typical overly cautious doctor (which was probably true), and buys a bike. He rides a lot, starts losing weight, and feels much better. We even stopped some of his meds.
Then, he wiped out. He wasn’t going very fast (he says less than 10mph), and he thinks maybe he hit a pine cone or something. Anyway, he broke his pelvis in two places plus various other bones. Very serious injuries for a 68-year-old man. The surgical repair went well, but he developed pneumonia in the hospital. We treated that, sent him home, and he came back a week later with a blood clot. The next year was a brutal journey of one setback after another, being transferred from nursing facilities to hospitals to rehab centers and back again, but he eventually overcame everything, and a year later was nearly back to normal, although he had a lot of back pain at that point. Since his wife now takes a similar view of his bicycle as I do, he’s looking for another way to get back in shape.
I see this sort of thing all the time. What’s frustrating is that Jim really didn’t do anything wrong. He worked hard, and saved for a nice retirement. He sat around a bit too much for a while – big deal. Then he responds appropriately by getting back in shape, and in the process nearly dies several times in a long series of medical catastrophes. It happens. Where exactly did Jim screw up? I’m not sure.
Because of my job, I have a bias against bicycles, but a lot of people really do get healthy on them.
If they don’t end up in a wheelchair.
Ha! Sorry!
But that’s the trick, right? Was it a good idea for Jim to start riding a bicycle? Absolutely. Of course, it was. Until it wasn’t.
How is he supposed to be able to anticipate when that is likely to transition from a good decision to a bad decision? It’s still the same decision. It only looks different in retrospect.
I’m sometimes asked how much of what I treat is a self-inflicted disease. I’ve noticed that the people who ask me this are often very trim, fit, and tan. But whatever.
I answer that everything I treat is self-inflicted. Or, possibly none of it. It’s surprisingly difficult to say because it’s not always clear which of our actions are self-destructive until later when we see how everything turns out.
I’ve noticed that my 90-year-old patients generally did not follow a particularly healthy lifestyle. Some of them did, of course, but many did not.
Americans have the longest lifespan on the planet (if you don’t count inner-city gun violence), and we’re mostly fat and out of shape. We eat garbage. We drink and smoke too much. And we live a really long time. I don’t get it.
So how does one live a long, healthy life? My first two suggestions are genetics and luck.
Some things are clearly dangerous. Cigarettes, excessive alcohol, street drugs, motorcycles, bicycles. But some people who indulge in all those things live long healthy lives. Still, you’re not helping your odds by engaging in certain behaviors.
But I see so many horrible things happen to people for no real good reason.
Winston Churchill, whose healthy lifestyle enabled him to live to the age of 90.
So my patients ask me how they can live a long, healthy, happy life. Early in my career, I wasn’t sure how to answer that. Now, after decades of study, I have absolutely no idea how to answer that. The more I learn, the less I understand. This stuff doesn’t make any sense.
It was simpler when I didn’t know all this stuff. “Get in shape! C’mon!” But now, having studied this for decades, I really don’t understand what it is that makes people live long, healthy lives. I just don’t understand.
Gosh, I’m a great physician. Sheesh…
Published in General
I have an elderly friend with Parkinsons, now he’s having vision issues from it: I know, because we’ve discussed it, that he would agree with you.
My advice to live a long, happy life:
Maybe the best answer is – it depends.
Rattlers. They strike without warning. For bears all you need is a friend… who runs slower than you do.
And drink more.
Depends is a good answer for a bear attack, for sure.
But there’s no antivenin for a bear bite.
I know mine would be full in three seconds . . .
Definitely bears.
Ableist!
Everyone who sees it laughs at my freebie of a rowing machine. The contraption – pre 1980 for sure, – has no electronic this’es or that’ses.
I don’t know what my rowing is doing to my heart rate or respiration or blood pressure. I figure through a complicated calculus of how a sundial focused on the handle and arm bars focused on my enthusiasm or lack thereof is equal to how many laps of the Olympic pool I might go and swim at once a month.
Also there is no big screen TV showing me what my rowing would look like were I outside the white cliffs of Dover or ensconced inside the sunny calm of remembered spots along the Potomac River.
The last comment reminds me that if the machine lets me face eastward then I have the 6,000 acres of lovely but taken for granted open space which presents me with trees of various sorts, plus the occasional deer, hawk, eagle or two, and maybe someday a cougar or bear.
It is old enough that the pedals to the machine have fallen off, only to have my spouse create new and better pedals. It keeps me in shape.
I would brag about my safety record on the gizmo. Except given my lack of balance, I could easily fall over on top of the handle bars one of these days when I am dismounting it. So I totally relate to the notion that no matter how carefully we seniors choose this exercise method over that one, our choice could still lead to our demise.
Five years ago, I missed a Women’s Meeting one month. My concerned colleagues queried me at the next meet up as to why I missed out. “I stood up too fast in the garden, forgetting that there was a thick branch over my head. So I clobbered that branch with full force, and then almost blacked out. That Sunday meeting was only 24 hours later, and I was still quite dizzy.”
After the appropriate comments of sympathy, three other women mentioned the same fate had befallen them.
Who knew if you are over 60 and a bit absent minded, that wearing a helmet while out pulling weeds might be a grand idea?
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Packing a .45 also helps.
My father lived to 93. He always said that if you’re going to get old, you’d better be tough.
A .44 magnum with keith rounds helps.
And Boss Mongo, probably the fittest person I ever interacted with died a couple of weeks ago.
When I was in high school, a guy came to give a presentation on Outward Bound, where he was a guide. He had been leading a group when they ran into a kodiak that charged. He had a M-1911 and he emptied it into the bear, which was only stopped because the last shot hit its spinal cord.
I read of an interesting study years ago in which researchers found that people who kept doing whatever they were doing in their fifties aged well. It was taking up new things that created problems. That certainly makes sense in terms of your body’s memory. Things you don’t do very often are going to cause a strain. If I try to move a piano, I’ll certainly pay for that attempt tomorrow. But lugging around my gardening tools is not difficult at all.
I read another study (sorry, I read for a living :-) ) years ago in which the researchers determined that older people described themselves as “healthy” if they could do the things they were used to doing. This sounds dumb, but it actually makes sense to me–I live next to a golf course. :-) People love to play golf, it’s part of their life routine, and as long as no health problem is bad enough to keep them off the golf course, they feel good.
There is also something I heard from an old Jewish guy: The more you complain the longer God makes you live.
Rucking has a totally different, and more violent meaning in rugby.
So longevity has to do with doing in old age what you were doing in middle age, walking, eating pop corn, drinking bourbon, and shooting bears in the spine. I like it.
And they’re not as fragile. All the horse-like animals are fragile.
I swear by my 2006 model ConceptII rowing machine. It lives in the bedroom under the window. I listen to podcasts while rowing. It is easy on joints and gives you a full body workout.
We only have black bears around here.
I guess that this was up in Alaska somewhere. It’s been a long time since the presentation.
I’m thankful right enough.
Is it? My father’s parents lived to 60 and 53 and both died of heart attacks. My father lived to 84, nearly 85, and never had a heart attack. His parents were thinner and in shape. He was always heavy. He smoked.
The 1970’s. Getting close to fifty years. 😜
Just about.
You work your way up, I would presume. Be sure to count the weight of the .44 Magnum and ammo you carry. (:
Good one Flicker. Just change out bourdon for port (sorry, Dr. B) and swatting away coyotes in the Presidio vs. shooting bears and sounds like a good life style. Maybe I will make it to 76.