There are two new health books out by practicing physicians who both have prominent side careers explaining medical principles for wellness and longevity. The first, by Dr. Nancy L. Snyderman, is "Medical Myths That Can Kill You," with the subhead, "And the 101 Truths That Will Save, Extend and Improve Your Life." The second, by Dr. Nortin M. Hadler, is "Worried Sick," with the subhead, "A Prescription for Health in an Overtreated America.'"
Dr. Snyderman, a surgeon and a veteran broadcast journalist, is the chief medical editor of NBC News. As she does in her TV reports, she dispenses the standard wisdom that we have all heard a million times before: don't smoke, exercise, lose weight, keep cholesterol down, eat right, etc. It's all backed up by medical science.
Dr. Hadler, a rheumatologist and professor of medicine at the University of North Carolina, is a fervent and longtime debunker of medical establishment truths. He tells us that we are all going to die and holding disease at bay for our entire lives is impossible and unnatural and that we should not even try. He says that the best we should strive for is to make it to 85 still be recognizably human.
Citing authoritative random and double-blind studies, Dr. Snyderman and Dr. Hadler both offer guidelines for the average healthy adult to achieve wellness. The only trouble, according to a New York Times review of both books by Abigail Zuger, M.D., is that the two physician-authors dispense "completely, utterly, diamentrically opposite advice."
Dr. Snyderman urges regular check-ups and screenings. Dr. Hadler writes that the annual physical exam is "entirely useless" and all those screenings for various cancers and heart diseases can cause more harm than help. Dr. Snyderman would have us take daily multivitamins. Dr. Hadler tells us that there is an enormous North American vitamin scam that does nothing for us but suck up our money. And so on, right down the line.
So, given starkly contrary advice from exhalted medical experts, what are we ordinary folk supposed to do? Choose one over the other? Pick and choose from both? Punt?
Fortunately, fully unqualified, I have personally developed an amazing new wellness system that will help you develop and maintain vigorous good health at least to age 120. Yes, you heard right, age 120. The system is called SCHLEP. It has six components that are easy to understand, joyful, and a snap to incorporate into your daily life -- without grunting and groaning in a gym.
Not only that, I dare say that both Dr. Snyderman and Dr. Hadler will embrace the SCHLEP
system because nothing in it contradicts the guidance in their books; indeed, the SCHLEP system is fully complementary. The six components of the SCHLEP system are: Sporting, Creating, Humanizing, Laboring, Equilibrating, and Preventing.
And just as the good doctors have authoritative studies behind their health guidance, so does the SCHLEP system. It is based on a 70-year trial based on the actual life experience of one study subject, me. Unlike the studies that Drs. Snyderman and Hadler cite, this one is compeletely unobjective. Indeed, it is rigorously subjective.
Hey, why not? The good doctors both cite authoritative studies and proudly claim to be objective. Yet on every issue they disagree on, one of them must necessarily be wrong. So even if my SCHLEP system turns out to be half wrong, I'm doing just as good as these famous experts. And, maybe, just maybe, I'll be more right than both of them. Maybe I'll even blow them both out of the water! Maybe I'll be offered Dr. Snyderman's job as Chief Medical Editor at NBC News!
Okay, so I am getting a little full of myself here. Still, did I got this old by accident? You think I got this old by slavishly following the advice of doctors that other doctors disagree with? No, I got this old by following the SCHLEP system -- and I fully expect it to get me a lot older.
Now, drumbeat, the SCHLEP system:
Be an athlete and stay an athlete. Why? Because that is what we have been made to be. We were not made to sit at a desk or on a couch or behind the wheel of a car. We were made to run through the forest chasing down our living food. To eat, our ancestors, gulping for air and flooding their lungs with oxygen, had to leap streams and vault over boulders and fallen trees and do so for miles every day. To eat, they had to compete and prevail -- or die.
We need to do the same and for the same reason. The trouble with the standard advice to "exercise" is that it is not urgent enough and demands too little. It tells people to walk thirty minutes three or four times a week. The fact is that we were made to run and to do so every day for hours not minutes.
