I only thought our society was lazy before. Now, I've discovered the new height of laziness.
We have lots of ideas about why Americans eat more and exercise less and the declining health that results. And there is no doubt that our habits are changing … and generally not toward healthy ones. Is one of the problems just plain laziness?
Think about the jumble of remote controls on your living room table. We don’t have to leave the couch (and the chips) to change the channel, switch to the DVD player, or adjust the volume. Now there are remotes for the gas fireplace and the air conditioner. I want one to refill my birdfeeders.
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| Healthy Las Vegas tourists rent mobility scooters to get around. |
My kids love to upgrade the stereos in their cars for more power, and all the aftermarket stereos now come with remotes! Tell me why a driver needs a remote to adjust the stereo in the dash? How lazy can we get?
Well, here’s a new height of lazy — perfectly healthy tourists going on vacation and avoiding the walking on the sidewalks by renting a “mobility scooter” intended for the disabled. In recent years a scooter company in Las Vegas has seen increasing numbers of healthy people renting their mobility scooters. You don’t have to walk and there’s even a cup holder for your high calorie drink!
Walking is good for us. Current recommendations for Americans' exercise is one hour a day! At first, that seems way too difficult to achieve. But if you break it out into smaller pieces, it can be done. One way to learn how many opportunities you have to walk is to buy a pedometer. Then compare your activity on a typical work day to one where you change your habits. Take the stairs instead of the elevator. Walk the dog for 20 minutes before work. I like to do this with my coffee from the kitchen brewer with the automatic timer that goes on while I’m in the shower. Maybe I could add some extra steps if I didn’t use that gadget! Go outside at lunch. Take a walk with your spouse instead of sitting on the couch. Take another walk after work (or a bike ride). Add it all up and you can really burn some calories and improve your health.
It’s making new habits that is so hard. But if you make it fun, and cut it into smaller bits — it’s not so hard. And please, when you go on vacation, leave the mobility scooters for the disabled folks who don’t have the opportunity to enjoy feeling their legs work for them.
Becoming a physician requires commitment. Commitment to hard work, study , becoming a lifelong learner. Commitment to do no harm, to place the needs of others as the highest priority. 
The opportunities to use a medical degree are as limitless as ones imagination. There are the obvious choices of office or hospital practice. There are small towns, big cities, academic opportunities to teach or do research. There are executive opportunities such as I have pursued, to make changes in the system to improve care for larger groups of patients than can be affected one at a time.
Dr. Michael Polifka, after leaving his primary care practice in Manchester due to medical disability, made a decision to make a difference by volunteering on international medical missions. Following is an excerpt of his words about this experience:
We are anchored several miles offshore here in Guatemala and travel to one of three different sites each day. There are surgeons (doing pre-op screening for elective surgeries on the ship in the up coming days), physicians of varied medical specialties, nurses, nurse practitioners, nurse educators, midwives, dentists. dental hygienists, optometrists, pharmacists and a batch of Navy Seabees (doing special construction projects). Each clinic site is packed, literally thousands of patients waiting to be seen each day; marginally organized chaos. I am doing general medicine, seeing pretty much anyone that comes in for a medical problem.
In the community clinics in Livingston and Morales, I am seeing the usual complement of poverty related illnesses, including intestinal parasites, asthma and aches and pains (from living a hard life). The clinic at the national hospital in Puerto Barrios is a bit different. Here patients have come from far and wide around the country to be seen for consultations for possible to medical treatments and technology not available to anyone outside of North America and Europe. There are lots of little successes, the simple medical interventions that will surely make patients better, albeit for a short time. And there are some of the impressive interventions; one of the surgeons, a fellow Project HOPE volunteer, saw a Mayan woman who walked 240 km over the prior 15 days to get here and arrange to repair her abdominal hernia on the ship (one of the seventy surgeries that will be done while the ship is in Guatemala).
