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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 don’t recall who the comedian was who said that his parents, both in their 90s, were being kept alive by hate. Neither one wanted to die first and give the other the satisfaction.
I prefer a 454 Casull, 300 grain. The 500 S&W is also OK. Of course you can pack more rounds in a 45 911, but I doubt you’d have time to get them off. I shot a Griz in the heart with a 300 Weatherby Mag at 80 yards. The bear didn’t know it was shot and charged another 50 yards before collapsing.
Not too long ago, there was a podcast with I think it was John Podhoretz, explaining how he fractured his ankle – maybe in 2 places? – just stepping down from a curb.
Bad jeans?
So all my primary care docs retired, although one died. So got a younger one. Great internist. Goes through the drill every year after the blood tests. Asks me if I really need the bacon and booze. And I say yes. Looks at the family history. And finally says, OK I think you can make it to next year. All I needed to hear before football season.
Winston Churchill is a interesting case. Not only did he eat to the point of gross obesity, smoke cigars frequently, and drink about 250 ml of spirits a day when he was trying to cut back, he also went around dodging bullets as a solder in his/her majesty’s various wars of the day. No doubt his habits as a senior peer had a lot to do with his earlier rough life. I attribute his durability to the Churchill luck, which graced his family as key servants of the British Crown going back centuries.
I’ve noticed a pattern in working class patients who had some physically demanding job and ate like horses when they were younger. They become more sedentary in retirement and gain weight because they want to eat like they always did. They get so fat that their hips or knees give out, they get diabetes and eventually lose a leg, or something, and they get a motorized wheel chair or scooter. So now they hardly even have to stand up, but they continue to eat like they’re still stacking hay bales every day. Pretty soon they have to graduate to a double wide wheel chair as they become incredibly obese. Then after a few more years they’re dead.
I’ve never seen one of these guys living to 90.
The habits developed early in life, especially with regard to diet, seem to be all important in how fit one is later on, and simply telling people to cut back doesn’t seem to do much good in the face of decades of habit.
Bear-Headed Snakes.
The one in Vermont?
Talk to the folks in South Bend about Mayor Pete’s efforts to create a bike friendly city. The guy is now Transportation Secretary.
His rhetoric from that office is embarrassing. For a guy with fancy degrees and a consulting background, he doesn’t even try to be cogent. It’s just a racket to move up.
Hey, I like bicycling. I don’t do long distance riding like some of the guys here on Ricochet. But an early morning (pre-dawn) 45 – 60 minute ride around town to get the circulation going a bit. Walking is too slow. I want to see more scenery. I can’t maintain a decent pace on a stationary bicycle unless I’m watching a movie or TV show with lots of action. I understand there are risks to riding in the outside world. My then 50 year old secretary had a serious bicycle accident some years ago. I ride before traffic builds, but need to be really careful around the several truck stops in my town, as the truckers are eager to get on the road for the day. And the trash trucks picking up their commercial accounts are the most dangerous, as the drivers are focused on getting to the next account, and are not watching for other vehicles on the road.
Like some others have said, my objective is to maintain “normal life functions” – to climb stairs without getting winded, to walk easily from the far reaches of the parking lot to the store (and to walk around the store), to sing in the church choir, to set up and take down chairs and tables at church and social functions, to wash the car and to mow the lawn (which I now do with a manual reel lawn mower!), etc.
I think a bear requires a .44 magnum, unless you’re referring to the .454 Casull . . .
Don’t you find that it cuts the grass a little too short?
I have been an avid cyclist throughout most of my life. At earlier times I was an avid mountain, ice, and rock, climber. I have never sustained a serious injury. Some of that is undoubtedly due to exceptional good luck, but a major part of good luck is preparedness and focus. Currently I am riding between 150 and 170 miles per week. My average speed on the bike is 19 MPH, but I do frequently hit 40+ MPH on downhill runs. Having a bike that is designed for that type of travel is essential. My current ride cost me more than my first three cars put together. I maintain it meticulously.
Clothing and lights are also very important accessories. My tail light is Garmin Varia Radar. It uses a form of Doppler radar to detect approaching vehicles and begins to flash a very noticeably bright red light when the car is detected. At the same time a display shows up on my computer showing the approaching vehicle and its relative distance from me. I have been told by drivers that the light is very visible at a distance of nearly a mile in bright sunlight. My clothing is also bright and noticeable. I always wear a helmet. I never allow my attention to drift from where I am and what I am doing.
I am 76 years old. I maintain, and always have maintained, a high level of fitness, doing weight training on days I don’t ride. I long ago decided to not become what we call a MAMIL (Middle Aged Men In Lycra). Good genetics helps, but it still requires a good deal of discipline. I know that there are risks entailed in road cycling. Everything I have done in my life entailed risks of one sort or another. So long as my body allows me to continue to train at my current levels I will do so. One day at a time seems to be the only sensible way to handle it. I refuse to allow the possibility of death or serious injury to turn me into a mushroom for the remaining years of my life.
This technology amazes me. I just bought an emergency flasher for $28 that is like this. It runs on AAA batteries.
The Varia radar is rechargeable, lasts about 4 hours on a full charge depending on the amount of traffic I encounter. It retails for $200, but can be gotten for $150 during annual sales. I consider it an investment more than well worth it.
I seriously can see that. The Subaru anti-collision / adaptive cruise control gear for that type of thing is just incredible.
This is the flasher I was talking about https://www.amazon.com/Flares-Arrow-Emergency-Roadside-Flashing/dp/B07SGY8ZTR/ref=sr_1_3?dchild=1&keywords=LED+Road+Flares+Safety+Turn+Arrow+Light+Emergency+Roadside+Flashing+Flares+Safety+Strobe+Light+-+Road+Warning+Beacon%2C+Detachable+Magnetic%2C+Unfolding+Rotating+blade%2C+Emergency+Car+Kit%2C+MADE+IN+KOREA&qid=1627312040&sr=8-3
The Marine Corps Mountain Warfare Training Center in Bridgeport, CA. It’s been quite a while since I was there.
A few related Burns jokes:
An interviewer says to Burns: “George, you smoke, you drink, you chase women – what does your doctor say about this?”
Burns: My doctor’s dead.
An interviewer says to Burns: “George, you’re 98 years old. When did you stop having sex?”
Burns looks at his watch and says “About 2 this morning”
Oh my gosh that’s wonderful
Well, that can’t hurt much.
A variation on the theme:
Old Guy: I don’t drink. I don’t smoke. I don’t drive fast cars. I don’t chase women, and tomorrow I’ll celebrate my 100th birthday.
Young Man: How?
I have some South Bend bicycling in my plans for this year. It has been a long time since I’ve ridden anywhere except around the edges. And it’s already four years since I did even that. It will be interesting to see what has changed.
Interesting. I was aware that such devices existed, but wasn’t sure they could do me much good, especially on a road with a lot of cars. But maybe they do the cars some good.
I suppose your device works only with Garmin computers. Mine is a Wahoo Elemnt Bolt.
That’s all you need. The rest is just marketing.
I don’t understand the point you’re making.
I mean, “Don’t be full of…”
There’s a character in the comic strip “Pearls Before Swine” known as “Jef The Cyclist.” His name was Jeff, but he dropped the second f for “streamlining.”
One example:
Just out of curiosity, what’s the point of only having the light flash when it detects cars? Wouldn’t it be simpler (and cheaper) to just flash all the time?
Although I can see the value of having a display on your handlebars that shows the approaching vehicle…