My friend Rich Pyle is a runner. No exaggeration, he looks thirty years young than he is. Not an ounce of fat. As if that were not bad enough for the rest of us, he has a full head of dark hair that he does not color. (Anybody with evidence that he does: please let me know. I'll take it from there.)
Of course, the reason the standard advice on exercise is so modest is that our health experts are realistic. They know that most people hate to exercise because they see it as grinding work. Doctors are tired of talking up exercise and being ignored. Today they settle for getting people to walk for 30 minutes two or three times a week.
It is nowhere near enough. Exercise does more good for us than any pill or combination of pills. That's where Sporting comes in. It transforms transforms exercise from a chore to a joy. It gets the juices flowing naturally. Exercise becomes a pleasurable habit and way of life. My Sporting happens to be tennis, swimming, and ice skating. None is a leisurely stroll in the park. All are vigorous, at least the way I do them.
I play singles tennis, above, at least once a week and often twice, as well as doubles two or three times a week. In summer, I often follow tennis with swimming. In winter, in addition to indoor tennis, I ice skate. Want to get your heart rate up? Try sprinting the length of a rink two or three times, which is what I do. Try playing hard tennis singles for an hour and a half, running and chasing balls all over the court, which is what I do.
Win or lose, I come off the court soaking wet and feeling just like one of our ancesters after a successful hunt. And then I do just what the Neanderthals did after a hunt: eat like a pig.
It's great fun, great cardio, and great eating. Exercise does not have to be boring and something to dread. If it is, you won't do it. So why not try Sporting? There a dozens of vigorous sports to choose from. What's your sport going to be? Don't choose your pain; choose your pleasure.
Creating? What's that got to do with wellness and longevity? It certainly is not exercise. It most certainly is. What's more, it is absolutely vital for overall well-being. Today, I started the day with an hour and a half of tough doubles tennis and am ending it creating -- by writing this post.
The two feed each other. All the running around the tennis court, all the charging the net gets oxygen-rich blood flooding to a 70-year-old brain, stirring the synapses that send signals from neuron to neuron. The vigorous exercise primes the brain for... thinking.
It may not seem so, but this post requires a good deal of thinking. Giving myself just a few hours, I have set my pea brain onto creating an entirely new wellness system, the SCHLEP system. And it may just sweep the nation. Well, maybe not. BUT, whether the SCHLEP system turns out to be helpful or hairbrained (you decide), my creative process has been fully engaged.
I started this section with an unscholarly quesion: What the hell can I write about the part creativity plays in keeping us vital? What I got out of my exercised brain at first was nothing. Blank. Zilch. Nada. Where were all the bright ideas I thought I had? I told myself: like our bodies, our brains have to get warmed up. (How's that for a good excuse?)
And then something came to me! Here it is:
Creativity frees us from our bodies and also from the cares of the world. Creative juices are the world's greatest anti-stress potion. Creativity kills the stress that is trying to kill us.
In the three or four hours I have been thinking about and writing this, not a worry has intruded into my creative bubble. Even though today the Dow Jones Industrial Average plunged 358.41 points and oil touched $140 a barrel and thousands of dollars evaporated from my 401K, I have been perfectly serene.
In fact, I have been literally out of my body. I have been completely unaware of my breathing, for example, which is the sure sign of a creative thrall. Of course, now that I mention breathing, I'm aware of it. Bummer. Just like that, creativity flies away. It's so fickle, so touchy. It's precious and knows it, like some girls I used to run around with in the old days
So I might as well stop now and go to bed. It is one a.m after all and I will be up at six for a couple of hours of reading and then tennis. But before I turn in, let me leave you with this:
Be creative. Express yourself. Whether it be through writing, or song, or art, or anything else that fully engages you and contributes your individuality to our world, creativity is a free and powerful elixir that can keep you well and young all your life.
On second thought, maybe it should be RE-HUMANIZING. Gradually, over many years, we have allowed ourselves to retreat from each other. With each step back, we have lost a bit of our humanity. Marriages, family, friends, fellow workers, and people generally have become more and more disposable.