Frustratingly, there are too many that we are unable to help either because of lack of technology, time in the country, or hours in a day; but never for lack of caring or personal effort by virtually everyone on the Comfort. There is a 45 year old mother of 5 children with a damaged heart valve that is beyond the surgical capacity of the ship; an 8 year old boy unable to walk from congenital contractures of the tendons in his legs that won’t be repaired as the operating room schedule for the time we are here is over filled. There is the 51 year-old father of three with the uncontrollable shaking and stiffness to the point of near immobility of Parkinson’s disease who needs a life time of medicines readily available in the U.S. but we don’t have with us. There is the 32 year old agricultural engineer, who has been treated for leukemia; he flies across the country from the capital to ask me to arrange a bone marrow transplant in the U.S. And there are the hundreds who will receive only a small or partial supply of medicine as we run out by the middle of each afternoon being overwhelmed by the number of people who come to each of the clinics.
I remain incredibly touched by the individual expressions of thanks; the smiles, the hugs, the prayers given. But I experienced something new on this trip. On the first day in Morales, I happened to be the first one off the bus and the first to reach the wall of people, a couple of thousand at least. As I said “Buenas dias” to those in earshot, there was a simultaneous chorus greeting back. At the back edge of the crowd, the wall quietly opened for us to pass, and then they spontaneously started to applaud. The lump in my throat was heavy as I fought back tears. And it was immediately apparent to me for all the people that we saw and even the thousands that we didn’t, we, from the wealthiest country in the world, came and showed them, the poor people of the world, that we cared. So perhaps sometimes the most important thing you can do is just to show up ... And the world will be a little better for it.
I just spent a week hiking. Three days in Colorado with my son and 3 days in Vermont with my wife. Among the many reasons I enjoy hiking, one is the opportunity for reflection.
The kind of people who hike seemed to be quite healthy. While that could be a matter of who chooses to hike, I believe it is also a consequence of the hiking. And in areas where people hike, there tend to be a number of other outdoor activities that become part of how people spend their spare time. I was astonished in Colorado to find the number of people on bicycles spending a day riding 5000 feet uphill, only to return down the same winding, spectacularly beautiful road to return home. And the walking, running, bicycling paths were both surprisingly ubiquitous, and wonderfully beautiful. I think outdoor recreation creates more interest in outdoor recreation, which therefore creates more opportunities. On Sunday, July 22nd, fortified by a great cup of coffee and 2 apples from the Winhall Market, my wife and I hiked the Overlook trail in the Jamaica State Park, a delightful 3 mile loop with a view of the West River and the cute town of Jamaica. It’s worth the trip.
So what are the health benefits of hiking? There is the obvious cardiovascular benefit, and calorie burning. Daily exercise is now a core component of recommendations for both maintaining health, and treating chronic disease. The lowering of blood pressure, reduction in weight, reduction in risk for heart attack and stroke, reduction in blood sugar for those with diabetes, all contribute to improved health. In addition, there are the other numerous benefits to outdoor recreation. The ones that appeal to me include the contemplative and even meditative aspect of walking in the woods. My favorite hiking companions (my son, my medical partner, and my wife), all share with me the enjoyment of long periods of silence while experiencing the woods. Something beyond relaxation happens to me at those times. John Kabat-Zinn would describe it as meditation while walking. Then there is passion -- the zeal for life and love. Why is it enhanced by outdoor exercise? Not sure, but it happens.
There is also the opportunity to see wildlife, and learn about the outdoors. This week I saw mountain goats, elk, numerous wildflowers, hawks, marmots, chipmunks, trout, and on and on. I love coming home having learned something new about our environment. Is that a health benefit? I think so … a mental health benefit.
And what about creativity? My brain seems to function better during and after exercise. I am more likely to come up with new ideas for issues I face at work and at home. Is that endorphins? Distraction? Peacefulness?
Communities are creating more built infrastructure to support walking, hiking, bicycling and other outdoor recreation. In Vermont, the Blueprint for Health, a statewide program funded by your tax dollars, brings together improved systems for care of people with chronic disease in doctor’s offices, with self-management education, and coordination with community resources for exercise. Medical studies show that people with chronic disease who exercise regularly experience better outcomes.
And yes, those are hiking poles in the photo -- keeps my knees healthy....