The wife or husband seems demanding. Dump the bitch. Boot the bum. Forget talking and working it out; divorce is easier and everybody is doing it anyway. Kids acting up? Punish them, teach them a lesson. So-called friends mispeak or otherwise act not to our liking. Get rid of them, more where they came from. Same with everybody else we come into contact in our lives.
At the large corporations that have increasingly come to dominate the workplace, numbers are more important than people. Millions of us are cubicle rats nibbling on tiny parts of a vast corporate system, dehumanized, isolated, powerless, dispensable. With our economy seemingly in freefall, hundreds of thousands are now in the process of being "terminated." (Along with a few other large companies, Google is a glaring exception to corporate dehumanization. It's official policy is humanization throughout the huge company -- and it is being implemented.)
In our apartments, people behind the next door are strangers. We ride with them in elevators and look up or down, anywhere, to avoid eye contact and having to speak. In our cozy suburbs, we live across the street from people we see coming and going, sometime for years, and somehow manage to avoid speaking -- though we will quickly fall into a dispute with those same neighbors over, literally, nothing.
The people we get glimpses of in car windows as we whiz by on our morning and evening commutes are literally mirages, a blur of faceless faces. It is easy and, in the hurly-burly and tension of rush-hour traffic, almost necessary to forget that these are human beings. Our only reminder of humanity is when we give each other the finger or the horn.
Supermarket clerks? Besides being nobodies, they are literally invisible. We don't even see them. If we did see them, we might notice a lot of blank faces, the result of streams of us completely ignoring them while we dig in our wallets or pocketbooks or stare silently at the cash register. Only the cash register, happily ringing away, shows signs of life.
The examples are endless, so I won't go on. I think you get the point. We have allowed ourselves to be dehumanized. And when we dehumanize others, we dehumanize ourselves. It is not only bad for our society, it is bad for our health because it robs us of joy and the will to live.
Humanizing is involvement with and caring about other human beings and not just your immediate family. We are social creatures and we are happiest and healthiest as involved members of a human community. A baby that is never touched or loved cannot develop into the human being that we have all been intended to be.
Now I don't mean that we have to around hugging everybody. If I went up to my nemesis Marty Griff and hugged him, he'd probably punch me in the mouth and I wouldn't blame him. No, small acts of humanity can be done that are easy, painless, and pay huge dividends.
For example, I won't hug Marty Griff but I will do my damndest to make him laugh. And when I succeed, especially when its at his own expense and especially when he is trying his best not to, we both become a little more human.
At the supermarket, I make eye contact with the clerks. I talk to them. No speeches, just a friendly word or two because after all they are busy. I am constantly amazed at how easy it is to turn a dead face into an alive one. A little poke of fun at myself ("Am I the oldest person you ever waited on?") can even draw a smile. The order gets rung up. There is no work stoppage. But a customer and a supermarket clerk, strangers, have shouted to the heavens, "We are human beings and we care about each other!"
I like to walk around our neighborhood. And when I meet a neighbor, I make a point of not looking way. And if I get eye contact back, I say hello. Some neighbors make it clear that they want nothing to do with me by studiously looking down until I have passed, which is the normal and accepted way. I don't force myself on them. But most reply and are quite willing to exchange pleasantries.
In this way, I have gotten to know many of our neighbors. Quite a few of them came to my recent 70th party, along with their spouses. I was happy to have them in our home and I think they enjoyed themselves. It was a humanizing occasion for them, for Barbara and me, and for the neighborhood. We are all that much healthier as human beings.
So, do not be an island. Get out of your own skin. Make eye contact. Talk to other people. Listen and learn from them. Tell them how wonderful they are. Love them. Make them laugh at and with you, as my grandniece Karena is doing at right in making fun of my grey beard. Grow as a human being. Be healthier and live longer. Humanize --- yourself and others.
Oh, yes, one last thing. According to several major studies, people with close ongoing connections to family, friends, and people generally are healthier and live longer than those who do not.
Every one of us is a battlefield of conflicting emotions and needs, but I have not met many with the warring extremes that I live with. At one extreme, I am a wild animal (Grrrr). At the other, I'm as sensitive as a teen-age girl. ("How COULD you say that to me?").
I have always been aware of the beast in me, chalking it up to maleness run amok. But only recently, and only after years of suspicions, have I come to recognize and accept an equally strong sensitive side. My youngest son took me aside and said, "Dad, you're more sensitive than you think." I was 69 and being given a little sonly advice for my own good. And, as if to prove his point, I took it to heart like some girly girl -- without a peep, but surprised that this sensitive side was so obvious.
What has this got to do with LABORING? Nothing, really, just that I don't want what I'm about to write about LABORING to make you think that I'm ALL animal. LABORING is working like a slave and loving it. It is doing extreme brute physical labor.
I get my cardio from tennis, swimming, and ice-skating, not to mention walking up and down our big hill. But we need more than cardio. Especially as we age, we need to maintain muscle strength. If we don't, it doesn't take long before we are not strong enough to put out the rubbish or carry groceries or maintain balance and prevent dangerous falls.
What I do to maintain muscle strength is build stone walls. And I am proud to say that I overdo it. I am an extreme wall builder. Working only with fieldstone, never using mortar, never paying for stones, I scavage for fieldstone at construction projects. I generally ask permission of contractors and I have never had one refuse. The only thing they ask is that I do not interfere with work and I scrupulously respect that.
When I first started wall-building, the rock were small. Gradually, as I grew stronger, the stones got bigger. These days I routinely pick up small boulders, which are needed for a solid base, and walk(while tightening abs, the key to a strong back) with them to my little Honda Civic. In addition to building massive walls at my home, I routinely build stone walls for family and friends.
This spring I built a big wall around the driveway at the Pennsylvania home of my son, Greg. I did it in two days of nonstop, brutal work. Greg's wife, Kelly, calls me "the machine." She says that "you feed the machine and it just keeps going." A few weeks ago, I built a long stone wall at my sister Ruby's lake cottage. She was amazed that I could do it, that I did it so fast, and that it looks so beautiful. Now she loves to sit with her coffee and look out at the lake framed by my stone wall, which looks like it has always been there. A week ago, I built a wall at my daughter Misha's house in Connecticut, left, only the latest of several feverish wall-building episodes.
Call me a masochist, but I like the brutal work. I like working outside. I like surprising people with how much hard work I can do and how fast I can get it done. There's one other important thing I like about it. It is also art. It is highly creative. It is purely natural. Finished, a fieldstone wall is truly a thing of beauty.
Aren't I afraid I'll hurt myself, strain something? Just the opposite. I'm afraid that I'll hurt myself or strain something if I don't build walls. I used to have back problems. They have disappeared since I began building stone walls in earnest. Never has my back been so strong.
Building a fieldstone wall is classic strength training. It exercises all the major muscle groups: back, legs, arms, shoulders, chest. All that bending, lifting, and walking with a 50-pound or more rock is certainly extreme exercise. But in order for muscles to grow stronger, they must be overworked. Once you become strong, stress on joints is reduced, you are more stable on your feet and less likely to fall, and you can impress your family and friends with how strong you are.
When my old Friend, Barbie Bell, issued a call for people to come to a "chuck the muck" party at her lakefront home, I showed up. I spent a happy two hours waste-deep in water shoveling black muck into buckets and wheelbarrows. In a later e-mail thanking me, she wrote: "thanks for coming and showing up all those young guys with your amazing strength and energy."
I don't think this is a word. Oh, well. When going where no one has gone before, when creating a whole new way of living, it is sometimes necessary to coin a new word. Thus: EQUILIBERATE. It is derived from equilibrium, which means the state of being equally balanced. An organism is said to be in equilibrium when it is oriented to and at peace with its environment. The environment is the world we are surrounded by every day.
Many of us let ourselves become prisoners of our environment. We hand over our lives to the whims and vagaries of the environment and, because we don't know any better, think that what we have and what we are is not enough-- and this makes up unhappy and unhealthy.
We let doctors tell us what is good for us instead of looking into our own hearts and listening to what our bodies are telling us. I am the world's foremost expert on my body and so are you. I have decided that extreme wall-building enhances my health and well-being, regardless of what my doctors say. It may be quirky not to say weird, but it's me. And I'm at peace with it.
What is your heart and body telling you? Oh, you don't know? Could it be that you are not listening?
We wish we could be more like others who have more money, live in a bigger house, are better looking, are more knowledgeable, have a more impressive job, are more popular, are in better health. I know lots of people who outdo me in each of these categories, but I still don't want to be them. I still want to be me.
For example, my friend Rich Pyle is tall, handsome, with a full head of hair that he doesn't color. I'm short, unhandsome, and bald. As much as I like Rich, I do not think more of him because he is better looking than I am or less of myself. What I look like is me. More than that, I'm happy with what I look like even though it fits nobody's idea of handsome.
So, my friend, EQUILIBERATE. Be at peace with your environment by owning it. Liberate yourself by throwing off everything that the environment tries to impose on you that is not you. Being yourself is great for your health and longterm well-being.
Finally, you think, something down to earth. Sorry you feel that way. Admittedly, the previous paragraphs might have struck you as, shall we say, flighty. Give them a chance? Let them sink into your grey matter? Let your brain mull them over while you sleep tonight?
You will? Great.
Prevention would seem to be an obviously good idea that is easy to understand and carry out. Like everything else in health care, however, it is more complicated than one would suspect at first glance. For one thing, it begs the question: How?
You already know not to smoke, to keep belly fat down, to control your cholesterol, to exercise, to watch that blood pressure, to eat your fruits and vegetables, and see a doctor regularly. The SCHLEP system assumes you are already doing these proven good things to greatly reduce your risk of getting chronic disease leading to a shortened life. The goal of SCHLEP is to take you to the next level: An extraordinarily long life in which you are healthy and viable until the day you die.
Does that mean that you have to take every available test so that you can catch cancer or heart disease -- the two biggest killers -- at the earliest possible moment? The answer is no. To do that, you would have to spend your life in doctor's offices and also subject yourself to unnecessary risk and expense.
A case in point is the CT scan, a $1 million machine that produces detailed images of the heart for from $500 to $1,500 a pop. On June 29, The New York Times ran a front page article describing how more than 150,000 people in this country received CT scans last year at a cost of more than $100 million, yet there is "scant evidence that the scans benefit most patients."
Moreover, the article details how demand for CT scans is driven not by patient needs but by the financial incentives of cardiologists and hospitals. When cardiologists in private practive have invested $1 million in a CT Scan, they can't afford to have the machine sit there unused. Needing some 3,000 scans to pay off the machine, the cardiologist has every incentive to use it aggressively and that is what is happening. It is the perfect setting for binges of self-referral, also known as conflict of interest.
Given to patients without symptoms, the CT scan sometimes does find dangerous blockages that require immediate bypass surgery, but such cases are rare. Cardiologists who oppose wide use of CT scans say that such cases are too rare to justify the cost and the radiation risks. A typical CT scan hits patients with radiation equal to over 1,000 conventional x-rays. And these doses are cumulative and additive.
I'll pass on the CT Scan, thank you. But there are certain tests that I think are important to take. An annual blood test is a must to track lipids for signs of diabetes, to check the PSA numbers for indications of prostate cancer, and to get a calcium count as a measure for calcified plaque in the arteries. An ultrafast scan, a series of X-rays can also produce a calcium score. And it is essential to discuss with your primary care doctor the meaning of these results.
I think that when we get this old, a thorough eye examination is essential. Both eyes must be dilated and checked for glaucoma and macular degeneration, diseases whose risk rises markedly as we age. And don't forget your feet. Many of us ignore our feet but there are important preventive measures we can and should take to keep those feet walking.
At my request, my VA primary care provider ordered an appointment for me with a VA eye doctor and a VA podiatrist. The appointments took place within two weeks of my request. For my book, the VA is the best source of preventive care in the U.S. In a later post, I'll have some interesting things to tell you about what I have learned about eyes and feet. Stay tuned.
So long and keep schlepping.
P.S. The SCHLEP system is guaranteed to help you live a healthy and happy life to at least age 120 or YOUR MONEY BACK!